Leitura clínica
Comentário
Antidepressivo ISRS com ações e usos similares aos da fluoxetina. Enantiômero S do Citalopram com farmacocinética similar. Administração oral em uma dose diária. É excretado no leite materno em pequena quantidade (Weisskopf 2020 y 2017, Delaney 2018, Hackett 2006, Rampono 2006, Castberg 2006) e os níveis no plasma dos lactentes cujas mães o tomam são indetectáveis ou muito baixos (Delaney 2018, Rampono 2006) . Majoritariamente, não foram observados problemas a curto nem a longo prazo em lactentes cujas mães o tomavam (Hackett 2006, Gentile 2006, Rampono 2006, Castberg 2006) . Há algum caso isolado de irritabilidade ou sonolência (Kronenfeld 2018) , enterocolite necrosante neonatal (Potts 2007) ou convulsão (Neuman 2014) após exposição intrauterina e/ou com polimedicação, que contrastam com a inocuidade descrita no restante das publicações. Pode ocorrer galactorreia associada ou não a hiperprolactinemia. (McGrane 2019, Pathania 2018, Suthar 2018, Kaba 2017, Shim 2009, Gulsun 2007) Diversas sociedades médicas e consensos de especialistas consideram seguro o uso desta medicação durante a amamentação. (Hale, Lactmed, Uguz 2021, Weisskopf 2020, Davanzo 2014 y 2011, Rowe 2013, Bellantuono 2013 y 2012, Berle 2011, Amir 2011) Podem ser preferíveis alternativas conhecidas mais seguras durante a amamentação, especialmente durante o período neonatal e em caso de prematuridade. (Orsolini 2015, Sriraman 2015, Patil 2011) As mulheres com depressão durante a gravidez precisam de mais apoio à amamentação por terem maior risco de problemas e interrupção precoce da amamentação. (Grzeskowiak 2018, Leggett 2017, Venkatesh 2017, Gorman 2012) Você pode consultar abaixo as informações deste produto relacionado: Depressão Materna (Produto seguro e/ou a amamentação é a melhor opção.)
Encontrabilidade
Outros nomes e marcas
Sinônimos e grafias 5
- Oxalato de escitalopram
- Εσκιταλοπράμη οξαλική
- Эсциталопрама Оксалат
- エスシタロプラムシュウ
- N06AB10
Marcas comerciais na fonte 62
- Aramix
- Axiomat
- Beaplen
- Celtium
- Cipralex
- Cipralex (Ципралекс)
- Citalax
- Citraz
- Coverfax
- E-Psiconor
- Ecitalex
- Ectiban
- Entact
- Escilan
- Escimylan
- Esciprox
- Esciterokam
- Esertia
- Esipral
- Esipram
- Esitalo
- Esopram (Эзопрам)
- Espran
- Essobel (Эссобел)
- Ex3
- Exodus
- Heipram
- Ipran
- Jovia
- Lexam
- Lexamil
- Lexapro
- Lexapro (来士普)
- Lextor
- Lideropram
- Loxalate
- Meridian (Argentina)
- Mylopram
- Neopresol
- Neozentius
- Nexipram
- Novo Humorap
- Optiser
- Premalex
- Rasec
- Reconter
- Reposil
- Restaural
- Sades
- Scipral
- Selective
- Selectra (Селектра)
- Seroplex
- Sipralexa
- Solatcit
- Tacipram
- Talogen
- Talomam
- Talpram
- Ticofarma
- Zenvas
- Zytomil
Dados da fonte
Farmacocinética
| Variável | Valor | Unidade |
|---|---|---|
| Biodisp. oral | 80 | % |
| Peso Molecular | 414 | daltons |
| Unión proteínas | 56 | % |
| Vd | 12 - 26 | l/Kg |
| pKa | 9,8 | - |
| Tmax | 4 - 5 | horas |
| T½ | 30 | horas |
| Índice L/P | 1,7 - 2,5 | - |
| Dosis Teórica | 0,004 - 0,01 | mg/Kg/d |
| Dosis Relativa | 1,7 - 9 | % |
Rastreabilidade
Bibliografia
- LactMed. Drugs and Lactation Database (LactMed). Internet. Bethesda (MD): National Library of Medicine (US); 2006-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK501922/ 2006 - Consultado el 16 de Abril de 2024 Texto completo (enlace a fuente original)
- Hale TW. Medications & Mothers' Milk. 1991- . Springer Publishing Company. Available from https://www.halesmeds.com Consultado el 10 de Abril de 2024 Texto completo (enlace a fuente original)
- Uguz F. A New Safety Scoring System for the Use of Psychotropic Drugs During Lactation. Am J Ther. 2021 Jan-Feb 01;28(1):e118-e126. Resumen
- Weisskopf E, Guidi M, Fischer CJ, Bickle Graz M, Beaufils E, Nguyen KA, Morisod Harari M, Rouiller S, Rothenburger S, Gaucherand P, Kassai-Koupai B, Borradori Tolsa C, Epiney M, Tolsa JF, Vial Y, Hascoët JM, Claris O, Eap CB, Panchaud A, Csajka C. A population pharmacokinetic model for escitalopram and its major metabolite in depressive patients during the perinatal period: Prediction of infant drug exposure through breast milk. Br J Clin Pharmacol. 2020 Aug;86(8):1642-1653. Resumen
- McGrane IR, Morefield CM, Aytes KL. Probable Galactorrhea Associated with Sequential Trials of Escitalopram and Duloxetine in an Adolescent Female. J Child Adolesc Psychopharmacol. 2019 Dec;29(10):788-789. Resumen
- Suthar N, Pareek V, Nebhinani N, Suman DK. Galactorrhea with antidepressants: A case series. Indian J Psychiatry. 2018 Jan-Mar;60(1):145-146. Resumen
- Pathania M, Goel B, Dhamija P, Kant R, Dhar M, Mittal S. A rare adverse drug reaction to escitalopram. J Family Med Prim Care. 2018 Mar-Apr;7(2):466-467. Resumen
- Kronenfeld N, Ziv Baran T, Berlin M, Karra N, Dinavitser N, Cohen R, Wiener Y, Schwartzberg E, Berkovitch M. Chronic use of psychotropic medications in breastfeeding women: Is it safe? PLoS One. 2018 May 21;13(5):e0197196. Resumen
- Delaney SR, Malik PRV, Stefan C, Edginton AN, Colantonio DA, Ito S. Predicting Escitalopram Exposure to Breastfeeding Infants: Integrating Analytical and In Silico Techniques. Clin Pharmacokinet. 2018 Dec;57(12):1603-1611. Resumen
- Grzeskowiak LE, Leggett C, Costi L, Roberts CT, Amir LH. Impact of serotonin reuptake inhibitor use on breast milk supply in mothers of preterm infants: a retrospective cohort study. Br J Clin Pharmacol. 2018 Jun;84(6):1373-1379. Resumen Texto completo (enlace a fuente original)
- Kaba D, Öner Ö. Galactorrhea After Selective Serotonin Reuptake Inhibitor Use in an Adolescent Girl: A Case Report. J Clin Psychopharmacol. 2017 Jun;37(3):374-376. Resumen
- Weisskopf E, Panchaud A, Nguyen KA, Grosjean D, Hascoët JM, Csajka C, Eap CB, Ansermot N; collaborators of the SSRI-Breast Milk study.. Simultaneous determination of selective serotonin reuptake inhibitors and their main metabolites in human breast milk by liquid chromatography-electrospray mass spectrometry. J Chromatogr B Analyt Technol Biomed Life Sci. 2017 Jul 1;1057:101-109. Resumen
- Venkatesh KK, Castro VM, Perlis RH, Kaimal AJ. Impact of antidepressant treatment during pregnancy on obstetric outcomes among women previously treated for depression: an observational cohort study. J Perinatol. 2017 Sep;37(9):1003-1009. Resumen
- Leggett C, Costi L, Morrison JL, Clifton VL, Grzeskowiak LE. Antidepressant Use in Late Gestation and Breastfeeding Rates at Discharge from Hospital. J Hum Lact. 2017 Nov;33(4):701-709. Resumen
- Orsolini L, Bellantuono C. Serotonin reuptake inhibitors and breastfeeding: a systematic review. Hum Psychopharmacol. 2015 Jan;30(1):4-20. Resumen
- Sriraman NK, Melvin K, Meltzer-Brody S. ABM Clinical Protocol #18: Use of Antidepressants in Breastfeeding Mothers. Breastfeed Med. 2015 Resumen Texto completo (enlace a fuente original) Texto completo (en nuestros servidores)
- Davanzo R, Bua J, Paloni G, Facchina G. Breastfeeding and migraine drugs. Eur J Clin Pharmacol. 2014 Resumen
- Neuman G, Colantonio D, Delaney S, Szynkaruk M, Ito S. Bupropion and Escitalopram During Lactation. Ann Pharmacother. 2014 Resumen
- Bellantuono C, Orsolini L, Bozzi F. [The safety profile of escitalopram in pregnancy and breastfeeding]. Riv Psichiatr. 2013 Resumen
- Bellantuono C, Bozzi F, Orsolini L. Safety of escitalopram in pregnancy: a case series. Neuropsychiatr Dis Treat. 2013 Resumen Texto completo (enlace a fuente original) Texto completo (en nuestros servidores)
- Rowe H, Baker T, Hale TW. Maternal medication, drug use, and breastfeeding. Pediatr Clin North Am. 2013 Feb;60(1):275-94. Resumen
- Bellantuono C, Bozzi F, Orsolini L, Catena-Dell'Osso M. The safety of escitalopram during pregnancy and breastfeeding: a comprehensive review. Hum Psychopharmacol. 2012 Resumen
- Gorman JR, Kao K, Chambers CD. Breastfeeding among women exposed to antidepressants during pregnancy. J Hum Lact. 2012 Resumen
- Patil AS, Kuller JA, Rhee EH. Antidepressants in pregnancy: a review of commonly prescribed medications. Obstet Gynecol Surv. 2011 Resumen
- Berle JO, Spigset O. Antidepressant Use During Breastfeeding. Curr Womens Health Rev. 2011 Resumen Texto completo (enlace a fuente original) Texto completo (en nuestros servidores)
- Davanzo R, Copertino M, De Cunto A, Minen F, Amaddeo A. Antidepressant drugs and breastfeeding: a review of the literature. Breastfeed Med. 2011 Resumen
- Amir LH, Pirotta MV, Raval M. Breastfeeding--evidence based guidelines for the use of medicines. Aust Fam Physician. 2011 Sep;40(9):684-90. Review. Resumen
- Lanza di Scalea T, Wisner KL. Antidepressant medication use during breastfeeding. Clin Obstet Gynecol. 2009 Resumen Texto completo (enlace a fuente original) Texto completo (en nuestros servidores)
- Shim SH, Lee YJ, Lee EC. A case of galactorrhea associated with excitalopram. Psychiatry Investig. 2009 Resumen Texto completo (enlace a fuente original) Texto completo (en nuestros servidores)
- Potts AL, Young KL, Carter BS, Shenai JP. Necrotizing enterocolitis associated with in utero and breast milk exposure to the selective serotonin reuptake inhibitor, escitalopram. J Perinatol. 2007 Resumen Texto completo (enlace a fuente original) Texto completo (en nuestros servidores)
- Gulsun M, Algul A, Semiz UB, Ates MA, Doruk A, Ebrinc S, Basoglu C, Cetin M. A case with euprolactinemic galactorrhea induced by escitalopram. Int J Psychiatry Med. 2007 Resumen
- Hackett LP, Ilett KF, Rampono J, Kristensen JH, Kohan R. Transfer of reboxetine into breastmilk, its plasma concentrations and lack of adverse effects in the breastfed infant. Eur J Clin Pharmacol. 2006 Resumen
- Gentile S. Escitalopram late in pregnancy and while breast-feeding. Ann Pharmacother. 2006 Resumen
- Rampono J, Hackett LP, Kristensen JH, Kohan R, Page-Sharp M, Ilett KF. Transfer of escitalopram and its metabolite demethylescitalopram into breastmilk. Br J Clin Pharmacol. 2006 Resumen Texto completo (enlace a fuente original) Texto completo (en nuestros servidores)
- Castberg I, Spigset O. Excretion of escitalopram in breast milk. J Clin Psychopharmacol. 2006 Resumen