Escitalopram is the most selective SSRI, used for depression and generalised anxiety disorder.
Also known as: escitalopram, lexapro, cipralex
Most selective SSRI (active enantiomer of citalopram).
Extremely selective SERT inhibition. No significant activity on other transporters.
Complete oral absorption. Bioavailability: 80%. Peak: 1-4 h.
Metabolised by CYP2C19 and CYP3A4. No active metabolites.
27-32 h.
Selective SSRI + CYP inhibitor: escitalopram levels may increase.
Escitalopram is metabolised by CYP2C19 and CYP3A4. Ritonavir inhibits CYP3A4 and CYP2C19. Co-administration may increase escitalopram levels 1.5-2-fold. The risk of serotonin syndrome is moderate. Monitor for serotonergic signs (agitation, tremor, diaphoresis). Reduce escitalopram dose by 50% if necessary. Alternative: citalopram (metabolised by CYP3A4, less susceptible to ritonavir).
SSRI + CYP inhibitor: ritonavir may increase escitalopram levels. Risk of serotonin syndrome.
Escitalopram is metabolised by CYP2C19 and CYP3A4. Ritonavir inhibits these pathways, increasing escitalopram levels.
Serotonergic signs.
Serotonin syndrome.
Monitor for serotonergic signs. Consider reducing dose by 25-50%.
DailyMed/FDA
No documented food or drink interactions.
No documented disease interactions.
No documented pregnancy or breastfeeding information.
Clinical and educational support tool. The information does not replace a medical prescription or the opinion of a qualified healthcare professional.
Medicines from the same therapeutic group (ATC classification) or the same pharmacological class.
