Nexito 20 mg Tablet

SSRI antidepressant for:

• Major depression
• Generalised anxiety disorder
• Panic disorder (with or without agoraphobia)
• Social anxiety disorder
• Obsessive-compulsive disorder (OCD)

Adults: 10 mg once daily; may be increased to maximum 20 mg daily after at least 1 week.

• Panic disorder: start 5 mg daily for the first week, then 10 mg.

Elderly (over 65) and liver impairment: start 5 mg; maximum 10 mg daily.

Adolescents 12–17 (depression, specialist): 10 mg daily, max 20 mg.

• Take once daily, morning or evening, with or without food.
• Improvement starts in 2–4 weeks; continue for at least 6 months after recovery.
• Do not stop suddenly — reduce over 1–2 weeks or longer.

• Use with MAO inhibitors (or within 14 days), linezolid or methylene blue
• Known QT prolongation or congenital long QT syndrome; use with other QT-prolonging drugs
• Use with pimozide
• Allergy to escitalopram or citalopram

Common: nausea, headache, insomnia or drowsiness, sweating, dizziness, dry mouth, diarrhoea or constipation, loss of appetite, tiredness, sexual problems (reduced libido, delayed ejaculation), yawning, anxiety at the start.

Less common: weight change, bruising, nosebleeds, palpitations.

Rare but serious: suicidal thoughts (especially under 25 years), serotonin syndrome, low sodium (elderly), QT prolongation, bleeding, seizures, mania, angle-closure glaucoma.

• Watch for worsening mood, agitation or suicidal thoughts, especially in the first weeks and after dose changes.
• Epilepsy, bipolar disorder, bleeding disorders, heart disease, diabetes, elderly: caution.
• Check sodium in elderly people if confused or drowsy.
• May affect driving at first; avoid alcohol.

Use in pregnancy only if benefit outweighs risk (small risk of newborn breathing problems and withdrawal; persistent pulmonary hypertension). Passes into milk — specialist decision; sertraline is often preferred while breastfeeding.

• MAO inhibitors, linezolid (contraindicated); tramadol, triptans, other antidepressants, lithium, St John's wort (serotonin syndrome)
• Aspirin, NSAIDs, warfarin, clopidogrel (bleeding)
• QT-prolonging drugs: antipsychotics, macrolides, some antihistamines, amiodarone, methadone
• Omeprazole, esomeprazole, cimetidine, fluconazole (raise levels — lower dose may be needed)
• Alcohol

Drowsiness, dizziness, tremor, nausea, fast heartbeat, seizures, QT prolongation, serotonin syndrome. Emergency care.

Store below 30°C.