Warnings
SUICIDALITY AND ANTIDEPRESSANT DRUGS
Escitalopram and other antidepressant medicines may increase suicidal thoughts or actions, especially in some people 24 years of age and younger within the first few months of treatment or when the dose is changed. If you are experiencing a mental health crisis, please call or text 988 to be connected with help, or go to your nearest hospital emergency department. Pay particular attention to such changes when escitalopram is started or when the dose is changed.
Patients, their families, and caregivers should be alert to the emergence of anxiety, restlessness, irritability, aggressiveness and insomnia. If these symptoms emerge, they should be reported to the patient’s prescriber or healthcare professional. All patients being treated with antidepressants for any indication should watch for and notify their healthcare provider for worsening symptoms, suicidality and unusual changes in behavior, especially during the first few months of treatment.
IMPORTANT SAFETY INFORMATION
Do not take escitalopram if you:
Are allergic to escitalopram, or any of the ingredients in escitalopram
Take any medication for Parkinson’s Disease or depression called monoamine oxidase inhibitors (MAOI), or if you have stopped taking an MAOI in the last 14 days as they may cause a dangerous increase in blood pressure. MAOIs include, but are not limited to: isocarboxazid, phenelzine, rasagiline, selegiline, tranylcypromine
Take St John’s Wort or 5-Hydroxytryptophan (5-HTP)
Also take pimozide (Orap) or citalopram (Celexa)
Are drinking large amounts of alcohol
Are using or abusing recreation drugs or prescription medications
Before you take escitalopram, tell your healthcare provider if you:
Have thoughts of suicide or harming yourself
Have a history of psychiatric or medical problems, including bipolar disorder
Have taken any medication in the past for your condition, whether effective or not
Have suffered adverse or side effects from previous medication therapies
Drink alcohol or use/abuse recreational or prescription drugs
Are pregnant, plan to become pregnant, or are breastfeeding
Inform your healthcare provider
Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, herbal supplements, and recreational drugs.
Escitalopram may affect the way other medicines work, and other medicines may affect the way escitalopram works, causing side effects. Especially tell your healthcare provider if you take any of the following:
Aspirin or nonsteroidal anti-inflammatory drugs (e.g. ibuprofen, naproxen, celecoxib, diclofenac)
Warfarin or other anticoagulants
Any other serotonergic medications including: trazodone, migraine medications (triptans), pain medications (tramadol), antibiotic linezolid, amphetamines
Escitalopram may increase the risk of bleeding when taking blood thinners or nonsteroidal anti-inflammatory drugs (NSAIDs). If you are currently taking blood thinners or NSAIDs, we strongly recommend that you inform your primary care provider that you have started taking this mental health medication and be sure to report any signs of abnormal bleeding to your provider, such as bleeding gums, unexplained bruising, or black, tarry stools.
Medication disposal
If you no longer need your medication, the best way to dispose of most types of old, unused, unwanted, or expired medicines (both prescription and over the counter) is to drop off the medicine at a drug take back site, location, or program immediately. You can use the DEA DIVERSION CONTROL DIVISION LOOKUP to find your nearest drug disposal site.
If no drug take back sites, locations, or programs are available in your area, and there are no specific disposal instructions (such as flushing) in the medication guide or package insert, you can visit FDA- Disposal of Unused Medicines for more information or follow these simple steps to dispose of most medicines in your trash at home:
Mix medicines (liquid or pills; do not crush tablets or capsules) with an unappealing substance such as dirt, cat litter, or used coffee grounds;
Place the mixture in a container such as a sealed plastic bag;
Throw away the container in your trash at home; and
Delete all personal information on the prescription label of empty medicine bottles or medicine packaging, then trash or recycle the empty bottle or packaging.
