escitalopram (Rx)

Brand and Other Names:Lexapro
  • Print

Dosing & Uses

AdultPediatricGeriatric

Dosage Forms & Strengths

tablet

  • 5mg
  • 10mg
  • 20mg

oral solution

  • 5mg/5mL

Major Depressive Disorder

Indicated for acute and maintenance treatment of major depressive disorder (MDD)

10 mg PO qDay; may increase to 20 mg/day after 1 week

Generalized Anxiety Disorder

Indicated for acute treatment of generalized anxiety disorder (GAD)

10 mg PO qDay; may increase to 20 mg/day after 1 week; maintain at lowest effective dose and assess need of therapy periodically if extended therapy required

Obsessive-Compulsive Disorder (Off-label)

10 mg PO qDay; may increase to 20 mg/day after 1 week; maintain at lowest effective dose and assess need of therapy periodically if extended therapy required

Insomnia (Off-label)

Secondary to Depression: 5-20 mg PO over 8 week period

Secondary to panic disorder in women: 5-10 mg PO over 8 week period

Vasomotor Symptoms Associated with Menopause (Off-label)

10 mg PO qDay; may increase to 20 mg PO qDay after 4 weeks if symptoms not adequately controlled

Dosage Modifications

Renal impairment

  • Mild-to-moderate: No dosage adjustment necessary
  • Severe: Use with caution; insufficient number of patients have been evaluated during chronic escitalopram treatment

Hepatic impairment

  • Mild-to-severe: 10 mg/day; racemic citalopram clearance decreased resulting in increased plasma concentration

Dosing Considerations

For extended therapy, maintain at lowest effective dose and assess periodically the need for continued therapy

Discontinuation of treatment

  • Symptoms associated with discontinuation of SSRIs and SNRIs have been; monitor for symptoms when discontinuing treatment
  • Gradual dose reduction rather than abrupt cessation is recommended
  • If intolerable symptoms occur following a dose reduction or discontinuation of treatment, then consider resuming the previously prescribed dose; subsequently, continue decreasing the dose at a more gradual rate

Switching to or from a monoamine oxidase inhibitor (MAOI) used to treat for psychiatric disorders

  • At least 14 days should elapse between discontinuation of an MAOI and initiation of escitalopram
  • Conversely, allow at least 14 days after stopping escitalopram before starting an MAOI

Dosage Forms & Strengths

tablet

  • 5mg
  • 10mg
  • 20mg

oral solution

  • 5mg/5mL

Major Depressive Disorder

<12 years: Safety and efficacy not established

≥12 years: 10 mg PO qDay; may increase dose after at least 3 weeks; not to exceed 20 mg/day

Dosage Modifications

Renal impairment

  • Mild-to-moderate: No dosage adjustment necessary
  • Severe: Use with caution; insufficient number of patients have been evaluated during chronic escitalopram treatment

Hepatic impairment

  • Mild-to-severe: 10 mg/day; clearance of racemic citalopram was decreased and plasma concentration were increased.

Dosing Considerations

For extended therapy, maintain at lowest effective dose and assess periodically the need for continued therapy

Discontinuation of treatment

  • Symptoms associated with discontinuation of SSRIs and SNRIs have been; monitor for symptoms when discontinuing treatment
  • Gradual dose reduction rather than abrupt cessation is recommended
  • If intolerable symptoms occur following a dose reduction or discontinuation of treatment, then consider resuming the previously prescribed dose; subsequently, continue decreasing the dose at a more gradual rate

Switching to or from a monoamine oxidase inhibitor (MAOI) used to treat for psychiatric disorders

  • At least 14 days should elapse between discontinuation of an MAOI and initiation of escitalopram
  • Conversely, allow at least 14 days after stopping escitalopram before starting an MAOI

Major Depressive Disorders/Generalized Anxiety Disorder

10 mg/day is recommended for most elderly; no additional benefits seen at 20 mg/day dose

Dosing Considerations

The elderly are more prone to SSRI/SNRI-induced hyponatremia

Next:

Interactions

Interaction Checker

and escitalopram

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

            All Interactions Sort By:
             activity indicator 

            Contraindicated (12)

            • cisapride

              escitalopram increases toxicity of cisapride by QTc interval. Contraindicated.

            • dronedarone

              escitalopram increases toxicity of dronedarone by QTc interval. Contraindicated.

            • goserelin

              goserelin increases toxicity of escitalopram by QTc interval. Contraindicated. Increases risk of torsades de pointes.

            • isocarboxazid

              isocarboxazid and escitalopram both increase serotonin levels. Contraindicated.

            • lefamulin

              lefamulin will increase the level or effect of escitalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Lefamulin is contraindicated with CYP3A substrates know to prolong the QT interval.

            • leuprolide

              leuprolide increases toxicity of escitalopram by QTc interval. Contraindicated. Increases risk of torsades de pointes.

            • phenelzine

              phenelzine and escitalopram both increase serotonin levels. Contraindicated.

            • procarbazine

              procarbazine and escitalopram both increase serotonin levels. Contraindicated. Combination is contraindicated within 2 weeks of MAOI use.

            • selegiline

              selegiline and escitalopram both increase serotonin levels. Contraindicated. At least 14 days should elapse between discontinuation of selegiline and initiation of treatment with a serotonergic drug.

            • thioridazine

              escitalopram increases toxicity of thioridazine by QTc interval. Contraindicated.

            • tranylcypromine

              tranylcypromine and escitalopram both increase serotonin levels. Contraindicated.

            • ziprasidone

              escitalopram and ziprasidone both increase QTc interval. Contraindicated.

              ziprasidone and escitalopram both increase QTc interval. Contraindicated.

            Serious - Use Alternative (118)

            • abametapir

              abametapir will increase the level or effect of escitalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. For 2 weeks after abametapir application, avoid taking drugs that are CYP3A4 substrates. If not feasible, avoid use of abametapir.

            • alfentanil

              alfentanil, escitalopram. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.

            • amiodarone

              escitalopram increases toxicity of amiodarone by QTc interval. Avoid or Use Alternate Drug.

            • amitriptyline

              escitalopram and amitriptyline both increase serotonin levels. Avoid or Use Alternate Drug.

              escitalopram increases toxicity of amitriptyline by QTc interval. Avoid or Use Alternate Drug.

            • amoxapine

              escitalopram and amoxapine both increase serotonin levels. Avoid or Use Alternate Drug.

            • apalutamide

              apalutamide will decrease the level or effect of escitalopram by affecting hepatic enzyme CYP2C19 metabolism. Avoid or Use Alternate Drug. Coadministration of apalutamide, a strong CYP2C19 inducer, with drugs that are CYP2C19 substrates can result in lower exposure to these medications. Avoid or substitute another drug for these medications when possible. Evaluate for loss of therapeutic effect if medication must be coadministered.

              apalutamide will decrease the level or effect of escitalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Coadministration of apalutamide, a strong CYP3A4 inducer, with drugs that are CYP3A4 substrates can result in lower exposure to these medications. Avoid or substitute another drug for these medications when possible. Evaluate for loss of therapeutic effect if medication must be coadministered. Adjust dose according to prescribing information if needed.

            • arsenic trioxide

              escitalopram increases toxicity of arsenic trioxide by QTc interval. Avoid or Use Alternate Drug.

            • artemether/lumefantrine

              escitalopram increases toxicity of artemether/lumefantrine by QTc interval. Avoid or Use Alternate Drug.

            • asenapine

              escitalopram increases toxicity of asenapine by QTc interval. Avoid or Use Alternate Drug.

            • azithromycin

              escitalopram increases toxicity of azithromycin by QTc interval. Avoid or Use Alternate Drug.

            • bupropion

              escitalopram increases toxicity of bupropion by unspecified interaction mechanism. Avoid or Use Alternate Drug. May lower seizure threshold; keep bupropion dose as low as possible.

            • buspirone

              escitalopram and buspirone both increase serotonin levels. Avoid or Use Alternate Drug.

            • chlorpromazine

              escitalopram increases toxicity of chlorpromazine by QTc interval. Avoid or Use Alternate Drug.

            • citalopram

              citalopram and escitalopram both increase serotonin levels. Avoid or Use Alternate Drug. Combination may increase risk of serotonin syndrome or neuroleptic malignant syndrome-like reactions. ECG monitoring is recommended, along with drugs that may prolong the QT interval.

              escitalopram increases toxicity of citalopram by QTc interval. Contraindicated.

            • clarithromycin

              clarithromycin, escitalopram. Either increases toxicity of the other by QTc interval. Avoid or Use Alternate Drug. To monitor for the prolongation of QT/QTc and/or development of ventricular tachyarrhythmias the labeling recommends monitoring QT interval or ECG.

              escitalopram increases toxicity of clarithromycin by QTc interval. Avoid or Use Alternate Drug.

              clarithromycin will increase the level or effect of escitalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

            • clomipramine

              escitalopram and clomipramine both increase serotonin levels. Avoid or Use Alternate Drug.

            • crizotinib

              escitalopram increases toxicity of crizotinib by QTc interval. Avoid or Use Alternate Drug.

            • cyclobenzaprine

              escitalopram and cyclobenzaprine both increase serotonin levels. Avoid or Use Alternate Drug.

            • desipramine

              escitalopram and desipramine both increase serotonin levels. Avoid or Use Alternate Drug.

            • desvenlafaxine

              escitalopram and desvenlafaxine both increase serotonin levels. Avoid or Use Alternate Drug.

            • dextromethorphan

              escitalopram and dextromethorphan both increase serotonin levels. Avoid or Use Alternate Drug.

            • disopyramide

              escitalopram increases toxicity of disopyramide by QTc interval. Avoid or Use Alternate Drug.

            • dofetilide

              dofetilide increases toxicity of escitalopram by QTc interval. Avoid or Use Alternate Drug.

              escitalopram increases toxicity of dofetilide by QTc interval. Avoid or Use Alternate Drug.

            • dosulepin

              escitalopram and dosulepin both increase serotonin levels. Avoid or Use Alternate Drug.

            • doxepin

              escitalopram and doxepin both increase serotonin levels. Avoid or Use Alternate Drug.

            • droperidol

              escitalopram increases toxicity of droperidol by QTc interval. Avoid or Use Alternate Drug.

            • encorafenib

              escitalopram increases toxicity of encorafenib by QTc interval. Avoid or Use Alternate Drug.

            • entrectinib

              escitalopram and entrectinib both increase QTc interval. Avoid or Use Alternate Drug.

            • enzalutamide

              enzalutamide will decrease the level or effect of escitalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

            • eribulin

              escitalopram increases toxicity of eribulin by QTc interval. Avoid or Use Alternate Drug.

            • erythromycin base

              escitalopram increases toxicity of erythromycin base by QTc interval. Avoid or Use Alternate Drug.

            • erythromycin ethylsuccinate

              escitalopram increases toxicity of erythromycin ethylsuccinate by QTc interval. Avoid or Use Alternate Drug.

            • erythromycin lactobionate

              escitalopram increases toxicity of erythromycin lactobionate by QTc interval. Avoid or Use Alternate Drug.

            • erythromycin stearate

              escitalopram increases toxicity of erythromycin stearate by QTc interval. Avoid or Use Alternate Drug.

            • fentanyl

              fentanyl, escitalopram. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.

            • fentanyl intranasal

              fentanyl intranasal, escitalopram. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.

            • fentanyl transdermal

              fentanyl transdermal, escitalopram. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.

            • fentanyl transmucosal

              fentanyl transmucosal, escitalopram. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.

            • flecainide

              escitalopram increases toxicity of flecainide by QTc interval. Avoid or Use Alternate Drug.

            • fluoxetine

              fluoxetine will increase the level or effect of escitalopram by affecting hepatic enzyme CYP2C19 metabolism. Avoid or Use Alternate Drug.

              escitalopram and fluoxetine both increase serotonin levels. Avoid or Use Alternate Drug.

            • fluvoxamine

              fluvoxamine and escitalopram both increase serotonin levels. Avoid or Use Alternate Drug.

            • foscarnet

              escitalopram increases toxicity of foscarnet by QTc interval. Avoid or Use Alternate Drug.

            • gilteritinib

              gilteritinib will decrease the level or effect of escitalopram by Other (see comment). Avoid or Use Alternate Drug. Coadministration of gilteritinib with drugs that inhibit 5HT2B or sigma nonspecific receptors. Avoid use of these drugs with gilteritinib unless coadministration is necessary.

            • glasdegib

              escitalopram and glasdegib both increase QTc interval. Avoid or Use Alternate Drug. If coadministration unavoidable, monitor for increased risk of QTc interval prolongation.

            • granisetron

              granisetron, escitalopram. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.

            • histrelin

              histrelin increases toxicity of escitalopram by QTc interval. Avoid or Use Alternate Drug. Increases risk of torsades de pointes.

            • hydromorphone

              hydromorphone, escitalopram. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.

            • hydroxychloroquine sulfate

              hydroxychloroquine sulfate and escitalopram both increase QTc interval. Avoid or Use Alternate Drug.

              escitalopram increases toxicity of hydroxychloroquine sulfate by QTc interval. Avoid or Use Alternate Drug.

            • ibutilide

              escitalopram increases toxicity of ibutilide by QTc interval. Avoid or Use Alternate Drug.

            • idelalisib

              idelalisib will increase the level or effect of escitalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Idelalisib is a strong CYP3A inhibitor; avoid coadministration with sensitive CYP3A substrates

            • iloperidone

              escitalopram increases toxicity of iloperidone by QTc interval. Avoid or Use Alternate Drug.

            • imipramine

              escitalopram and imipramine both increase serotonin levels. Avoid or Use Alternate Drug.

            • inotuzumab

              escitalopram increases toxicity of inotuzumab by QTc interval. Avoid or Use Alternate Drug.

            • ivosidenib

              ivosidenib and escitalopram both increase QTc interval. Avoid or Use Alternate Drug. Avoid coadministration of QTc prolonging drugs with ivosidenib or replace with alternate therapies. If coadministration of a QTc prolonging drug is unavoidable, monitor for increased risk of QTc interval prolongation.

              ivosidenib will decrease the level or effect of escitalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of sensitive CYP3A4 substrates with ivosidenib or replace with alternate therapies. If coadministration is unavoidable, monitor patients for loss of therapeutic effect of these drugs.

            • levomilnacipran

              escitalopram and levomilnacipran both increase serotonin levels. Avoid or Use Alternate Drug.

            • linezolid

              linezolid and escitalopram both increase serotonin levels. Avoid or Use Alternate Drug. Linezolid may increase serotonin as a result of MAO-A inhibition. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring, whichever comes first.

            • lofepramine

              escitalopram and lofepramine both increase serotonin levels. Avoid or Use Alternate Drug.

            • lonafarnib

              lonafarnib will increase the level or effect of escitalopram by affecting hepatic enzyme CYP2C19 metabolism. Avoid or Use Alternate Drug. Lonafarnib may increase the AUC and peak concentration of CYP2C19 substrates. If coadministration unavoidable, monitor for adverse reactions and reduce the CYP2C19 substrate dose in accordance with its approved product labeling.

            • lopinavir

              escitalopram increases toxicity of lopinavir by QTc interval. Avoid or Use Alternate Drug.

            • lorcaserin

              escitalopram and lorcaserin both increase serotonin levels. Avoid or Use Alternate Drug.

            • macimorelin

              macimorelin and escitalopram both increase QTc interval. Avoid or Use Alternate Drug. Macimorelin causes an increase of ~11 msec in the corrected QT interval. Avoid coadministration with drugs that prolong QT interval, which could increase risk for developing torsade de pointes-type ventricular tachycardia. Allow sufficient washout time of drugs that are known to prolong the QT interval before administering macimorelin.

            • maprotiline

              escitalopram and maprotiline both increase serotonin levels. Avoid or Use Alternate Drug.

            • mefloquine

              mefloquine increases toxicity of escitalopram by QTc interval. Avoid or Use Alternate Drug. Mefloquine may enhance the QTc prolonging effect of high risk QTc prolonging agents.

            • meperidine

              escitalopram and meperidine both increase serotonin levels. Avoid or Use Alternate Drug.

              meperidine, escitalopram. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.

            • methadone

              escitalopram increases toxicity of methadone by QTc interval. Avoid or Use Alternate Drug.

            • methylene blue

              methylene blue and escitalopram both increase serotonin levels. Avoid or Use Alternate Drug. Methylene blue may increase serotonin as a result of MAO-A inhibition. If methylene blue must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last methylene blue dose or after 2 weeks of monitoring, whichever comes first.

            • metoclopramide

              metoclopramide and escitalopram both increase serotonin levels. Avoid or Use Alternate Drug. Additive effects; increased risk for serotonin syndrome, neuroleptic malignant syndrome, dystonia, or other extrapyramidal reactions

            • metoclopramide intranasal

              escitalopram, metoclopramide intranasal. Either increases effects of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Avoid use of metoclopramide intranasal or interacting drug, depending on importance of drug to patient.

            • milnacipran

              escitalopram and milnacipran both increase serotonin levels. Avoid or Use Alternate Drug.

            • morphine

              morphine, escitalopram. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.

            • nefazodone

              escitalopram and nefazodone both increase serotonin levels. Avoid or Use Alternate Drug.

              nefazodone will increase the level or effect of escitalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

            • netupitant/palonosetron

              netupitant/palonosetron, escitalopram. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.

            • nilotinib

              escitalopram increases toxicity of nilotinib by QTc interval. Avoid or Use Alternate Drug.

            • nortriptyline

              escitalopram and nortriptyline both increase serotonin levels. Avoid or Use Alternate Drug.

            • ondansetron

              escitalopram and ondansetron both increase QTc interval. Avoid or Use Alternate Drug. Avoid with congenital long QT syndrome; ECG monitoring recommended with concomitant medications that prolong QT interval, electrolyte abnormalities, CHF, or bradyarrhythmias.

              ondansetron, escitalopram. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.

            • osimertinib

              escitalopram increases toxicity of osimertinib by QTc interval. Avoid or Use Alternate Drug.

            • ozanimod

              ozanimod increases toxicity of escitalopram by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Avoid or Use Alternate Drug. Because the active metabolite of ozanimod inhibits MAO-B in vitro, there is a potential for serious adverse reactions, including hypertensive crisis. Therefore, coadministration of ozanimod with drugs that can increase norepinephrine or serotonin is not recommended. Monitor for hypertension with concomitant use.

            • paliperidone

              escitalopram increases toxicity of paliperidone by QTc interval. Avoid or Use Alternate Drug.

            • palonosetron

              palonosetron, escitalopram. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.

            • panobinostat

              escitalopram and panobinostat both increase QTc interval. Avoid or Use Alternate Drug. Panobinostat is known to significantly prolong QT interval. Panobinostat prescribing information states use with drugs known to prolong QTc is not recommended.

            • paroxetine

              escitalopram and paroxetine both increase serotonin levels. Avoid or Use Alternate Drug.

            • pazopanib

              escitalopram increases toxicity of pazopanib by QTc interval. Avoid or Use Alternate Drug.

            • pentamidine

              escitalopram increases toxicity of pentamidine by QTc interval. Avoid or Use Alternate Drug.

            • phentermine

              escitalopram, phentermine. Either increases toxicity of the other by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of serotonin syndrome.

            • pimavanserin

              escitalopram increases toxicity of pimavanserin by QTc interval. Avoid or Use Alternate Drug.

            • pimozide

              pimozide, escitalopram. Mechanism: unknown. Contraindicated. Risk of long QT syndrome.

              escitalopram increases toxicity of pimozide by QTc interval. Contraindicated.

            • pitolisant

              escitalopram and pitolisant both increase QTc interval. Avoid or Use Alternate Drug.

            • procainamide

              escitalopram increases toxicity of procainamide by QTc interval. Avoid or Use Alternate Drug.

            • protriptyline

              escitalopram and protriptyline both increase serotonin levels. Avoid or Use Alternate Drug.

            • quetiapine

              escitalopram increases toxicity of quetiapine by QTc interval. Avoid or Use Alternate Drug.

            • quinidine

              escitalopram increases toxicity of quinidine by QTc interval. Avoid or Use Alternate Drug.

            • rasagiline

              rasagiline and escitalopram both increase serotonin levels. Avoid or Use Alternate Drug. Severe CNS toxicity associated with hyperpyrexia has been reported with the combined treatment of an antidepressant and rasagiline. Avoid combination within 14 days of MAOI use.

            • remifentanil

              remifentanil, escitalopram. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.

            • ribociclib

              ribociclib increases toxicity of escitalopram by QTc interval. Avoid or Use Alternate Drug.

              escitalopram increases toxicity of ribociclib by QTc interval. Avoid or Use Alternate Drug.

            • saquinavir

              escitalopram increases toxicity of saquinavir by QTc interval. Avoid or Use Alternate Drug.

              saquinavir will increase the level or effect of escitalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

            • selegiline transdermal

              selegiline transdermal and escitalopram both increase serotonin levels. Avoid or Use Alternate Drug.

            • selinexor

              selinexor, escitalopram. unspecified interaction mechanism. Avoid or Use Alternate Drug. Patients treated with selinexor may experience neurological toxicities. Avoid taking selinexor with other medications that may cause dizziness or confusion.

            • sertraline

              escitalopram and sertraline both increase serotonin levels. Avoid or Use Alternate Drug.

              escitalopram increases toxicity of sertraline by QTc interval. Avoid or Use Alternate Drug.

            • sorafenib

              escitalopram increases toxicity of sorafenib by QTc interval. Avoid or Use Alternate Drug.

            • sotalol

              escitalopram and sotalol both increase QTc interval. Avoid or Use Alternate Drug.

            • St John's Wort

              escitalopram and St John's Wort both increase serotonin levels. Avoid or Use Alternate Drug.

            • sufentanil

              sufentanil, escitalopram. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.

            • tedizolid

              tedizolid, escitalopram. Either increases effects of the other by Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. both increase serotonin levels; increased risk of serotonin syndrome.

            • tetrabenazine

              escitalopram increases toxicity of tetrabenazine by QTc interval. Avoid or Use Alternate Drug.

            • toremifene

              escitalopram increases toxicity of toremifene by QTc interval. Avoid or Use Alternate Drug.

            • trazodone

              escitalopram and trazodone both increase serotonin levels. Avoid or Use Alternate Drug.

            • trimipramine

              escitalopram and trimipramine both increase serotonin levels. Avoid or Use Alternate Drug.

            • triptorelin

              triptorelin increases toxicity of escitalopram by QTc interval. Avoid or Use Alternate Drug. Increases risk of torsades de pointes.

            • tucatinib

              tucatinib will increase the level or effect of escitalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid concomitant use of tucatinib with CYP3A substrates, where minimal concentration changes may lead to serious or life-threatening toxicities. If unavoidable, reduce CYP3A substrate dose according to product labeling.

            • umeclidinium bromide/vilanterol inhaled

              escitalopram increases toxicity of umeclidinium bromide/vilanterol inhaled by QTc interval. Avoid or Use Alternate Drug. Exercise extreme caution when vilanterol coadministered with drugs that prolong QTc interval; adrenergic agonist effects on the cardiovascular system may be potentiated.

            • vandetanib

              escitalopram, vandetanib. Either increases toxicity of the other by QTc interval. Avoid or Use Alternate Drug. Avoid coadministration with drugs known to prolong QT interval; if a drug known to prolong QT interval must be used, more frequent ECG monitoring is recommended.

            • vemurafenib

              vemurafenib and escitalopram both increase QTc interval. Avoid or Use Alternate Drug. Concomitant use of vemurafenib with drugs that prolong QT interval is not recommended.

              escitalopram increases toxicity of vemurafenib by QTc interval. Avoid or Use Alternate Drug.

            • venlafaxine

              escitalopram and venlafaxine both increase serotonin levels. Avoid or Use Alternate Drug.

            • vilanterol/fluticasone furoate inhaled

              escitalopram increases toxicity of vilanterol/fluticasone furoate inhaled by QTc interval. Avoid or Use Alternate Drug. Exercise extreme caution when vilanterol coadministered with drugs that prolong QTc interval; adrenergic agonist effects on the cardiovascular system may be potentiated.

            • vilazodone

              escitalopram, vilazodone. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug. Concomitant therapy should be discontinued immediately if signs or symptoms of serotonin syndrome emerge and supportive symptomatic treatment should be initiated. .

            • vortioxetine

              escitalopram, vortioxetine. Either increases effects of the other by serotonin levels. Avoid or Use Alternate Drug.

            • voxelotor

              voxelotor will increase the level or effect of escitalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Voxelotor increases systemic exposure of sensitive CYP3A4 substrates. Avoid coadministration with sensitive CYP3A4 substrates with a narrow therapeutic index. Consider dose reduction of the sensitive CYP3A4 substrate(s) if unable to avoid.

            • warfarin

              escitalopram increases levels of warfarin by decreasing metabolism. Avoid or Use Alternate Drug.

            Monitor Closely (223)

            • 5-HTP

              escitalopram and 5-HTP both increase serotonin levels. Modify Therapy/Monitor Closely.

            • aceclofenac

              escitalopram, aceclofenac. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

            • acemetacin

              escitalopram, acemetacin. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

            • alfuzosin

              escitalopram and alfuzosin both increase QTc interval. Use Caution/Monitor.

            • almotriptan

              almotriptan, escitalopram. Either increases toxicity of the other by serotonin levels. Modify Therapy/Monitor Closely. Exercise caution when concomitantly using agents that enhance serotonin activity. Monitor for the development of serotonin toxicity/serotonin syndrome during such therapy.

            • amifampridine

              escitalopram increases toxicity of amifampridine by Other (see comment). Modify Therapy/Monitor Closely. Comment: Amifampridine can cause seizures. Coadministration with drugs that lower seizure threshold may increase this risk.

            • amobarbital

              amobarbital will decrease the level or effect of escitalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • amoxapine

              escitalopram increases toxicity of amoxapine by QTc interval. Use Caution/Monitor.

            • apixaban

              escitalopram increases effects of apixaban by anticoagulation. Use Caution/Monitor. SSRIs may inhibit platelet aggregation, thus increase bleeding risk when coadministered with anticoagulants.

            • apomorphine

              escitalopram increases toxicity of apomorphine by QTc interval. Use Caution/Monitor.

            • arformoterol

              escitalopram increases toxicity of arformoterol by QTc interval. Use Caution/Monitor.

            • aspirin

              escitalopram, aspirin. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

            • aspirin rectal

              escitalopram, aspirin rectal. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

            • aspirin/citric acid/sodium bicarbonate

              escitalopram, aspirin/citric acid/sodium bicarbonate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

            • atazanavir

              atazanavir increases levels of escitalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Increased risk of serotonin syndrome.

            • atomoxetine

              escitalopram increases levels of atomoxetine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

            • azithromycin

              azithromycin increases toxicity of escitalopram by QTc interval. Use Caution/Monitor.

            • bedaquiline

              escitalopram and bedaquiline both increase QTc interval. Modify Therapy/Monitor Closely. ECG should be monitored closely

            • benzhydrocodone/acetaminophen

              benzhydrocodone/acetaminophen, escitalopram. Either increases effects of the other by serotonin levels. Use Caution/Monitor. Coadministration of drugs that affect the serotonergic neurotransmitter system may result in serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation and dose adjustment.

            • betrixaban

              escitalopram, betrixaban. Either increases levels of the other by anticoagulation. Use Caution/Monitor. SSRIs may inhibit platelet aggregation, thus increase bleeding risk when coadministered with anticoagulants.

            • buprenorphine subdermal implant

              escitalopram, buprenorphine subdermal implant. Either increases toxicity of the other by serotonin levels. Use Caution/Monitor. Concomitant use could result in life-threatening serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation, and during dose adjustment of the serotonergic drug. Discontinue buprenorphine if serotonin syndrome is suspected.

            • buprenorphine, long-acting injection

              escitalopram, buprenorphine, long-acting injection. Either increases toxicity of the other by serotonin levels. Use Caution/Monitor. Concomitant use could result in life-threatening serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation, and during dose adjustment of the serotonergic drug. Discontinue buprenorphine if serotonin syndrome is suspected.

            • butabarbital

              butabarbital will decrease the level or effect of escitalopram by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.

            • butalbital

              butalbital will decrease the level or effect of escitalopram by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.

            • cannabidiol

              cannabidiol will increase the level or effect of escitalopram by affecting hepatic enzyme CYP2C19 metabolism. Modify Therapy/Monitor Closely. Consider reducing the dose of sensitive CYP2C19 substrates, as clinically appropriate, when coadministered with cannabidiol.

            • carbamazepine

              carbamazepine will decrease the level or effect of escitalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • celecoxib

              escitalopram, celecoxib. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

            • cenobamate

              cenobamate will decrease the level or effect of escitalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Increase dose of CYP3A4 substrate, as needed, when coadministered with cenobamate.

              cenobamate will increase the level or effect of escitalopram by affecting hepatic enzyme CYP2C19 metabolism. Modify Therapy/Monitor Closely. Consider a dose reduction of CYP2C19 substrates, as clinically appropriate, when used concomitantly with cenobamate.

              cenobamate, escitalopram. Either increases effects of the other by sedation. Use Caution/Monitor.

            • chloramphenicol

              chloramphenicol will increase the level or effect of escitalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • chloroquine

              chloroquine increases toxicity of escitalopram by QTc interval. Use Caution/Monitor.

            • choline magnesium trisalicylate

              escitalopram, choline magnesium trisalicylate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

            • ciprofloxacin

              escitalopram increases toxicity of ciprofloxacin by QTc interval. Use Caution/Monitor.

            • clofazimine

              escitalopram increases toxicity of clofazimine by QTc interval. Modify Therapy/Monitor Closely.

            • clomipramine

              escitalopram increases toxicity of clomipramine by QTc interval. Use Caution/Monitor.

            • clonidine

              clonidine, escitalopram. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration enhances CNS depressant effects.

            • clopidogrel

              escitalopram increases effects of clopidogrel by pharmacodynamic synergism. Use Caution/Monitor. SSRIs affect platelet activation; coadministration of SSRIs with clopidogrel may increase the risk of bleeding.

            • clozapine

              escitalopram increases levels of clozapine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Plasma levels of clozapine may be increased, resulting in increased pharmacologic and toxic effects. Adjust clozapine dose as needed when initiating or discontinuing certain SSRIs. .

              escitalopram increases toxicity of clozapine by QTc interval. Use Caution/Monitor.

            • cobicistat

              cobicistat will increase the level or effect of escitalopram by Other (see comment). Use Caution/Monitor. Carefully titrate dose of the antidepressant to the desired effect, including using the lowest feasible initial or maintenance dose, and monitor its response during coadministration with SSRIs and cobicistat.

              cobicistat will increase the level or effect of escitalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • cocaine

              escitalopram and cocaine both increase serotonin levels. Modify Therapy/Monitor Closely.

            • crizotinib

              crizotinib increases levels of escitalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.

              crizotinib and escitalopram both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.

            • cyproheptadine

              cyproheptadine decreases effects of escitalopram by pharmacodynamic antagonism. Use Caution/Monitor. Cyproheptadine may diminish the serotonergic effect of SSRIs.

            • dabrafenib

              dabrafenib will decrease the level or effect of escitalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.

            • dasatinib

              escitalopram increases toxicity of dasatinib by QTc interval. Use Caution/Monitor.

            • defibrotide

              defibrotide increases effects of escitalopram by Other (see comment). Use Caution/Monitor. Comment: Defibrotide may enhance effects of platelet inhibitors.

            • degarelix

              escitalopram increases toxicity of degarelix by QTc interval. Use Caution/Monitor.

            • desipramine

              escitalopram increases toxicity of desipramine by QTc interval. Use Caution/Monitor.

            • deutetrabenazine

              escitalopram increases toxicity of deutetrabenazine by QTc interval. Use Caution/Monitor.

            • dexfenfluramine

              escitalopram and dexfenfluramine both increase serotonin levels. Modify Therapy/Monitor Closely.

            • dexmethylphenidate

              dexmethylphenidate increases effects of escitalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • dextroamphetamine

              escitalopram and dextroamphetamine both increase serotonin levels. Modify Therapy/Monitor Closely.

            • diazepam intranasal

              diazepam intranasal, escitalopram. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration may potentiate the CNS-depressant effects of each drug.

            • dichlorphenamide

              dichlorphenamide, escitalopram. sedation. Use Caution/Monitor.

            • diclofenac

              escitalopram, diclofenac. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

            • diflunisal

              escitalopram, diflunisal. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

            • dihydroergotamine

              escitalopram and dihydroergotamine both increase serotonin levels. Modify Therapy/Monitor Closely.

            • dihydroergotamine intranasal

              escitalopram and dihydroergotamine intranasal both increase serotonin levels. Modify Therapy/Monitor Closely.

            • dolasetron

              dolasetron, escitalopram. Either increases toxicity of the other by serotonin levels. Use Caution/Monitor. Monitor ECG, symptoms of serotonin syndrome especially during initiation/titration.

              escitalopram increases toxicity of dolasetron by QTc interval. Use Caution/Monitor.

            • duloxetine

              duloxetine and escitalopram both increase serotonin levels. Use Caution/Monitor.

            • duvelisib

              duvelisib will increase the level or effect of escitalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Coadministration with duvelisib increases AUC of a sensitive CYP3A4 substrate which may increase the risk of toxicities of these drugs. Consider reducing the dose of the sensitive CYP3A4 substrate and monitor for signs of toxicities of the coadministered sensitive CYP3A substrate.

            • edoxaban

              escitalopram increases effects of edoxaban by anticoagulation. Use Caution/Monitor. SSRIs may inhibit platelet aggregation, thus increase bleeding risk when coadministered with anticoagulants.

            • efavirenz

              efavirenz will increase the level or effect of escitalopram by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.

              efavirenz will decrease the level or effect of escitalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • elagolix

              elagolix will increase the level or effect of escitalopram by affecting hepatic enzyme CYP2C19 metabolism. Modify Therapy/Monitor Closely. Elagolix is a weak CYP2C19 inhibitor. Caution with sensitive CYP2C19 substrates.

              elagolix will decrease the level or effect of escitalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Elagolix is a weak-to-moderate CYP3A4 inducer. Monitor CYP3A substrates if coadministered. Consider increasing CYP3A substrate dose if needed.

            • eletriptan

              eletriptan and escitalopram both increase serotonin levels. Modify Therapy/Monitor Closely.

            • elvitegravir/cobicistat/emtricitabine/tenofovir DF

              elvitegravir/cobicistat/emtricitabine/tenofovir DF increases levels of escitalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Cobicistat is a CYP3A4 inhibitor; contraindicated with CYP3A4 substrates for which elevated plasma concentrations are associated with serious and/or life-threatening events.

            • encorafenib

              encorafenib, escitalopram. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Encorafenib both inhibits and induces CYP3A4 at clinically relevant plasma concentrations. Coadministration of encorafenib with sensitive CYP3A4 substrates may result in increased toxicity or decreased efficacy of these agents.

            • ergotamine

              escitalopram and ergotamine both increase serotonin levels. Modify Therapy/Monitor Closely.

            • eslicarbazepine acetate

              eslicarbazepine acetate will increase the level or effect of escitalopram by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.

            • esomeprazole

              esomeprazole will increase the level or effect of escitalopram by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.

            • etodolac

              escitalopram, etodolac. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

            • etravirine

              etravirine will increase the level or effect of escitalopram by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.

              etravirine will decrease the level or effect of escitalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • ezogabine

              ezogabine, escitalopram. Either increases toxicity of the other by QTc interval. Use Caution/Monitor. Slight and transient QT-prolongation observed with ezogabine, particularly when dose titrated to 1200 mg/day. QT interval should be monitored when ezogabine is prescribed with agents known to increase QT interval.

              escitalopram increases toxicity of ezogabine by QTc interval. Use Caution/Monitor. Slight and transient QT-prolongation observed, particularly when dose titrated to 1200mg/day. QT interval should be monitored when ezogabine is prescribed with agents known to increase QT interval.

            • fedratinib

              fedratinib will increase the level or effect of escitalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Adjust dose of drugs that are CYP3A4 substrates as necessary.

              fedratinib will increase the level or effect of escitalopram by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. Adjust dose of drugs that are CYP2C19 substrates as necessary.

            • felbamate

              felbamate will increase the level or effect of escitalopram by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.

            • fenbufen

              escitalopram, fenbufen. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

            • fenfluramine

              escitalopram and fenfluramine both increase serotonin levels. Modify Therapy/Monitor Closely.

              fenfluramine, escitalopram. Either increases effects of the other by serotonin levels. Use Caution/Monitor. Coadministration with drugs that increase serotoninergic effects may increase the risk of serotonin syndrome.

            • fenoprofen

              escitalopram, fenoprofen. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

            • fish oil triglycerides

              fish oil triglycerides will increase the level or effect of escitalopram by anticoagulation. Use Caution/Monitor. Prolonged bleeding reported in patients taking antiplatelet agents or anticoagulants and oral omega-3 fatty acids. Periodically monitor bleeding time in patients receiving fish oil triglycerides and concomitant antiplatelet agents or anticoagulants.

            • fluconazole

              fluconazole will increase the level or effect of escitalopram by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.

              escitalopram increases toxicity of fluconazole by QTc interval. Use Caution/Monitor.

            • fluoxetine

              escitalopram and fluoxetine both increase QTc interval. Modify Therapy/Monitor Closely.

            • fluphenazine

              escitalopram increases toxicity of fluphenazine by QTc interval. Use Caution/Monitor.

            • flurbiprofen

              escitalopram, flurbiprofen. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

            • fondaparinux

              escitalopram increases effects of fondaparinux by anticoagulation. Use Caution/Monitor. SSRIs may inhibit platelet aggregation, thus increase bleeding risk when coadministered with anticoagulants.

            • formoterol

              escitalopram increases toxicity of formoterol by QTc interval. Use Caution/Monitor.

            • fosamprenavir

              fosamprenavir increases levels of escitalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Potential for increased toxicity. Increased risk of serotonin syndrome.

            • fosphenytoin

              fosphenytoin will decrease the level or effect of escitalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • fostemsavir

              escitalopram and fostemsavir both increase QTc interval. Use Caution/Monitor. QTc prolongation reported with higher than recommended doses of fostemsavir.

            • frovatriptan

              frovatriptan and escitalopram both increase serotonin levels. Modify Therapy/Monitor Closely.

            • gabapentin

              gabapentin, escitalopram. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.

            • gabapentin enacarbil

              gabapentin enacarbil, escitalopram. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.

            • gemifloxacin

              escitalopram increases toxicity of gemifloxacin by QTc interval. Use Caution/Monitor.

            • gemtuzumab

              escitalopram increases toxicity of gemtuzumab by QTc interval. Use Caution/Monitor.

            • green tea

              green tea, escitalopram. Other (see comment). Use Caution/Monitor. Comment: Combination may increase risk of bleeding.

            • haloperidol

              haloperidol and escitalopram both increase QTc interval. Use Caution/Monitor.

              escitalopram increases toxicity of haloperidol by QTc interval. Use Caution/Monitor.

            • hydrocodone

              hydrocodone, escitalopram. Either increases effects of the other by serotonin levels. Use Caution/Monitor. Coadministration of drugs that affect the serotonergic neurotransmitter system may result in serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation and dose adjustment.

            • hydroxyurea

              escitalopram, hydroxyurea. Other (see comment). Use Caution/Monitor. Comment: Combination may increase risk of myelosuppression.

            • ibrutinib

              ibrutinib will increase the level or effect of escitalopram by anticoagulation. Use Caution/Monitor. Ibrutinib may increase the risk of hemorrhage in patients receiving antiplatelet or anticoagulant therapies and monitor for signs of bleeding.

            • ibuprofen

              escitalopram, ibuprofen. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

            • ibuprofen IV

              escitalopram, ibuprofen IV. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

            • iloperidone

              iloperidone increases levels of escitalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Iloperidone is a time-dependent CYP3A inhibitor and may lead to increased plasma levels of drugs predominantly eliminated by CYP3A4.

            • indacaterol, inhaled

              indacaterol, inhaled, escitalopram. QTc interval. Use Caution/Monitor. Drugs that are known to prolong the QTc interval may have an increased the risk of ventricular arrhythmias.

              escitalopram increases toxicity of indacaterol, inhaled by QTc interval. Use Caution/Monitor.

            • indapamide

              escitalopram increases toxicity of indapamide by QTc interval. Use Caution/Monitor.

            • indinavir

              indinavir increases levels of escitalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Potential for increased toxicity. Increased risk of serotonin syndrome.

            • indomethacin

              escitalopram, indomethacin. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

            • ioflupane I 123

              escitalopram decreases effects of ioflupane I 123 by receptor binding competition. Use Caution/Monitor. Drugs that bind to dopamine transporter receptor with high affinity may interfere with the image following ioflupane I 123 administration.

            • isoniazid

              isoniazid will increase the level or effect of escitalopram by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.

              escitalopram and isoniazid both increase serotonin levels. Modify Therapy/Monitor Closely.

            • isradipine

              escitalopram increases toxicity of isradipine by QTc interval. Use Caution/Monitor.

            • istradefylline

              istradefylline will increase the level or effect of escitalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Istradefylline 40 mg/day increased peak levels and AUC of CYP3A4 substrates in clinical trials. This effect was not observed with istradefylline 20 mg/day. Consider dose reduction of sensitive CYP3A4 substrates.

            • itraconazole

              itraconazole will increase the level or effect of escitalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • ketoprofen

              escitalopram, ketoprofen. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

            • ketorolac

              escitalopram, ketorolac. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

            • ketorolac intranasal

              escitalopram, ketorolac intranasal. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

            • L-tryptophan

              escitalopram and L-tryptophan both increase serotonin levels. Modify Therapy/Monitor Closely.

            • lamotrigine

              lamotrigine increases toxicity of escitalopram by unspecified interaction mechanism. Modify Therapy/Monitor Closely. CNS depressants may increase the toxic effects of selective serotonin reuptake inhibitors; psychomotor impairment may be enhanced.

            • lapatinib

              escitalopram increases toxicity of lapatinib by QTc interval. Use Caution/Monitor.

            • lasmiditan

              lasmiditan, escitalopram. Either increases effects of the other by sedation. Use Caution/Monitor. Coadministration of lasmiditan and other CNS depressant drugs, including alcohol have not been evaluated in clinical studies. Lasmiditan may cause sedation, as well as other cognitive and/or neuropsychiatric adverse reactions.

              escitalopram increases effects of lasmiditan by serotonin levels. Use Caution/Monitor. Coadministration may increase risk of serotonin syndrome.

            • lemborexant

              lemborexant, escitalopram. Either increases effects of the other by sedation. Modify Therapy/Monitor Closely. Dosage adjustment may be necessary if lemborexant is coadministered with other CNS depressants because of potentially additive effects.

            • lenvatinib

              escitalopram and lenvatinib both increase QTc interval. Use Caution/Monitor. Lenvatinib prescribing information recommends monitoring ECG closely when coadministered with QT prolonging drugs.

            • levofloxacin

              escitalopram increases toxicity of levofloxacin by QTc interval. Use Caution/Monitor.

            • lisdexamfetamine

              escitalopram, lisdexamfetamine. Either increases effects of the other by serotonin levels. Use Caution/Monitor. Initiate with lower doses and monitor for signs and symptoms of serotonin syndrome, particularly during initiation or dosage increase. If serotonin syndrome occurs, discontinue along with concomitant serotonergic drug(s).

            • lithium

              escitalopram and lithium both increase serotonin levels. Modify Therapy/Monitor Closely.

            • lofexidine

              escitalopram increases toxicity of lofexidine by QTc interval. Use Caution/Monitor.

            • lopinavir

              lopinavir increases levels of escitalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Potential for increased toxicity. Increased risk of serotinin syndrome.

            • lorlatinib

              lorlatinib will decrease the level or effect of escitalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • lornoxicam

              escitalopram, lornoxicam. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

            • lsd

              escitalopram and lsd both increase serotonin levels. Modify Therapy/Monitor Closely.

            • lumacaftor/ivacaftor

              lumacaftor/ivacaftor, escitalopram. affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. In vitro studies suggest that lumacaftor may induce and ivacaftor may inhibit CYP2C19 substrates. .

              lumacaftor/ivacaftor will decrease the level or effect of escitalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. A higher dose of escitalopram may be required to obtain desired therapeutic effect. Escitalopram is a CYP3A and CYP2C19 substrate. Lumacaftor/ivacaftor is a strong inducer of CYP3A and has the potential to induce CYP2C19.

            • lurasidone

              lurasidone, escitalopram. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: Potential for increased CNS depressant effects when used concurrently; monitor for increased adverse effects and toxicity.

            • maprotiline

              escitalopram increases toxicity of maprotiline by QTc interval. Use Caution/Monitor.

            • meclofenamate

              escitalopram, meclofenamate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

            • mefenamic acid

              escitalopram, mefenamic acid. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

            • mefloquine

              escitalopram increases toxicity of mefloquine by QTc interval. Use Caution/Monitor.

            • meloxicam

              escitalopram, meloxicam. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

            • metformin

              escitalopram increases effects of metformin by pharmacodynamic synergism. Use Caution/Monitor.

            • midazolam intranasal

              midazolam intranasal, escitalopram. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Concomitant use of barbiturates, alcohol, or other CNS depressants may increase the risk of hypoventilation, airway obstruction, desaturation, or apnea and may contribute to profound and/or prolonged drug effect.

            • mifepristone

              mifepristone, escitalopram. QTc interval. Modify Therapy/Monitor Closely. Use alternatives if available.

              mifepristone will increase the level or effect of escitalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              escitalopram increases toxicity of mifepristone by QTc interval. Use Caution/Monitor.

            • mirtazapine

              escitalopram and mirtazapine both increase serotonin levels. Modify Therapy/Monitor Closely.

            • mitotane

              mitotane decreases levels of escitalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Mitotane is a strong inducer of cytochrome P-4503A4; monitor when coadministered with CYP3A4 substrates for possible dosage adjustments.

            • modafinil

              modafinil will increase the level or effect of escitalopram by affecting hepatic enzyme CYP2C19 metabolism. Modify Therapy/Monitor Closely.

            • morphine

              escitalopram and morphine both increase serotonin levels. Modify Therapy/Monitor Closely.

            • moxifloxacin

              escitalopram and moxifloxacin both increase QTc interval. Modify Therapy/Monitor Closely.

              moxifloxacin and escitalopram both increase QTc interval. Modify Therapy/Monitor Closely.

            • nabumetone

              escitalopram, nabumetone. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

            • nafcillin

              nafcillin will decrease the level or effect of escitalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • naproxen

              escitalopram, naproxen. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

            • naratriptan

              naratriptan and escitalopram both increase serotonin levels. Modify Therapy/Monitor Closely.

            • nelfinavir

              nelfinavir increases levels of escitalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Potential for increased toxicity. Increased risk of serotonin syndrome.

            • nortriptyline

              escitalopram increases toxicity of nortriptyline by QTc interval. Use Caution/Monitor.

            • octreotide

              escitalopram increases toxicity of octreotide by QTc interval. Use Caution/Monitor.

            • ofloxacin

              escitalopram increases toxicity of ofloxacin by QTc interval. Use Caution/Monitor.

            • olanzapine

              escitalopram increases toxicity of olanzapine by QTc interval. Use Caution/Monitor. Limited data, including some case reports, suggest that olanzapine may be associated with a significant prolongation of the QTc interval in rare instances.

            • oliceridine

              escitalopram, oliceridine. Either increases toxicity of the other by serotonin levels. Modify Therapy/Monitor Closely.

            • olodaterol inhaled

              escitalopram and olodaterol inhaled both increase QTc interval. Use Caution/Monitor. Drugs that prolong the QTc interval and may potentiate the effects of beta2 agonists on the cardiovascular system; increased risk of ventricular arrhythmias

            • omeprazole

              omeprazole will increase the level or effect of escitalopram by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.

            • osilodrostat

              osilodrostat and escitalopram both increase QTc interval. Use Caution/Monitor.

              escitalopram and osilodrostat both increase QTc interval. Use Caution/Monitor. Dose dependent QT prolongation - avoid drugs known to prolong the QT interval

            • osimertinib

              osimertinib and escitalopram both increase QTc interval. Use Caution/Monitor. Conduct periodic monitoring with ECGs and electrolytes in patients taking drugs known to prolong the QTc interval.

            • oxaliplatin

              oxaliplatin will increase the level or effect of escitalopram by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.

            • oxaprozin

              escitalopram, oxaprozin. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

            • oxcarbazepine

              oxcarbazepine will increase the level or effect of escitalopram by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.

            • oxycodone

              oxycodone increases effects of escitalopram by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Opioids may enhance the serotonergic effects of SSRIs and increase risk for serotonergic syndrome.

            • ozanimod

              ozanimod and escitalopram both increase QTc interval. Modify Therapy/Monitor Closely. The potential additive effects on heart rate, treatment with ozanimod should generally not be initiated in patients who are concurrently treated with QT prolonging drugs with known arrhythmogenic properties.

            • parecoxib

              escitalopram, parecoxib. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

            • pasireotide

              escitalopram and pasireotide both increase QTc interval. Modify Therapy/Monitor Closely.

            • pentazocine

              escitalopram and pentazocine both increase serotonin levels. Modify Therapy/Monitor Closely.

            • pentobarbital

              pentobarbital will decrease the level or effect of escitalopram by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.

            • perphenazine

              escitalopram increases toxicity of perphenazine by QTc interval. Use Caution/Monitor.

            • phenobarbital

              phenobarbital will decrease the level or effect of escitalopram by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.

              phenobarbital will decrease the level or effect of escitalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • phenytoin

              phenytoin will decrease the level or effect of escitalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • piroxicam

              escitalopram, piroxicam. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

            • posaconazole

              escitalopram increases toxicity of posaconazole by QTc interval. Use Caution/Monitor.

              posaconazole will increase the level or effect of escitalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • pregabalin

              pregabalin, escitalopram. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.

            • primidone

              primidone will decrease the level or effect of escitalopram by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.

              primidone will decrease the level or effect of escitalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • propafenone

              escitalopram increases toxicity of propafenone by QTc interval. Use Caution/Monitor.

            • protriptyline

              escitalopram increases toxicity of protriptyline by QTc interval. Use Caution/Monitor.

            • quetiapine

              quetiapine, escitalopram. Either increases toxicity of the other by QTc interval. Use Caution/Monitor. Avoid use with drugs that prolong QT and in patients with risk factors for prolonged QT interval. Postmarketing cases show QT prolongation with overdose in patients with concomitant illness or with drugs known to cause electrolyte imbalance or prolong QT.

            • quinine

              escitalopram and quinine both increase QTc interval. Use Caution/Monitor.

            • ranolazine

              escitalopram increases toxicity of ranolazine by QTc interval. Use Caution/Monitor.

            • remimazolam

              remimazolam, escitalopram. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely. Coadministration may result in profound sedation, respiratory depression, coma, and/or death. Continuously monitor vital signs during sedation and recovery period if coadministered. Carefully titrate remimazolam dose if administered with opioid analgesics and/or sedative/hypnotics.

            • ribociclib

              ribociclib will increase the level or effect of escitalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • rifabutin

              rifabutin will decrease the level or effect of escitalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • rifampin

              rifampin will decrease the level or effect of escitalopram by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.

              rifampin will decrease the level or effect of escitalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • rifapentine

              rifapentine will decrease the level or effect of escitalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • rilpivirine

              rilpivirine increases toxicity of escitalopram by QTc interval. Use Caution/Monitor. Rilpivirine should be used with caution when co-administered with a drug with a known risk of Torsades de Pointes.

              escitalopram increases toxicity of rilpivirine by QTc interval. Use Caution/Monitor.

            • risperidone

              escitalopram increases toxicity of risperidone by QTc interval. Use Caution/Monitor.

            • ritonavir

              ritonavir increases levels of escitalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Potential for increased toxicity. Increased risk of serotonin syndrome.

            • rivaroxaban

              escitalopram increases effects of rivaroxaban by pharmacodynamic synergism. Use Caution/Monitor. Combination may increase risk of bleeding.

            • rizatriptan

              rizatriptan and escitalopram both increase serotonin levels. Modify Therapy/Monitor Closely.

            • romidepsin

              escitalopram increases toxicity of romidepsin by QTc interval. Use Caution/Monitor.

            • safinamide

              escitalopram, safinamide. Either increases toxicity of the other by serotonin levels. Use Caution/Monitor. Monitor patients for symptoms of serotonin syndrome if SSRIs are coadministered with safinamide.

            • salicylates (non-asa)

              escitalopram, salicylates (non-asa). Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

            • salsalate

              escitalopram, salsalate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

            • SAMe

              escitalopram and SAMe both increase serotonin levels. Modify Therapy/Monitor Closely.

            • secobarbital

              secobarbital will decrease the level or effect of escitalopram by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.

              secobarbital will decrease the level or effect of escitalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • selpercatinib

              selpercatinib increases toxicity of escitalopram by QTc interval. Use Caution/Monitor.

            • sodium sulfate/?magnesium sulfate/potassium chloride

              sodium sulfate/?magnesium sulfate/potassium chloride increases effects of escitalopram by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of seizures when using bowel preps together with drugs that lower the seizure threshold.

            • sodium sulfate/potassium sulfate/magnesium sulfate

              sodium sulfate/potassium sulfate/magnesium sulfate increases effects of escitalopram by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of seizures when using bowel preps together with drugs that lower the seizure threshold.

            • sodium sulfate/potassium sulfate/magnesium sulfate/polyethylene glycol

              escitalopram, sodium sulfate/potassium sulfate/magnesium sulfate/polyethylene glycol. Other (see comment). Use Caution/Monitor. Comment: Caution when bowel preps are used with drugs that cause SIADH or NSAIDs; increased risk for water retention or electrolyte imbalance.

            • solifenacin

              escitalopram increases toxicity of solifenacin by QTc interval. Use Caution/Monitor.

            • sorafenib

              sorafenib and escitalopram both increase QTc interval. Use Caution/Monitor.

            • stiripentol

              stiripentol will decrease the level or effect of escitalopram by affecting hepatic enzyme CYP2C19 metabolism. Modify Therapy/Monitor Closely. Consider reducing the dose of CYP2C19 substrates, if adverse reactions are experienced when administered concomitantly with stiripentol.

            • sufentanil SL

              sufentanil SL, escitalopram. Either increases effects of the other by serotonin levels. Use Caution/Monitor. Coadministration of drugs that affect the serotonergic neurotransmitter system may result in serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation and dose adjustment.

            • sulfasalazine

              escitalopram, sulfasalazine. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

            • sulindac

              escitalopram, sulindac. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

            • sumatriptan

              sumatriptan and escitalopram both increase serotonin levels. Modify Therapy/Monitor Closely.

            • sumatriptan intranasal

              sumatriptan intranasal and escitalopram both increase serotonin levels. Modify Therapy/Monitor Closely.

            • sunitinib

              escitalopram increases toxicity of sunitinib by QTc interval. Use Caution/Monitor.

            • tacrolimus

              escitalopram increases toxicity of tacrolimus by QTc interval. Use Caution/Monitor.

            • tapentadol

              escitalopram and tapentadol both increase serotonin levels. Modify Therapy/Monitor Closely.

            • tazemetostat

              tazemetostat will decrease the level or effect of escitalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • tecovirimat

              tecovirimat will increase the level or effect of escitalopram by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. Tecovirimat is a weak inhibitor of CYP2C8 and CYP2C19. Monitor for adverse effects if coadministered with sensitive substrates of these enzymes.

              tecovirimat will decrease the level or effect of escitalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Tecovirimat is a weak CYP3A4 inducer. Monitor sensitive CYP3A4 substrates for effectiveness if coadministered.

            • telavancin

              escitalopram increases toxicity of telavancin by QTc interval. Use Caution/Monitor.

            • tipranavir

              tipranavir will increase the level or effect of escitalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • tizanidine

              tizanidine increases toxicity of escitalopram by pharmacodynamic synergism. Use Caution/Monitor. CNS depressants may enhance the psychomotor impairment of escitalopram.

            • tolfenamic acid

              escitalopram, tolfenamic acid. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

            • tolmetin

              escitalopram, tolmetin. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

            • tramadol

              escitalopram and tramadol both increase serotonin levels. Modify Therapy/Monitor Closely.

            • triclabendazole

              triclabendazole will increase the level or effect of escitalopram by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. If plasma concentrations of the CYP2C19 substrates are elevated during triclabendazole, recheck plasma concentration of the CYP2C19 substrates after discontinuation of triclabendazole.

            • trimipramine

              escitalopram increases toxicity of trimipramine by QTc interval. Use Caution/Monitor.

            • valerian

              valerian and escitalopram both increase sedation. Use Caution/Monitor.

            • vardenafil

              escitalopram increases toxicity of vardenafil by QTc interval. Use Caution/Monitor.

            • vorapaxar

              escitalopram, vorapaxar. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Additive antiplatelet effect may occur; SSRIs and SNRIs may cause platelet serotonin depletion .

            • voriconazole

              voriconazole will increase the level or effect of escitalopram by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.

              escitalopram increases toxicity of voriconazole by QTc interval. Use Caution/Monitor.

              voriconazole will increase the level or effect of escitalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • vorinostat

              escitalopram increases toxicity of vorinostat by QTc interval. Use Caution/Monitor.

            • zanubrutinib

              escitalopram, zanubrutinib. Either increases effects of the other by anticoagulation. Modify Therapy/Monitor Closely. Zanubrutinib-induced cytopenias increases risk of hemorrhage. Coadministration of zanubritinib with antiplatelets or anticoagulants may further increase this risk.

            • zolmitriptan

              zolmitriptan and escitalopram both increase serotonin levels. Modify Therapy/Monitor Closely.

            Minor (35)

            • acebutolol

              escitalopram increases levels of acebutolol by decreasing metabolism. Minor/Significance Unknown.

            • almotriptan

              escitalopram, almotriptan. Mechanism: unknown. Minor/Significance Unknown. Risk of weakness, dyspnea, chest pain.

            • atenolol

              escitalopram increases levels of atenolol by decreasing metabolism. Minor/Significance Unknown.

            • betaxolol

              escitalopram increases levels of betaxolol by decreasing metabolism. Minor/Significance Unknown.

            • bisoprolol

              escitalopram increases levels of bisoprolol by decreasing metabolism. Minor/Significance Unknown.

            • bortezomib

              bortezomib will increase the level or effect of escitalopram by affecting hepatic enzyme CYP2C19 metabolism. Minor/Significance Unknown.

            • bumetanide

              bumetanide, escitalopram. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Possible additive hyponatremia.

            • carvedilol

              escitalopram increases levels of carvedilol by decreasing metabolism. Minor/Significance Unknown.

            • celiprolol

              escitalopram increases levels of celiprolol by decreasing metabolism. Minor/Significance Unknown.

            • darunavir

              darunavir will increase the level or effect of escitalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown. Coadministration with SSRIs, TCAs, or trazodone may require dose titration of antidepressant to desired effect (eg, using the lowest feasible initial or maintenance dose). Monitor for antidepressant response.

            • eletriptan

              escitalopram, eletriptan. Mechanism: unknown. Minor/Significance Unknown. Risk of weakness, dyspnea, chest pain.

            • esmolol

              escitalopram increases levels of esmolol by decreasing metabolism. Minor/Significance Unknown.

            • ethacrynic acid

              ethacrynic acid, escitalopram. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Possible additive hyponatremia.

            • felodipine

              felodipine will increase the level or effect of escitalopram by affecting hepatic enzyme CYP2C19 metabolism. Minor/Significance Unknown.

            • frovatriptan

              escitalopram, frovatriptan. Mechanism: unknown. Minor/Significance Unknown. Risk of weakness, dyspnea, chest pain.

            • furosemide

              furosemide, escitalopram. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Possible additive hyponatremia.

            • labetalol

              escitalopram increases levels of labetalol by decreasing metabolism. Minor/Significance Unknown.

            • lithium

              escitalopram, lithium. Mechanism: unknown. Minor/Significance Unknown. Risk of neurotoxicity.

            • metoprolol

              escitalopram increases levels of metoprolol by decreasing metabolism. Minor/Significance Unknown.

            • nadolol

              escitalopram increases levels of nadolol by decreasing metabolism. Minor/Significance Unknown.

            • naratriptan

              escitalopram, naratriptan. Mechanism: unknown. Minor/Significance Unknown. Risk of weakness, dyspnea, chest pain.

            • nebivolol

              escitalopram increases levels of nebivolol by decreasing metabolism. Minor/Significance Unknown.

            • panax ginseng

              panax ginseng increases effects of escitalopram by pharmacodynamic synergism. Minor/Significance Unknown.

            • parecoxib

              parecoxib will increase the level or effect of escitalopram by affecting hepatic enzyme CYP2C19 metabolism. Minor/Significance Unknown.

            • penbutolol

              escitalopram increases levels of penbutolol by decreasing metabolism. Minor/Significance Unknown.

            • pindolol

              escitalopram increases levels of pindolol by decreasing metabolism. Minor/Significance Unknown.

            • pleurisy root

              pleurisy root decreases effects of escitalopram by unspecified interaction mechanism. Minor/Significance Unknown. Theoretical interaction.

            • propranolol

              escitalopram increases levels of propranolol by decreasing metabolism. Minor/Significance Unknown.

            • rizatriptan

              escitalopram, rizatriptan. Mechanism: unknown. Minor/Significance Unknown. Risk of weakness, dyspnea, chest pain.

            • sotalol

              escitalopram increases levels of sotalol by decreasing metabolism. Minor/Significance Unknown.

            • sumatriptan

              escitalopram, sumatriptan. Mechanism: unknown. Minor/Significance Unknown. Risk of weakness, dyspnea, chest pain.

            • sumatriptan intranasal

              escitalopram, sumatriptan intranasal. Mechanism: unknown. Minor/Significance Unknown. Risk of weakness, dyspnea, chest pain.

            • timolol

              escitalopram increases levels of timolol by decreasing metabolism. Minor/Significance Unknown.

            • torsemide

              torsemide, escitalopram. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Possible additive hyponatremia.

            • zolmitriptan

              escitalopram, zolmitriptan. Mechanism: unknown. Minor/Significance Unknown. Risk of weakness, dyspnea, chest pain.

            Previous
            Next:

            Adverse Effects

            >10%

            Headache (24%)

            Nausea (15-18%)

            Ejaculation disorder (9-14%)

            Somnolence (4-13%)

            Insomnia (7-12%)

            1-10%

            Xerostomia (4-9%)

            Constipation (3-6%)

            Fatigue (2-8%)

            Diarrhea (8%)

            Libido decrease (3-7%)

            Anorgasmia (2-6%)

            Indigestion (1-6%)

            Rhinitis (5%)

            Flu-like syndrome (5%)

            Neck/shoulder pain (3%)

            Decreased appetite (3%)

            Vomiting (3%)

            Sinusitis (3%)

            Lethargy (3%)

            Menstrual disorder (2%)

            Flatulence (2%)

            Toothache (2%)

            Yawning (2%)

            Menstrual disorder (1%)

            Weight gain (1%)

            Postmarketing Reports

            Blood and lymphatic system disorders: Anemia, agranulocytosis, aplastic anemia, hemolytic anemia, idiopathic thrombocytopenia purpura, leukopenia, thrombocytopenia

            Cardiac disorders: Atrial fibrillation, bradycardia, cardiac failure, myocardial infarction, tachycardia, torsades de pointes, ventricular arrhythmia, ventricular tachycardia

            Ear and labyrinth disorders: Vertigo

            Endocrine disorders: Diabetes mellitus, hyperprolactinemia, SIADH

            Eye disorders: Angle closure glaucoma, diplopia, mydriasis, visual disturbance

            Gastrointestinal disorder: Dysphagia, gastrointestinal hemorrhage, gastroesophageal reflux, pancreatitis, rectal hemorrhage

            General disorders and administration site conditions: Abnormal gait, asthenia, edema, fall, feeling abnormal, malaise

            Hepatobiliary disorders: Fulminant hepatitis, hepatic failure, hepatic necrosis, hepatitis

            Immune system disorders: Allergic reaction, anaphylaxis

            Investigations: Bilirubin increased, decreased weight, QT prolongation, hepatic enzymes increased, hypercholesterolemia, INR increased, prothrombin decreased

            Metabolism and nutrition disorders: Hyperglycemia, hypoglycemia, hypokalemia, hyponatremia

            Musculoskeletal and connective tissue disorders: Muscle cramp, muscle stiffness, muscle weakness, rhabdomyolysis

            Nervous system disorders: Akathisia, amnesia, ataxia, choreoathetosis, cerebrovascular accident, dysarthria, dyskinesia, dystonia, extrapyramidal disorders, grand mal seizures (or convulsions), myoclonus, nystagmus, Parkinsonism, restless legs, seizures, syncope, tardive dyskinesia, tremor

            Pregnancy, puerperium and perinatal conditions: Spontaneous abortion

            Psychiatric disorders: Acute psychosis, aggression, agitation, anger, anxiety, apathy, completed suicide, confusion, depersonalization, depression aggravated, delirium, delusion, disorientation, feeling unreal, hallucinations (visual and auditory), mood swings, nervousness, nightmare, panic reaction, paranoia, restlessness, self-harm or thoughts of self-harm, suicide attempt, suicidal ideation, suicidal tendency

            Renal and urinary disorders: Acute renal failure, dysuria, urinary retention

            Reproductive system and breast disorders: Menorrhagia, priapism

            Respiratory, thoracic and mediastinal disorders: Dyspnea, epistaxis, pulmonary embolism, pulmonary hypertension of the newborn

            Skin and SC tissue disorders: Alopecia, angioedema, dermatitis, ecchymosis, erythema multiforme, photosensitivity reaction, Stevens Johnson syndrome, toxic epidermal necrolysis, urticaria

            Vascular Disorders: Deep vein thrombosis, flushing, hypertensive crisis, hypotension, orthostatic hypotension, phlebitis, thrombosis

            Previous
            Next:

            Warnings

            Black Box Warnings

            Suicidality and antidepressants

            • In short-term studies, antidepressants increased the risk of suicidal thinking and behavior in children, adolescents, and young adults (<24 years) taking antidepressants for major depressive disorders and other psychiatric illnesses
            • This increase was not seen in patients >24 years; a slight decrease in suicidal thinking was seen in adults >65 years
            • Depression and certain other psychiatric disorders are themselves associated with increases in the risk of suicide
            • Monitor patients of all ages initiating antidepressant therapy and closely observe for clinical worsening, suicidality, or unusual changes in behavior
            • Advise families and caregivers of the need for close observation and communication with the prescriber
            • Not approved children aged <12 years

            Contraindications

            Hypersensitivity to escitalopram or citalopram

            Pimozide

            Monoamine oxidase inhibitors (MAOIs)

            • Use of MAOIs intended to treat psychiatric disorders with escitalopram or within 14 days of discontinuation
            • Use of escitalopram within 14 days of stopping an MAOI intended to treat psychiatric disorders
            • Starting escitalopram in a patients being treated with MAOIs such as linezolid or IV methylene blue

            Cautions

            Conflicting evidence regarding use of SSRIs during pregnancy and increased risk of persistent pulmonary hypertension of the newborn, or PPHN (see Pregnancy)

            In neonates exposed to SNRIs/SSRIs late in third trimester: risk of complications such as feeding difficulties, irritability, and respiratory problems

            Prior to initiating treatment, screen patients for any personal or family history of bipolar disorder, mania, or hypomania

            Caution with seizure disorder, bipolar mania, severe renal impairment; not FDA approved for the treatment of bipolar depression

            SNRIs/SSRIs have been associated with the development of SIADH; hyponatremia has been reported rarely

            Activation of mania/hypomania reported in a small proportion of patients with major affective disorders treated with citalopram and other marketed drugs effective in treatment of major depressive disorder

            May worsen psychosis in some patients and precipitate a shift to mania or hypomania in patients with bipolar disorder

            Consider changing therapeutic regimen, in patients whose depression is persistently worse, or who are experiencing emergent suicidal thoughts or behaviors

            Risk of hyponatremia

            Risk of mydriasis; may trigger angle closure attack in patients with angle closure glaucoma with anatomically narrow angles without a patent iridectomy

            Bone fractures are associated with antidepressant therapy; consider the possibility of a fracture in patients with unexplained bone pain, swelling, or bruising

            Prescribe the smallest quantity of tablets consistent with good patient care and alert family or caregiver to monitor for emergence of suicidality and associated behaviors (anxiety, agitation, panic attacks, insomnia, hostility, akathisia, impulsivity, irritability)

            SSRIs/SNRIs increase risk of abnormal bleeding (further increased if concomitant aspirin, NSAIDs or anticoagulants, or hemorrhagic diathesis)

            Prolongation of QT interval and ventricular arrhythmias reported, especially in female patients with preexisting QT prolongation or other risk factors

            Risk of cognitive and motor function impairment; use caution when operating heavy machinery

            Use with caution in patients with history of seizure disorders or conditions predisposing to seizures including brain damage and alcoholism

            May cause or exacerbate sexual dysfunction

            Gradually taper dose before discontinuation; abrupt discontinuation may cause dysphoric mood, dizziness, sensory disturbances, agitation, confusion, anxiety, headache, insomnia, tinnitus, seizures, irritability

            Drug interaction overview

            • Escitalopram is a CYP3A4 and CYP2C19 substrate
            • Risk of serotonin syndrome or neuroleptic malignant syndrome (NMS)-like reactions have been reported with SSRIs and SNRIs both when taken alone, but especially when coadministered with other serotonergic agents (including triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, tryptophan, buspirone, amphetamines, and St. John’s Wort); if symptoms occur, discontinue therapy and initiate supportive treatment; if concomitant use of escitalopram with other serotonergic drugs is clinically warranted, be aware of the increased risk for serotonin syndrome, particularly during treatment initiation and dose increases
            • May impair platelet aggregation that can result in increased risk of bleeding events including GI bleeding especially if taken concomitantly with aspiring, warfarin, or NSAIDs
            • Owing to primary CNS effects, caution when coadministered with other centrally acting drugs
            • Did not potentiate cognitive and motor effects of alcohol in a clinical trial; however, as with other psychotropic medications, alcohol is not recommended
            Previous
            Next:

            Pregnancy & Lactation

            Pregnancy

            There are no adequate and well-controlled studies in pregnant women; therefore, use during pregnancy only if the potential benefit justifies the potential risk to the fetus

            In some cases, the clinical picture is consistent with serotonin syndrome

            Effect on labor and delivery in humans is unknown

            Neonates exposed to escitalopram and other SSRIs/SNRIs

            • Neonates exposed to SSRIs/SNRIs late in the third trimester have developed complications requiring prolonged hospitalization, respiratory support, and tube feeding
            • Such complications can arise immediately upon delivery
            • Reported clinical findings include respiratory distress, cyanosis, apnea, seizures, temperature instability, feeding difficulty, vomiting, hypoglycemia, hypotonia, hypertonia, hyperreflexia, tremor, jitteriness, irritability, and constant crying
            • These features are consistent with toxic effects of SSRIs and SNRIs or, possibly, drug discontinuation syndrome

            Lactation

            Escitalopram is excreted in human breast milk

            Limited data from women taking 10-20 mg escitalopram showed that exclusively breast-fed infants receive a ~3.9% of the maternal weight-adjusted dose of escitalopram and 1.7% of the maternal weight-adjusted dose of desmethylcitalopram

            Caution should be exercised and breastfeeding infants should be observed for adverse reactions when administered to a nursing woman

            Pregnancy Categories

            A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA: Information not available.

            Previous
            Next:

            Pharmacology

            Mechanism of Action

            S-enantiomer of racemic citalopram; inhibits the reuptake of serotonin, with little or no effect on norepinephrine or dopamine reuptake

            Absorption

            Peak plasma time: 5 hr (single 20-mg dose)

            Bioavailability: 80% (IV citalopram)

            Distribution

            Protein bound: 56%

            Vd: 12 L/kg (citalopram)

            Metabolism

            CYP3A4, CYP2C19

            Metabolites: Insignificant potency

            Enzymes inhibited: CYP2D6

            Elimination

            Half-life: 27-32 hr

            Dialyzable: No

            Renal clearance: 42 mL/min

            Total body clearance: 600 mL/min

            Excretion: Urine (8%)

            Previous
            Next:

            Administration

            Oral Administrationº

            Administer once daily, in the morning or evening, with or without food

            Storage

            Store at 20-25ºC (68-77ºF); excursions permitted to 15-30°C (59-86ºF)

            Previous
            Next:

            Images

            BRAND FORM. UNIT PRICE PILL IMAGE
            escitalopram oxalate oral
            -
            20 mg tablet
            escitalopram oxalate oral
            -
            10 mg tablet
            escitalopram oxalate oral
            -
            20 mg tablet
            escitalopram oxalate oral
            -
            10 mg tablet
            escitalopram oxalate oral
            -
            5 mg tablet
            escitalopram oxalate oral
            -
            5 mg tablet
            escitalopram oxalate oral
            -
            10 mg tablet
            escitalopram oxalate oral
            -
            20 mg tablet
            escitalopram oxalate oral
            -
            20 mg tablet
            escitalopram oxalate oral
            -
            10 mg tablet
            escitalopram oxalate oral
            -
            5 mg tablet
            escitalopram oxalate oral
            -
            20 mg tablet
            escitalopram oxalate oral
            -
            5 mg/5 mL solution
            escitalopram oxalate oral
            -
            5 mg tablet
            escitalopram oxalate oral
            -
            10 mg tablet
            escitalopram oxalate oral
            -
            5 mg tablet
            escitalopram oxalate oral
            -
            10 mg tablet
            escitalopram oxalate oral
            -
            20 mg tablet
            escitalopram oxalate oral
            -
            10 mg tablet
            escitalopram oxalate oral
            -
            20 mg tablet
            escitalopram oxalate oral
            -
            10 mg tablet
            escitalopram oxalate oral
            -
            20 mg tablet
            escitalopram oxalate oral
            -
            20 mg tablet
            escitalopram oxalate oral
            -
            5 mg/5 mL solution
            escitalopram oxalate oral
            -
            5 mg tablet
            escitalopram oxalate oral
            -
            5 mg tablet
            escitalopram oxalate oral
            -
            5 mg/5 mL solution
            escitalopram oxalate oral
            -
            20 mg tablet
            escitalopram oxalate oral
            -
            5 mg tablet
            escitalopram oxalate oral
            -
            10 mg tablet
            escitalopram oxalate oral
            -
            5 mg/5 mL solution
            escitalopram oxalate oral
            -
            20 mg tablet
            escitalopram oxalate oral
            -
            10 mg tablet
            escitalopram oxalate oral
            -
            5 mg tablet
            escitalopram oxalate oral
            -
            20 mg tablet
            escitalopram oxalate oral
            -
            10 mg tablet
            escitalopram oxalate oral
            -
            20 mg tablet
            escitalopram oxalate oral
            -
            5 mg tablet
            escitalopram oxalate oral
            -
            10 mg tablet
            escitalopram oxalate oral
            -
            5 mg tablet
            Lexapro oral
            -
            20 mg tablet
            Lexapro oral
            -
            5 mg tablet
            Lexapro oral
            -
            10 mg tablet

            Copyright © 2010 First DataBank, Inc.

            Previous
            Next:

            Patient Handout

            Patient Education
            escitalopram oxalate oral

            ESCITALOPRAM - ORAL

            (ES-sye-TAL-oh-pram)

            COMMON BRAND NAME(S): Lexapro

            WARNING: Antidepressant medications are used to treat a variety of conditions, including depression and other mental/mood disorders. These medications can help prevent suicidal thoughts/attempts and provide other important benefits. However, studies have shown that a small number of people (especially people younger than 25) who take antidepressants for any condition may experience worsening depression, other mental/mood symptoms, or suicidal thoughts/attempts. Therefore, it is very important to talk with the doctor about the risks and benefits of antidepressant medication (especially for people younger than 25), even if treatment is not for a mental/mood condition.Tell the doctor right away if you notice worsening depression/other psychiatric conditions, unusual behavior changes (including possible suicidal thoughts/attempts), or other mental/mood changes (including new/worsening anxiety, panic attacks, trouble sleeping, irritability, hostile/angry feelings, impulsive actions, severe restlessness, very rapid speech). Be especially watchful for these symptoms when a new antidepressant is started or when the dose is changed.

            USES: Escitalopram is used to treat depression and anxiety. It works by helping to restore the balance of a certain natural substance (serotonin) in the brain. Escitalopram belongs to a class of drugs known as selective serotonin reuptake inhibitors (SSRI). It may improve your energy level and feelings of well-being and decrease nervousness.

            HOW TO USE: Read the Medication Guide and, if available, the Patient Information Leaflet provided by your pharmacist before you start taking escitalopram and each time you get a refill. If you have any questions, ask your doctor or pharmacist.Take this medication by mouth with or without food as directed by your doctor, usually once daily in the morning or evening. The dosage is based on your medical condition, response to treatment, age, and other medications you may be taking. Be sure to tell your doctor and pharmacist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).If you are using the liquid form of this medication, carefully measure the dose using a special measuring device/spoon. Do not use a household spoon because you may not get the correct dose.To reduce your risk of side effects, your doctor may direct you to start taking this drug at a low dose and gradually increase your dose. Follow your doctor's instructions carefully. Do not increase your dose or use this drug more often or for longer than prescribed. Your condition will not improve any faster, and your risk of side effects will increase. Take this medication regularly to get the most benefit from it. To help you remember, take it at the same time each day.Keep taking this medication even if you feel well. Do not stop taking this medication without consulting your doctor. Some conditions may become worse when this drug is suddenly stopped. Also, you may experience symptoms such as mood swings, headache, tiredness, sleep changes, and brief feelings similar to electric shock. To prevent these symptoms while you are stopping treatment with this drug, your doctor may reduce your dose gradually. Consult your doctor or pharmacist for more details. Report any new or worsening symptoms right away.It may take 1 to 2 weeks to feel a benefit from this drug and 4 weeks to feel the full benefit of this medication. Tell your doctor if your condition does not improve or if it worsens.

            SIDE EFFECTS: See also Warning section.Nausea, dry mouth, trouble sleeping, constipation, tiredness, drowsiness, dizziness, and increased sweating may occur. If any of these effects persist or worsen, tell your doctor promptly.Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: decreased interest in sex, changes in sexual ability, easy bruising/bleeding.Get medical help right away if you have any very serious side effects, including: bloody/black/tarry stools, fainting, fast/irregular heartbeat, vomit that looks like coffee grounds, seizures, eye pain/swelling/redness, widened pupils, vision changes (such as seeing rainbows around lights at night, blurred vision).This medication may increase serotonin and rarely cause a very serious condition called serotonin syndrome/toxicity. The risk increases if you are also taking other drugs that increase serotonin, so tell your doctor or pharmacist of all the drugs you take (see Drug Interactions section). Get medical help right away if you develop some of the following symptoms: fast heartbeat, hallucinations, loss of coordination, severe dizziness, severe nausea/vomiting/diarrhea, twitching muscles, unexplained fever, unusual agitation/restlessness.Rarely, males may have a painful or prolonged erection lasting 4 or more hours. If this occurs, stop using this drug and get medical help right away, or permanent problems could occur.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

            PRECAUTIONS: Before taking escitalopram, tell your doctor or pharmacist if you are allergic to it; or to citalopram; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: personal or family history of bipolar/manic-depressive disorder, personal or family history of suicide attempts, liver disease, seizures, intestinal ulcers/bleeding (peptic ulcer disease) or bleeding problems, low sodium in the blood (hyponatremia), personal or family history of glaucoma (angle-closure type).Escitalopram may cause a condition that affects the heart rhythm (QT prolongation). QT prolongation can rarely cause serious (rarely fatal) fast/irregular heartbeat and other symptoms (such as severe dizziness, fainting) that need medical attention right away.The risk of QT prolongation may be increased if you have certain medical conditions or are taking other drugs that may cause QT prolongation. Before using escitalopram, tell your doctor or pharmacist of all the drugs you take and if you have any of the following conditions: certain heart problems (heart failure, slow heartbeat, recent heart attack, QT prolongation in the EKG), family history of certain heart problems (QT prolongation in the EKG, sudden cardiac death).Low levels of potassium or magnesium in the blood may also increase your risk of QT prolongation. This risk may increase if you use certain drugs (such as diuretics/"water pills") or if you have conditions such as severe sweating, diarrhea, or vomiting. Talk to your doctor about using escitalopram safely.This drug may make you dizzy or drowsy. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Avoid alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).The liquid form of this medication may contain sugar and/or aspartame. Caution is advised if you have diabetes, phenylketonuria (PKU), or any other condition that requires you to limit/avoid these substances in your diet. Ask your doctor or pharmacist about using this medication safely.Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).Older adults may be more sensitive to the side effects of this drug, such as QT prolongation (see above), loss of coordination, or bleeding. They may also be more likely to lose too much salt (hyponatremia), especially if they are also taking "water pills" (diuretics) with this medication. Loss of coordination can increase the risk of falling.Children may be more sensitive to the side effects of this drug, especially loss of appetite and weight loss. Monitor weight and height in children who are taking this drug.During pregnancy, this medication should be used only when clearly needed. It may harm an unborn baby. Also, babies born to mothers who have used this drug during the last 3 months of pregnancy may rarely develop withdrawal symptoms such as feeding/breathing difficulties, seizures, muscle stiffness, or constant crying. If you notice any of these symptoms in your newborn, tell the doctor promptly.Since untreated mental/mood problems (such as depression, anxiety, obsessive-compulsive disorder, panic disorder) can be a serious condition, do not stop using this medication unless directed by your doctor. If you are planning pregnancy, become pregnant, or think you may be pregnant, immediately discuss with your doctor the benefits and risks of using this medication during pregnancy.This medication passes into breast milk and may have undesirable effects on a nursing infant. Consult your doctor before breast-feeding.

            DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this drug include: other drugs that can cause bleeding/bruising (including antiplatelet drugs such as clopidogrel, NSAIDs such as ibuprofen, "blood thinners" such as warfarin).Aspirin can increase the risk of bleeding when used with this medication. However, if your doctor has directed you to take low-dose aspirin for heart attack or stroke prevention (usually 81-162 milligrams a day), you should continue taking it unless your doctor instructs you otherwise. Ask your doctor or pharmacist for more details.Taking MAO inhibitors with this medication may cause a serious (possibly fatal) drug interaction. Avoid taking MAO inhibitors (isocarboxazid, linezolid, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, safinamide, selegiline, tranylcypromine) during treatment with this medication. Most MAO inhibitors should also not be taken for two weeks before and after treatment with this medication. Ask your doctor when to start or stop taking this medication.The risk of serotonin syndrome/toxicity increases if you are also taking other drugs that increase serotonin. Examples include street drugs such as MDMA/"ecstasy," St. John's wort, certain antidepressants (including other SSRIs such as fluoxetine/paroxetine, SNRIs such as duloxetine/venlafaxine), tryptophan, among others. The risk of serotonin syndrome/toxicity may be more likely when you start or increase the dose of these drugs.Tell your doctor or pharmacist if you are taking other products that cause drowsiness including alcohol, marijuana (cannabis), antihistamines (such as cetirizine, diphenhydramine), drugs for sleep or anxiety (such as alprazolam, diazepam, zolpidem), muscle relaxants, and opioid pain relievers (such as codeine).Check the labels on all your medicines (such as allergy, pain/fever reducers, or cough-and-cold products) because they may contain ingredients that cause drowsiness or increase the risk of bleeding. Ask your pharmacist about using those products safely.Many drugs besides escitalopram may affect the heart rhythm (QT prolongation), including amiodarone, pimozide, procainamide, quinidine, sotalol, among others.Escitalopram is very similar to citalopram. Do not use medications containing citalopram while using escitalopram.This medication may interfere with certain medical/laboratory tests (including brain scan for Parkinson's disease), possibly causing false test results. Make sure laboratory personnel and all your doctors know you use this drug.

            OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.

            NOTES: Do not share this medication with others.Keep all regular medical and psychiatric appointments.

            MISSED DOSE: If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

            STORAGE: Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

            Information last revised March 2021. Copyright(c) 2021 First Databank, Inc.

            IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

            Previous
            Next:

            Formulary

            FormularyPatient Discounts

            Adding plans allows you to compare formulary status to other drugs in the same class.

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

            Adding plans allows you to:

            • View the formulary and any restrictions for each plan.
            • Manage and view all your plans together – even plans in different states.
            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
            Additional Offers
            Email to Patient

            From:

            To:

            The recipient will receive more details and instructions to access this offer.

            By clicking send, you acknowledge that you have permission to email the recipient with this information.

            Email Forms to Patient

            From:

            To:

            The recipient will receive more details and instructions to access this offer.

            By clicking send, you acknowledge that you have permission to email the recipient with this information.

            Previous
            Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.