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LOSIRAM (ESCITALOPRAM) 20 mg. №28 tablets
LOSIRAM (ESCITALOPRAM) 20 mg. №28 tablets

LOSIRAM (ESCITALOPRAM) 20 mg. №28 tablets

Brand: Bilim Pharmaceuticals
Product Code: losiram
Availability: In Stock
Price: $38.00
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1. What Losiram is and what it is used for:
Losiram contains escitalopram as active substance. Losiram belongs to a group of antidepressants called selective serotonin reuptake inhibitors (SSRIs). These drugs act on the serotonin system in the brain by increasing the serotonin concentration. The disorders of the serotoninergic system are considered an important factor in the setting of depression and related affections.
Losiram contains escitalopram and is used to treat depression (major episodes of depression) and anxiety disorders (such as panic disorder with or without agoraphobia, social anxiety disorder, generalized anxiety disorder, and obsessive-compulsive disorder). It may take several weeks to improve the patient's condition. Continue to take Losiram, even if it takes some time before you feel an improvement in your condition.
In case you do not feel better or if you feel unwell, you should talk to a doctor.
2. Before you take losiram:
Do not take Losiram
- if you are allergic (hypersensitive) to escitalopram or any of the other ingredients of Losiram
- if you take other medicines belonging to a group called MAO inhibitors, including selegiline (used to treat Parkinson's disease), moclobemide (used in the treatment of depression) and linezolid (an antibiotic).
- if you were born with a heart rhythm disorder or if you had an episode of heart rhythm disorder (observed on the ECG, a clinical examination to assess the functional stage of the initiation).
- if you are taking medicines for heart rhythm disorders or that may affect the heart rate (see section 2 "Taking other medicines").
Warnings and precautions:
Please tell your doctor if you have any other clinical or medical condition because the doctor should take this into account. Tell your doctor, in particular:
- if you have epilepsy; treatment with Losiram should be stopped if seizures first occur or if there is an increase in seizure frequency (see also section 4, "Possible Adverse Reactions");
- if you suffer from hepatic or renal impairment; your doctor may need to adjust your dose;
- if you have diabetes; Losiram treatment may affect glucose control; dose adjustment of insulin and / or oral antidiabetic agents may be necessary;
- if you have a decrease in the amount of sodium in the blood
- if you have a tendency to easily manifest bleeding or bruising;
- if you get electroconvulsive treatment;
- if you have coronary heart disease;
- if you suffer or have suffered from heart disease or if you have recently had a heart attack;
- if you have a reduced heart rate at rest and / or you know it can lower salt levels in the blood as a result of prolonged and severe diarrhea or vomiting or diuretic use;
- if you feel rapid or irregular heartbeat, faintness, dizziness in a standing upright posture that may indicate an abnormality in the rhythm of the heart. --- If you have or have previously had eye problems, such as some forms of glaucoma (increased intraocular pressure).
Some patients with manic-depressive illness may enter a phase of mania. It is characterized by unusual and rapidly changing ideas, exaggerated happiness, and excessive physical activity. If you experience such symptoms, talk to your doctor.
Symptoms such as restlessness or difficulty in sitting or standing may also occur in the first few weeks of treatment. Tell your doctor immediately if you have any of these symptoms.
Thoughts of suicide and worsening of your state of depression or anxiety
The depression and / or anxiety disorder you suffer may sometimes lead to self-harm or suicide. These may be increased at the start of treatment with antidepressants because the action of all these drugs occurs over time, usually in about 2 weeks and sometimes even more. You are more inclined towards such ideas:
-If you had previous thoughts of suicide or self-harm.
-If you're a young adult. Information from clinical trials shows that there is an increased risk of suicidal behavior in adults aged less than 25 years who suffer from a mental illness and have been treated with an antidepressant.
If you have any thoughts of self-harm or suicide, no matter what time, contact your doctor immediately or contact a hospital without delay.
It may be helpful to ask a close relative or relative to tell you that you feel depressed or have an anxiety disorder and want to read this leaflet. At the same time, you can ask the person to tell you if they do not believe that your depression or anxiety is aggravated or worries about any change in your behavior.
Use in children and adolescents under 18 years of age:
Losiram should not normally be used in children and adolescents under the age of 18 years. You should also be aware that patients under the age of 18 years are at increased risk for side effects, such as suicidal tendencies, suicidal ideation and hostility (predominantly aggressiveness, oppositional behavior and anger) when using drugs in this class. However, your doctor may prescribe Losiram for patients younger than 18 years of age if he / she decides that this is best for the patients. If your doctor prescribed Losiram for a patient under the age of 18 and you want to talk about it, please go back to your doctor. You should tell your doctor if any of the symptoms listed above appear in a patient under the age of 18 years of age with Losiram. Also, for this age group, long-term safety effects of Losiram on growth, maturation and cognitive and behavioral development have not been demonstrated.
Using with other medicines:
Please tell your doctor or pharmacist if you are taking or have recently taken any other medicines, including medicines obtained without a prescription.
Tell your doctor if you are using any of the following medicines:
- "Non-selective monoamine oxidase inhibitors (MAOIs)" containing phenelzine, iproniazide, isocarboxazide, nialamide or tranylcypromine as active substance. If you have used any of these medicines, you must wait 14 days before taking Losiram. After stopping Losiram, you must allow it to pass 7 days before using any of these medicines.
- "Selective, reversible MAO-A inhibitors" containing moclobemide (used to treat depression).
- "Irreversible MAO-B inhibitors" containing selegiline (used to treat Parkinson's disease). These increase the risk of adverse reactions.
-Antibiotic linezolid.
-Lithium (used in the treatment of manic-depressive disorders) and tryptophan.
Imipramine and desipramine (both used in the treatment of depression).
-Sumatriptan and related medicines (used to treat migraine) and tramadol (used against severe pain). These increase the risk of side effects.
Cimetidine and omeprazole (used in the treatment of gastric ulcer), fluvoxamine (antidepressant) and ticlopidine (used to reduce the risk of stroke). These may lead to an increase in Losiram in the blood.
- Hypericum perforatum - a plant that is used against depressive states.
- Acetylsalicylic acid and non-steroidal anti-inflammatory drugs (medicines used to relieve pain or thinning the blood, so-called anticoagulants). These can increase the tendency to bleed.
-Warfarin, dipyridamole and phenprocoumon (medicines used to thin the blood, so-called anticoagulants). Your doctor will probably check your blood clotting time when it starts or stops Losiram treatment to check if your anticoagulant dose remains appropriate.
-Mefloquine (used in the treatment of malaria), bupropion (used to treat depression) and tramadol (used to treat severe pain) due to the possible risk of contracting the seizure threshold.
-Neuroleptics (medicines for the treatment of schizophrenia, psychosis), due to the possible risk of contracting the seizure and antidepressant threshold.
-Flecainide, propafenone and metoprolol (used in cardiovascular diseases) clomipramine and nortriptyline (antidepressants) and risperidone, thioridazine and haloperidol (antipsychotics). Losiram doses may need to be adjusted.
-Medicines that lower potassium or magnesium levels in the blood as they increase the risk of life-threatening cardiac rhythm disturbances.
Do not take Losiram if you are treated for heart rhythm disorders or heart rhythm disorders such as class IA and III antiarrhythmics, antipsychotics (eg phenothiazine derivatives, pimozide, haloperidol), tricyclic antidepressants, some antimicrobial agents (for example, sparfloxacin, moxifloxacin, iv erythromycin, pentamidine, antimalarials, especially halofantrine), certain antihistamines (astemizole, mizolastine). If you have any further questions on this, you should talk to your doctor.
Taking LOSIRAM with food, drink and alcohol:
Losiram should be taken with or without food (see section 3 "How to take Losiram").
Like many drugs, it is not recommended to take Losiram concomitantly with alcohol, although Losiram is not expected to interact with alcohol.
Fertility, pregnancy and breastfeeding:
Tell your doctor if you are or intend to become pregnant. Do not take Losiram if you are pregnant or breast-feeding unless you have discussed with your doctor the risks and benefits involved.
If you take Losiram during the last 3 months of pregnancy, you should be aware that your newborn may experience the following manifestations: breathing problems, bluish skin, convulsions, changes in body temperature, feeding difficulties, vomiting, low blood sugar levels , muscular rigidity or flaccid muscles, exaggerated reflexes, tremor, nausea, irritability, lethargy, continuous crying, drowsiness, and sleeping difficulties. If your newborn has any of these symptoms, please tell your doctor immediately. Make sure your nurse and / or your doctor know you are using Losiram. When using during the last three months of pregnancy, medicines such as Losiram may increase the risk of a severe disease in newborns, called congenital lung hypertension (HPPN), causing the newborn to breathe more quickly and appear to grow. These symptoms usually occur within the first 24 hours of birth. If this happens to your child, contact your midwife and / or doctor immediately. If you use Losiram during pregnancy, you should never suddenly stop treatment. Losiram is excreted in breast milk.
Studies in animals have shown that citalopram, a drug similar to escitalopram, reduces the quality of sperm. Theoretically, this could affect fertility, but to date, no impact on fertility in humans has been observed.
3. How to take Losiram:
Always take Losiram exactly as your doctor has told you. You should talk to your doctor or pharmacist if you are not sure how to take it.
Grown ups
The usual Losiram recommended dose is 10 mg a day given in a single socket. The dose may be increased by your doctor up to a maximum of 20 mg a day.
Panic disorder
The initial dose of Losiram is 5 mg per day given in a single dose in the first week, before increasing the dose to 10 mg per day. The dose may then be increased by your doctor up to a maximum of 20 mg per day.
Social anxiety disorders
The usual Losiram recommended dose is 10 mg a day given in a single socket. Your doctor may either decrease the dose to 5 mg a day or increase it to a maximum of 20 mg a day depending on how you respond to the medicine.
Generalized anxiety disorders
The usual Losiram recommended dose is 10 mg a day given in a single socket. The dose may be increased by your doctor to a maximum of 20 mg a day.
Obsessive-compulsive disorder
The usual Losiram recommended dose is 10 mg a day given in a single socket. The dose may be increased by your doctor to a maximum of 20 mg a day.
Elderly patients (over 65 years of age)
The usual starting dose for Losiram is 5 mg per day given as a single dose. The dose may be increased by your doctor to 10 mg a day.
Children and adolescents (under 18 years of age)
As a rule, Losiram should not be given to children and adolescents. For more information, please see section 2 "Before you take Losiram".
You can take Losiram with or without food. Swallow the tablet with some water. Do not chew them, that the taste is bitter. If necessary, you can divide the tablets by placing them on a flat surface with the incision facing upwards. The tablet can then be broken by pressing down on each end of the tablet using both thumbs.
Duration of treatment
It may take several weeks before you feel better. Continue to take Losiram even if it takes a while before you feel better about your condition.
Do not change the dose of your medicine without first talking to your doctor.
Continue to take Losiram as long as your doctor has told you. If you stop treatment too early, the symptoms may return. It is recommended that the treatment be continued for at least 6 months after you feel better again.
If you take more Losiram than you should
If you take more Losiram than the prescribed dose, contact your doctor or emergency department of the nearest hospital immediately. Do so even if you do not have any signs of discomfort yet. Some signs of overdosage may be dizziness, tremor, agitation, convulsions, coma, nausea, vomiting, changes in heart rate, decreased blood pressure, and changes in the balance of salts and fluids in your body. When you go to a doctor or hospital, take the Losiram box with you.
If you forget to take Losiram:
Do not take a double dose to make up for a forgotten dose. If you forget to take a dose and remember before going to bed, take it immediately. The next day continue treatment as usual. If you remember when it's night or the next day, stop taking the missed dose and continue treatment as usual.
If you stop taking Losiram Do not stop taking Losiram until your doctor tells you this. When you are finished with the cure, it is generally recommended that Losiram be gradually reduced over a number of weeks. When you stop taking Losiram, especially if you do this suddenly, you may experience symptoms of discontinuation of treatment. These are common when treatment with Losiram is discontinued. The risk is greater when Losiram is used for a longer period, in high doses, or if doses are reduced too quickly. Many people think these symptoms are mild and continue on their responsibility within two weeks. However, in some patients, the symptoms may be severe in intensity or may be prolonged (2-3 months or longer). If you experience severe symptoms of discontinuing treatment when you stop taking Losiram, please
tell your doctor. It may recommend that you start using the tablets again and give up more slowly. Symptoms of discontinuation include dizziness (instability or imbalance), tingling sensations and numbness, burning sensations and (less frequently) electric shock, including headaches, sleep disturbances (intense dreams, nightmares, inability to sleeplessness), anxiety, headache, feeling sick (nausea), sweating (including night sweats), feeling unrestrained or agitated, tremor, confusion or disorientation, feeling or irritability, diarrhea (loss of faeces), visual disturbances, rapid or strong heartbeats (palpitations).
If you have any further questions on this medicine, ask your doctor or pharmacist.
4. Possible adverse reactions:
Like all medicines, Losiram can cause side effects, although not everybody gets them.
Usually, side effects disappear after a few weeks of treatment. Please note that some of the reactions may also be symptoms of your illness and, as a result, they will improve when you begin to feel better.
Ask your doctor if you experience any of the following side effects during treatment:
Uncommon (affects 1 user in 100):
- Unusual bleeding, including gastrointestinal bleeding.
Rare (affects 1 user in 1000):
- if you have swelling in your skin, tongue, lips or face or have difficulty in breathing or swallowing (allergic reactions), ask your doctor or go to the hospital immediately.
- you have high fever, agitation, confusion, tremor, and sudden muscle contractions, these may be signs of a rare condition called serotonin syndrome. If you feel these, ask your doctor.
Frequency not known:
frequency can not be estimated from the available data.
- urinary problems.
-convulsions, see also the point. "Take special care with Losiram".
- yellowing of the skin and white eyes that are signs of liver function / hepatitis.
-births of the irregular and rapid, faint heart, which may be symptoms of a life-threatening car-diac rhythm, known as torsades de pointes.
- Self-harming or suicidal thoughts, see also section 2 "Warnings and Precautions".
In addition to the above mentioned adverse reactions, the following were reported:
Very common (affects more than 1 user in 10):
- bad condition (nausea).
Common (affects 1 user in 10):
- it is clogged or secreted (sinusitis);
- decrease or increase in appetite;
- anxiety, restlessness, unusual dreams, difficulty sleeping, drowsiness, dizziness, yawning, tremor, skin prickling sensation;
- diarrhea, constipation, vomiting, dry mouth;
- increase of welding;
muscle and joint (arthralgia and myalgia);
- sexual distractions (ejaculation delay, erection problems, reduced desire to have sexual intercourse, and women may have difficulty getting orgasm);
-obose, fever;
- weight gain.
Uncommon (affects 1 user in 100):
urticaria (rash), rash, itching (pruritus).
tooth scarring, agitation, restlessness, panic attack, confusion.
sleep disturbances, taste disturbances, fainting (syncope).
pupillary enlargement, visual disturbance, ringing in the ears (tinnitus)
-hair loss.
- excessive menstrual bleeding.
- Irregular menstrual period.
- decrease in body weight.
 - fast heartbeat.
- swelling of arms or legs.
Nasal bleeding.
Rare (affects 1 user in 1000):
aggression, depersonalization, hallucinations;
- rare heartbreaks.
Frequency not known (frequency can not be estimated from the available data):
- decrease in sodium in the blood (symptoms of a state of illness and illness with muscle weakness or confusion).
- Men in standing up due to low blood pressure (orthostatic hypotension).
abnormal liver function tests (increase in liver enzymes in the blood).
- movement disorders (involuntary movements of the muscles).
- painful endurance (priapism).
Bleeding, including bleeding in the skin and mucous membranes (bruising).
Sudden swelling of the skin or mucous membranes (angioedema).
-creased excretion of urine (inadequate secretion of ADH).
- Dairy secretion in males and nursing women.
- an increased risk of fractures was seen in patients taking this type of medicine.
- heart rate collapse (called "QT interval prolongation" observed on ECG, which analyzes the electrical activity of the heart).
In addition, a number of side effects are known to occur in relation to medicines that work in the same way as escitalopram (the active substance in Losiram). These are:
-Motor drive (acatisation).
- appetite suppression.
If any of the side effects gets serious, or if you notice any side effects not listed in this leaflet, please tell your doctor or pharmacist.
Reporting of adverse reactions
If you experience any side effects, talk to your doctor or pharmacist.
5. How to store Losiram:
Keep out of the reach and sight of children!
Store below 25 ° C in the original package.
Do not use Losiram after the expiry date which is stated on the carton and the blister pack after EXP. The expiration date refers to the last day of that month.
Medicines should not be disposed of via household water. Ask your pharmacist how to dispose of medicines you no longer need. These measures will help to protect the environment.
6. Additional information:
What Losiram contains,
Active substance:
Losiram 10 mg film-coated tablets contain escitalopram oxalate equivalent to 10 mg escitalopram.
Losiram 20 mg film-coated tablets contain escitalopram oxalate equivalent to 20 mg escitalopram.
Excipients: microcrystalline cellulose PH 102, croscarmellose sodium, colloidal anhydrous silica, magnesium stearate, white opaque YS-IR 7003 (hydroxypropyl methyl cellulose (3cP), hydroxypropyl methyl cellulose (5cP), titanium oxide (E171), polyethylene glycol 400, polysorbate 80).
What Losiram looks like and contents of the pack:
Losiram is in the form of white, oblong, biconvex, film-coated tablets with incision on one side. 2 blister strips of 14 blister strips in a carton box with patient leaflet.
The holder of the registration certificate and the manufacturer
The marketing authorization holder
Bilim İlaç Sanayi in Ticaret A.Ş.
Kaptanpaşa Mahallesi, Zincirlikuyu Cad. No: 184
34440 Beyoglu-Istanbul-Turkey
Bilim İlaç Sanayi in Ticaret A.Ş.
Gebze Organize Sanayi Bölgesi, 1900 Sokak, No: 1904,
41480 Gebze-Kocaeli-Turkey