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Prilect

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Document: Prilect film-coated tablet ENG PL change

Package leaflet: Information for the user


Prilect 5 mg film-coatedtablets

Prilect 10 mg film-coatedtablets

Prilect 15 mg film-coatedtablets

Prilect 20 mg film-coatedtablets

escitalopram


Read all of this leaflet carefully before you start taking this medicine because it contains important information for you


  • Keep this leaflet. You may need to read it again.

  • If you have any further questions, ask your doctor or pharmacist.

  • This medicine has been prescribed for you only. Do not pass it on to others. It may harm them, even if their signs of illness are the same as yours.

  • If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. See section 4.



What is in this leaflet:


1. What Prilect is and what it is used for

2. What you need to know before you take Prilect

3. How to take Prilect

4. Possible side effects

5. How to store Prilect

6. Contents of the pack and other information


1. What Prilect is and what it is used for


Prilect contains the active substance escitalopram. Prilect belongs to a group of antidepressants called selective serotonin reuptake inhibitors (SSRIs). These medicines act on the serotonin-system in the brain by increasing the serotonin level. Disturbances in the serotonin-system are considered an important factor in the development of depression and related diseases.


Prilect contains escitalopram and is used to treat depression (major depressive episodes) and anxiety disorders (such as panic disorder with or without agoraphobia, social anxiety disorder, generalised anxiety disorder and obsessive-compulsive disorder).


It may take a couple of weeks before you start to feel better. Continue to take Prilect even if it takes some time before you feel any improvement in your condition.


You must talk to a doctor if you do not feel better or if you feel worse.


2. What you need to know before you take Prilect


Do not take Prilect



Warnings and precautions


Talk to your doctor or pharmacist before taking Prilect. Please tell your doctor if you have any other condition or illness, as your doctor may need to take this into consideration. In particular, tell your doctor:


Please note

Some patients with manic-depressive illness may enter into a manic phase. This is characterized by unusual and rapidly changing ideas, inappropriate happiness and excessive physical activity. If you experience this, contact your doctor.


Symptoms such as restlessness or difficulty to sit or stand still can also occur during the first weeks of the treatment. Tell your doctor immediately if you experience these symptoms.


Thoughts of suicide and worsening of your depression or anxiety disorder

If you are depressed and/or have anxiety disorders you can sometimes have thoughts of harming or killing yourself. These may be increased when first starting antidepressants, since these medicines all take time to work, usually about two weeks but sometimes longer.

You may be more likely to think like this:

If youhave thoughts of harming or killing yourself at any time, contact your doctor or go to a hospital straight away.

You may find it helpful to tell a relative or close friendthat you are depressed or havean anxiety disorder, and ask them to read this leaflet. You might ask them to tell you if they think your depression or anxiety is getting worse, or if they are worried about changes in your behaviour.


Children and adolescents

Prilect should normally not be used for children and adolescents under 18 years. Also, you should know that patients under 18 have an increased risk of side effects such as suicide attempts, suicidal thoughts and hostility (predominately aggression, oppositional behaviour and anger) when they take this class of medicines. Despite this, your doctor may prescribe Prilect for patients under 18 because he/she decides that this is in their best interest. If your doctor has prescribed Prilect for a patient under 18 and you want to discuss this, please go back to your doctor. You should inform your doctor if any symptoms listed above develop or worsen when patients under 18 are taking Prilect. Also, the long term safety effects concerning growth, maturation and cognitive and behavioural development of Prilect in this age group have not yet been demonstrated.


Other medicines and Prilect


Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines.


Tell your doctor if you are taking any of the following medicines:



Do not take Prilect if you take medicines for heart rhythm problems or medicines that may affect the heart’s rhythm, such as Class IA and III antiarrhythmics, antipsychotics (e.g. phenothiazine derivatives, pimozide, haloperidol), tricyclic antidepressants, certain antimicrobial agents (e.g. sparfloxacin, moxifloxacin, erythromycin IV, pentamidine, anti-malarian treatment particularly halofantrine), certain antihistamines (astemizole, mizolastine). If you have any further questions about this you should speak to your doctor.


Prilect with food, drink and alcohol


Prilect can be taken with or without food (see section 3 “How to take Prilect”).


As with many medicines, combining Prilect with alcohol is not advisable, although Prilect is not expected to interact with alcohol.


Pregnancy, breast-feeding and fertility


Inform your doctor if you are pregnant or planning to become pregnant. Do not take Prilect if you are pregnant or breast-feeding, unless you and your doctor have discussed the risks and benefits involved.


If you take Prilect during the last 3 months of your pregnancy you should be aware that the following effects may be seen in your newborn baby: trouble with breathing, bluish skin, fits, body temperature changes, feeding difficulties, vomiting, low blood sugar, stiff or floppy muscles, vivid reflexes, tremor, jitteriness, irritability, lethargy, constant crying, sleepiness and sleeping difficulties. If your newborn baby has any of these symptoms, please contact your doctor immediately.


Make sure your midwife and/or doctor know you are on Entact. When taken during pregnancy, particularly in the last 3 months of pregnancy, medicines like Entact may increase the risk of a serious condition in babies, called persistent pulmonary hypertension of the newborn (PPHN), making the baby breathe faster and appear bluish. These symptoms usually begin during the first 24 hours after the baby is born. If this happens to your baby you should contact your midwife and/or doctor immediately.


If used during pregnancy Prilect should never be stopped abruptly.


It is expected that Prilect will be excreted into breast milk.


Citalopram, a medicine like escitalopram, has been shown to reduce the quality of sperm in animal studies. Theoretically, this could affect fertility, but impact on human fertility has not been observed as yet.


Driving and using machines


You are advised not to drive a car or operate machinery until you know how Prilect affects you.


3. How to take Prilect


Always take this medicine exactly as your doctor has told you. Check with your doctor or pharmacist if you are not sure.


Adults

Depression

The normally recommended dose of Prilect is 10 mg taken as one daily dose. The dose may be increased by your doctor to a maximum of 20 mg per day.


Panic disorder

The starting dose of Prilect is 5 mg as one daily dose for the first week before increasing the dose to 10 mg per day.The dose may be further increased by your doctor to a maximum of 20 mg per day.


Social anxiety disorder

The normally recommended dose of Prilect is 10 mg taken as one daily dose. Your doctor can either decrease your dose to 5 mg per day or increase the dose to a maximum of 20 mg per day, depending on how you respond to the medicine.


Generalised anxiety disorder

The normally recommended dose of Prilect is 10 mg taken as one daily dose. The dose may be increased by your doctor to a maximum of 20 mg per day.


Obsessive-compulsive disorder

The normally recommended dose of Prilect is 10 mg taken as one daily dose. The dose may be increased by your doctor to a maximum of 20 mg per day.


Elderly patients (above 65 years of age)

The recommended starting dose of Prilect is 5 mg taken as one daily dose. The dose may be increased by your doctor to 10 mg per day.


Children and adolescents

Prilect should not normally be given to children and adolescents. For further information please see section 2 “What you need to know before you take Prilect”.


You can take Prilect with or without food. Swallow the tablet with some water. Do not chew them, as the taste is bitter.


If necessary, you can divide the tablets by firstly placing the tablet on a flat surface with the score facing upwards. The tablets may then be broken by pressing down on each end of the tablet, using both forefingers as shown in the drawing.



Duration of treatment


It may take a couple of weeks before you start to feel better. Continue to take Prilect even if it takes some time before you feel any improvement in your condition.


Do not change the dose of your medicine without talking to your doctor first.


Continue to take Prilect for as long as your doctor recommends. If you stop your treatment too soon, your symptoms may return. It is recommended that treatment should be continued for at least 6 months after you feel well again.


If you take more Prilect than you should


If you take more than the prescribed dose of Prilect, contact your doctor or nearest hospital emergency department immediately.Do this even if there are no signs of discomfort. Some of the signs of an overdose could bedizziness, tremor, agitation, convulsion, coma, nausea, vomiting, change in heart rhythm, decreased blood pressure and change in body fluid/salt balance. Take the Prilect box/container with you when you go to the doctor or hospital.


If you forget to take Prilect


Do not take a double dose to make up for forgotten doses. If you do forget to take a dose, and you remember before you go to bed, take it straight away. Carry on as usual the next day. If you only remember during the night, or the next day, leave out the missed dose and carry on as usual.


If you stop taking Prilect


Do not stop taking Prilect until your doctor tells you to do so. When you have completed your course of treatment, it is generally advised that the dose of Prilect is gradually reduced over a number of weeks.


When you stop taking Prilect, especially if it is abruptly, you may feel discontinuation symptoms. These are common when treatment with Prilect is stopped. The risk is higher, when Prilect has been used for a long time or in high doses or when the dose is reduced too quickly. Most people find that the symptoms are mild and go away on their own within two weeks. However, in some patients they may be severe in intensity or they may be prolonged (2-3 months or more). If you get severe discontinuation symptoms when you stop taking Prilect, please contact your doctor. He or she may ask you to start taking your tablets again and come off them more slowly.


Discontinuation symptoms include: Feeling dizzy (unsteady or off-balance), feelings like pins and needles, burning sensations and (less commonly) electric shock sensations, including in the head, sleep disturbances (vivid dreams, nightmares, inability to sleep), feeling anxious, headaches, feeling sick (nausea), sweating (including night sweats), feeling restless or agitated, tremor (shakiness), feeling confused or disorientated, feeling emotional or irritable, diarrhoea (loose stools), visual disturbances, fluttering or pounding heartbeat (palpitations).


If you have any further questions on the use of this product, ask your doctor or pharmacist.


4. Possible side effects



Like all medicines, this medicine can cause side effects, although not everybody gets them.


The side effects usually disappear after a few weeks of treatment. Please be aware that many of the effects may also be symptoms of your illness and therefore will improve when you start to get better.


If you experience any of the following symptoms you should contact your doctor or go to the hospital straight away:


Uncommon (may affect up to 1 in 100 people):

Unusual bleeds, including gastrointestinal bleeds


Rare (may affect up to 1 in 1,000 people):


Not known (frequency cannot be estimated from the available data):

Difficulties urinating


In addition to above the following side effects have been reported:


Very common (may affect more than 1 in 10 people):


Common (may affect up to 1 in 10 people):


Uncommon (may affect up to 1 in 100 people):


Rare (may affect up to 1 in 1,000 people):


Not known (frequency cannot be estimated from the available data):


In addition, a number of side effects are known to occur with drugs that work in a similar way to escitalopram (the active ingredient of Prilect). These are:


Reporting of side effects

If you get any side effects, talk to your doctor or pharmacist.This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the national reporting system (to be completed nationally). By reporting side effects you can help provide more information on the safety of this medicine.


5. How to store Prilect


Keep this medicine out of the sight and reach of children.


Do not use this medicine after the expiry date, which is stated on the label or carton after EXP. The expiry date refers to the last day of that month.


This medicine does not require any special storage conditions.


Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.


6. Contents of the pack and other information


What Prilect contains


The active substance is escitalopram. Each Prilecttablet contains 5 mg, 10 mg, 15 mg or 20 mg escitalopram (as oxalate).


The other ingredients are:

Core: microcrystalline cellulose, colloidal anhydrous silica, talc, croscarmellose sodium and magnesium stearate.

Coating: hypromellose, macrogol 400 and titanium dioxide (E 171).


What Prilect looks like and contents of the pack


Prilect is presented as 5 mg, 10 mg, 15 mg and 20 mg film-coated tablets. The tablets are described below.


5 mg: Round, white biconvex film-coated tablets marked with “EK” on one side.


10 mg: Oval, white film-coated tablets. The tablets are scored and marked with “E” and “L” on each side of the score on one side of the tablet.


15 mg: Oval, white film-coated tablets. The tablets are scored and marked with “E” and “M” on each side of the score on one side of the tablet.


20 mg: Oval, white film-coated tablets. The tablets are scored and marked with “E” and “N” on each side of the score on one side of the tablet.


Prilect is available in the following pack sizes:


Blister (transparent) in cardboard box

5, 10, 15 and 20 mg : 14, 28, 56 and 98 tablets


Blisters (white) in cardboard box

5, 10, 15 and 20 mg: 14, 20, 28, 50, 100 and 200 tablets


Polypropylene container

15 and 20 mg: 100 tablets

5 and 10 mg: 100 and 200 tablets


Unit dose:

5, 10, 15 and 20 mg: 49x1, 56x1, 98x1, 100x1 and 500x1 tablets


Not all pack sizes may be marketed.


Marketing Authorisation Holder and Manufacturer


To be completed nationally


This medicinal product is authorised in the Member States of the EEA under the following names:


Italy:

Entact

Spain:

Esertia

Sweden:

Prilect


This leaflet was last revised in:

5 September 2013 To be completed nationally

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