Placida PLUS Overdose

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Consists of escitalopram, etizolam

What happens if I overdose Escitalopram (Placida PLUS)?

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately.

Proper storage of Escitalopram (Placida PLUS):

Store Escitalopram (Placida PLUS) at room temperature, between 59 and 86 degrees F (15 and 30 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep Escitalopram (Placida PLUS) out of the reach of children and away from pets.

Overdose of Escitalopram (Placida PLUS) in details

When a dose is taken in higher dose than the recommended doses, it is called Overdose. Overdose always needs a clinical supervision. Any medicine or drug when consumed in Overdose produces untoward side effects on one or various organs in the body. A medicine is excreted in the kidney or metabolized in the liver most of the times. This process goes without any hurdles when taken in normal dose, but when taken in an overdose, the body is not able to metabolize it or send it out properly which causes the effects of anoverdose.
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There have been 3 reports of Escitalopram (Placida PLUS) overdose including doses of up to 600 mg. All the 3 patients recovered and no symptoms associated with the overdoses were reported. Also in clinical trials of racemic citalopram, there were no reports of fatal citalopram overdose involving overdoses of up to 2000 mg.

Symptoms of overdose with racemic citalopram are dizziness, tremor, agitation, somnolence, unconsciousness, seizures, tachycardia, changes in the ECG with ST-T changes, broadening of the QRS complex, prolonged QT interval, arrhythmias, respiratory depression, sweating, nausea, tremor, amnesia, confusion, coma, hyperventilation, cyanosis, vomiting, rhabdomyolysis, metabolic acidosis, hypokalaemia. It is anticipated that overdoses with Escitalopram (Placida PLUS) would result in similar symptoms.

There is no specific antidote. Gastric lavage should be carried out as soon as possible after oral ingestion. Establish and maintain an airway, ensure adequate oxygenation and respiratory function. Cardiac and vital signs monitoring are recommended along with general symptomatic supportive measures.

What should I avoid while taking Escitalopram (Placida PLUS)?

Avoid taking tryptophan while you are taking Escitalopram (Placida PLUS).

Ask your doctor before taking a nonsteroidal anti-inflammatory drug (NSAID) for pain, arthritis, fever, or swelling. This includes aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib (Celebrex), diclofenac, indomethacin, meloxicam, and others. Using an NSAID with Escitalopram (Placida PLUS) may cause you to bruise or bleed easily.

Drinking alcohol can increase certain side effects of Escitalopram (Placida PLUS).

Escitalopram (Placida PLUS) may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Escitalopram (Placida PLUS) warnings

Warnings are a mix of Precautions. Contraindications and interactions and serious harmful effects associated with the medicine intake. A diabetic or Hypertensive patient need to be warned about few drug interactions. A known hypersensitivity patient needs to be careful about the reactions or anaphylactic shock. A pregnant woman or a breastfeeding woman should be warned of certain medications. A Hepatitis [liver disease] patient or a cardiac patient should avoid few drugs.
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With caution Escitalopram (Placida PLUS) Elder Pharmaceuticals should be used in patients with renal insufficiency (creatinine clearance below 30 ml / min), hypomania, mania, pharmacologically uncontrolled epilepsy, depression with suicide attempts, diabetes, in elderly patients, with cirrhosis of the liver, the tendency to bleeding, simultaneously with the admission of drugs that lower the threshold of convulsive readiness, causing hyponatremia, with alcohol, with drugs metabolized with the participation of isoenzymes CYP2C19.

Escitalopram (Placida PLUS) should be prescribed only after 2 weeks after discontinuation of irreversible MAO inhibitors, and 24 h after cessation of treatment reversible inhibitor of MAO.

Non-selective MAO inhibitors may be prescribed no earlier than 7 days after discontinuation of this medication.

Escitalopram (Placida PLUS) Elder Pharmaceuticals should be abolished in the case of epileptic seizures or quickening in pharmacologically uncontrolled epilepsy.

With the development of manic this drug should be abolished.

Escitalopram (Placida PLUS) can increase the concentration of glucose in diabetes, which may require dose adjustment of hypoglycemic medications.

With the development of serotonin syndrome this medicine should be immediately withdrawn and a symptomatic therapy prescribed.

During the treatment, patients should avoid driving vehicles and other activities that require high concentration and speed of psychomotor reactions.

What should I discuss with my healthcare provider before taking Escitalopram (Placida PLUS)?

It is dangerous to try and purchase Escitalopram (Placida PLUS) on the Internet or from vendors outside of the United States. Medications distributed from Internet sales may contain dangerous ingredients, or may not be distributed by a licensed pharmacy. Samples of Escitalopram (Placida PLUS) purchased on the Internet have been found to contain haloperidol (Haldol), a potent antipsychotic drug with dangerous side effects. For more information, contact the U.S. Food and Drug Administration (FDA) or visit www.fda.gov/buyonlineguide.

You should not use this medicine if you are allergic to Escitalopram (Placida PLUS) or citalopram (Celexa), or if:

Do not use Escitalopram (Placida PLUS) if you have taken an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, phenelzine, rasagiline, selegiline, and tranylcypromine. After you stop taking Escitalopram (Placida PLUS), you must wait at least 14 days before you start taking an MAOI.

To make sure Escitalopram (Placida PLUS) is safe for you, tell your doctor if you have:

Some young people have thoughts about suicide when first taking an antidepressant. Your doctor will need to check your progress at regular visits while you are using Escitalopram (Placida PLUS). Your family or other caregivers should also be alert to changes in your mood or symptoms.

FDA pregnancy category C. Taking an SSRI antidepressant during pregnancy may cause serious lung problems or other complications in the baby. However, you may have a relapse of depression if you stop taking your antidepressant. Tell your doctor right away if you become pregnant while taking Escitalopram (Placida PLUS). Do not start or stop taking this medicine during pregnancy without your doctor's advice.

Escitalopram (Placida PLUS) can pass into breast milk and may harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

Escitalopram (Placida PLUS) should not be given to a child younger than 12 years old.

Escitalopram (Placida PLUS) precautions

Certain people who are very sick or very old or who are sensitive show an exacerbation of side effect of the drug which can turn dangerous at times. So, it is very important to remember the precautions while taking the medicine. Pregnancy and Breastfeeding are also special categories wherein extra care or precaution is needed when taking a drug. Few patients may have a hypersensitivity reaction to few medications, and that can be life-threatening rarely. Penicillin hypersensitivity is one example. Diarrhea, rashes are few other symptoms which need a watch. A patient with other co-existing diseases like liver disease, heart disease, kidney disease should take special precautions.
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Concomitant administration of serotonin re-uptake inhibitor with a MAOI, have led to serious, sometimes fatal, reactions including hyperthermia, rigidity, myoclonus, autonomic instability with possible rapid fluctuations of vital signs and mental status changes that include extreme agitation progressing to delirium and coma. These reactions have also been reported in patients who have recently discontinued SSRI treatment and have been started on a MAOI. Some cases presented with features resembling neuroleptic malignant syndrome. Therefore, it is recommended that Escitalopram (Placida PLUS) may be started after 14 days of discontinuing treatment with an irreversible MAOI and at least 1 day after discontinuing treatment with the reversible MAOI moclobemide. Similarly, at least 7 days should elapse after stopping Escitalopram (Placida PLUS) before starting a nonselective MAOI.

Some patients with panic disorder may experience increased anxiety symptoms at the beginning of the treatment with antidepressants. This paradoxical reaction usually subsides within 2 weeks during continued treatment. A low starting dose is advised to reduce the likelihood of an anxiogenic effect.

Selective serotonin re-uptake inhibitors (SSRIs) should be avoided in patients with unstable epilepsy and patients with controlled epilepsy should be monitored. SSRIs should be discontinued if there is an increase in seizure frequency.

Caution is also advised with the use of SSRIs in patients with a history of mania/hypomania. The drug should be discontinued in any patient entering the manic phase.

Close monitoring is advised during the 1st weeks of therapy when the risk of suicide is increased. Caution is advised with the concurrent use of SSRIs and ECT. Treatment with SSRIs may alter glycaemic control in patients with diabetes. The dosage of insulin and/or oral hypoglycaemics may need to be adjusted.

Hyponatraemia has been reported rarely with SSRIs due to inappropriate antidiuretic hormone secretion (SIADH). This generally resolves on discontinuation of therapy but caution is advised in patients at risk eg, elderly, cirrhotic patients or patients concomitantly treated with medications known to cause hyponatraemia.

There have been reports of cutaneous bleeding abnormalities eg, ecchymoses and purpura with SSRIs.

Escitalopram (Placida PLUS) has not been systemically evaluated in patients with recent history of myocardial infarction or unstable heart disease. Caution is advised in patients with diseases or conditions that produce altered metabolism or haemodynamic response.

When stopping therapy, the dose should be gradually reduced over a period of 1 or 2 weeks in order to avoid possible withdrawal reactions.

Effects on the Ability to Drive or Operate Machinery: Because many psychoactive drugs may impair judgment, thinking or motor skills, patients should be cautioned about operating hazardous machinery, including automobiles.

Use in pregnancy & lactation: Rat reproductive studies performed with Escitalopram (Placida PLUS) showed embryo fetotoxic effects but no incidence of malformations. No clinical data are available regarding exposed pregnancies and the risk for humans is unknown. Therefore, Escitalopram (Placida PLUS) should be used during pregnancy only if the potential benefit outweighs the potential risk.

It is expected that Escitalopram (Placida PLUS) will be excreted into human milk, therefore, a decision should be made whether to discontinue nursing or to discontinue Escitalopram (Placida PLUS), taking into account the importance of the drug to the mother.

What happens if I miss a dose of Escitalopram (Placida PLUS)?

When you miss a dose, you should take it as soon as you remember, but you should take care that it should be well spaced from the next dose. You should not take an extra dose at the time of the second dose as it will become a double dose. The double dose can give unwanted side effects, so be careful. In chronic conditions or when you have a serious health issue, if you miss a dose, you should inform your health care provider and ask his suggestion.

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

Etizolam (Placida PLUS) warnings

Warnings are a mix of Precautions. Contraindications and interactions and serious harmful effects associated with the medicine intake. A diabetic or Hypertensive patient need to be warned about few drug interactions. A known hypersensitivity patient needs to be careful about the reactions or anaphylactic shock. A pregnant woman or a breastfeeding woman should be warned of certain medications. A Hepatitis [liver disease] patient or a cardiac patient should avoid few drugs.
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Chronic pulmonary insufficiency, muscle weakness, impaired liver or kidney function, or in patients with history of alcohol or drug addiction. Elderly or debilitated patients. May affect performance of skilled tasks. Patients with personality disorders or organic brain changes. Hypotension occasionally occur with high dosage. Dependence.

Etizolam (Placida PLUS) precautions

Certain people who are very sick or very old or who are sensitive show an exacerbation of side effect of the drug which can turn dangerous at times. So, it is very important to remember the precautions while taking the medicine. Pregnancy and Breastfeeding are also special categories wherein extra care or precaution is needed when taking a drug. Few patients may have a hypersensitivity reaction to few medications, and that can be life-threatening rarely. Penicillin hypersensitivity is one example. Diarrhea, rashes are few other symptoms which need a watch. A patient with other co-existing diseases like liver disease, heart disease, kidney disease should take special precautions.

Chronic pulmonary insufficiency, muscle weakness, impaired liver or kidney function, or in patients with history of alcohol or drug addiction. Elderly or debilitated patients. May affect performance of skilled tasks. Patients with personality disorders or organic brain changes. Hypotension occasionally occur with high dosage. Dependence.

References

  1. DrugBank. "etizolam". http://www.drugbank.ca/drugs/DB09166 (accessed September 17, 2018).
  2. DrugBank. "Escitalopram". http://www.drugbank.ca/drugs/DB01175 (accessed September 17, 2018).
  3. MeSH. "Antidepressive Agents, Second-Generation". https://www.ncbi.nlm.nih.gov/mesh/68... (accessed September 17, 2018).

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Information checked by Dr. Sachin Kumar, MD Pharmacology

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