Selector

Селектра Drug photo

The description is actual on 08.04.2015

  • Latin name: Selectra
  • ATH code: N06AB10
  • Active ingredient: Estsitalopram (Escitalopram)
  • Producer: Actavis Group hf. (Iceland)

Structure

1 tablet can include 5; 10; 15 or 20 mg of an estsitalopram – active ingredients.

Minor ingredients: talc, silicon dioxide, microcrystallic cellulose, magnesium stearate, croscarmellose sodium.

Cover: opadray white (03F28446).

Release form

Selektr's drug is issued in the form of tablets in a film cover, with various mass part of active ingredient, on 10 or 14 pieces in the blister.

Pharmacological action

Antidepressive.

Pharmacodynamics and pharmacokinetics

Selektr's antidepressant – medicine from group of the selective serotonin reuptake inhibitors (SSRI) which thanks to the action increases the maintenance of a neuromediator of serotonin in a synaptic gap prolongs and strengthens its impact on postsynaptic sites of receptors. Estsitalopram practically does not contact other receptors, including: serotoninovy 5-HT1A; dopamine D1 and D2; alpha 1-, alpha 2-, beta and adrenergic; cholinergic muskarinovy; opioid; histamine H1; benzodiazepine and 5-HT2 receptors.

Meal does not affect absorption of an estsitalopram. Level of bioavailability is about 80%. Plasma TCmax about 4 hours. At oral administration of Vd varies from 12 to 26 l/kg. Communication with plasma proteins, both the estsitalopram, and its main metabolites, is carried out for 80%.

Metabolic transformations take place in a liver, before allocation of active didemetilirovanny and demetilirovanny metabolites. Partial release of active ingredient of drug, as well as its metabolites, happens in the form of glucuronides.

At numerous internal use the average content of both metabolites, as a rule, equals 28-31% and respectively less than 5% of the level of an estsitalopram. Formation of a demetilirovanny metabolite is mainly carried out by means of CYP2C19 cytochrome, with possible participation of isoenzymes of CYP2D6 and CYP3A4.

At insufficient activity at the patient of CYP2C19 the maintenance of an estsitalopram is doubled at which in comparison with patients high activity of this isoenzyme is observed. Essential fluctuations of content of drug, at insufficient activity of CYP2D6 are not revealed.

At multiple oral administration of T1/2 about 0,6 l/min equal to about 30 hours, with clearance. The main metabolites possess more long T1/2. Removal of an estsitalopram, together with its main metabolites, is carried out by kidneys and a metabolic way — a liver.

Estsitalopram shows linear kinetics. Css is observed approximately in 7 days. At reception of a daily dose of 10 mg, average Css equals the 50th nmol/l, with individual variations from 20 to 125 nmol/l.

At advanced age, after 65 years, removal of an estsitalopram happens more slowly, and plasma contents is one and a half times higher.

Indications to use

Contraindications

Absolute:

  • breastfeeding;
  • hypersensitivity;
  • age till 15 years;
  • parallel use with MAO inhibitors;
  • pregnancy.

Relative:

  • insufficiency of kidneys, at KK is less than 30 ml/min.;
  • age of 15-18 years;
  • maniacal frustration;
  • hypomania;
  • uncontrollable epilepsy;
  • diabetes mellitus;
  • suicide depression;
  • advanced age;
  • predisposition to bleedings;
  • cirrhosis;
  • the combined use with ethanol; the drugs causing a hyponatremia; reducing convulsive readiness; metabolized CYP2C19 cytochrome.

Side effects

To bowl of all side effects were observed for the first 14 days of therapy then their activity and frequency of manifestation went down or completely stopped.

TSNS:

GASTROINTESTINAL TRACT:

  • dryness in an oral cavity;
  • diarrhea;
  • nausea;
  • frustration of flavoring feelings;
  • vomiting;
  • loss of appetite;
  • lock.

Endocrine system:

  • galactorrhoea;
  • lowering of secretion of ADG.

Cardiovascular system:

  • orthostatic hypotension.

Urinogenital system:

Integuments:

Laboratory indicators:

  • change of hepatic function;
  • hyponatremia.

Allergic reactions:

Others:

  • hyperthermia;
  • the increased perspiration;
  • sinusitis;
  • mialgiya;
  • arthralgia;
  • withdrawal (at the sudden termination of treatment).

Selector, application instruction

The application instruction of Selektra recommends single daily oral (internal) dose of tablets to the patients who reached age of 15 years.

Panic states

For the first 7 days of therapy recommend reception of a daily dose of 5 mg, with further increase up to 10 mg. Being coordinated with individual sensitivity of the patient to an estsitalopram it is possible to increase a daily dose to a maximum – 20 mg. Therapy long, maximum efficiency of treatment is observed, as a rule, in 3 months.

Depressions

As a rule, appoint 10 mg of Selektra once at 24 o'clock. Being coordinated with individual sensitivity of the patient to an estsitalopram it is possible to increase a daily dose to a maximum – 20 mg. Antidepressive efficiency in most cases develops throughout the 2nd – the 4th week. For the purpose of fixing of a positive effect, after leveling of symptomatology of a depression, it is necessary to continue treatment of 6 more months.

Age after 65 years

The recommended daily and maximum doses have to be lowered twice.

Pathologies of kidneys

At KK more than 30 ml/min. are not present need to adjust Selektra's dosages. In the return case apply the minimum doses of an estsitalopram, with their gradual increase according to individual reaction of the patient.

Liver pathologies

The initial daily dosage of Selektra equals 5 mg. Being coordinated with individual sensitivity of the patient to an estsitalopram it is possible to increase a daily dose to a maximum – 10 mg.

Hypoactivity of CYP2C19 cytochrome

Patients with insufficient activity of CYP2C19, for 14 days, demand purpose of an initial daily dose of 5 mg. Being coordinated with individual sensitivity of the patient to an estsitalopram it is possible to increase a daily dose to a maximum – 10 mg.

Treatment cancellation

For leveling of symptomatology of a withdrawal, it is necessary to lower Selektra's dose consistently, for 7-14 days.

Overdose

At overdose by Selektra observed: agitation, dizziness, stupefaction, a tremor, convulsive attacks, drowsiness, tachycardia, arrhythmia, changes on an ECG, breath suppression, vomiting, a metabolic acidosis, rabdomioliz, a hypopotassemia, an acute renal failure (very seldom).

The supporting and symptomatic therapy, with a gastric lavage, oxygenation, monitoring of respiratory and cardiovascular systems is shown.

Interaction

Parallel use with MAO inhibitors increases risk of forming of a serotoninovy syndrome, and also other heavy collateral manifestations.

The combined appointment with serotonergic drugs (including with triptanes and Tramadol) can become the reason of development of a serotoninovy syndrome.

The concomitant use with the means reducing convulsive readiness can lead to spasms.

Estsitalopram increases effect of drugs of lithium and Tryptophane, increases toxicity of means with a St. John's Wort, efficiency of anticoagulants (it is necessary to watch indicators of coagulability of blood).

Strong CYP2D6 and CYPZA4 inhibitors (including Propafenon, Flekainid, Metoprolol, Klomipramin, Desipramine, Nortriptilin, Thioridazine, Risperidon, the Haloperidol), and also the medicines which are metabolized CYP2C19 isoenzyme (including Omeprazol) increase the plasma maintenance of an estsitalopram.

Estsitalopram doubles plasma keeping of Metoprolol and Desipramine.

Terms of sale

Selektr's medicine is sold in the presence of the recipe.

Storage conditions

Selektra's tablets need to be kept at a temperature up to 25 °C.

Period of validity

Medicine keeps the efficiency for 24 months.

Special instructions

Selektr's drug can be appointed only in 24 hours after cancellation of treatment with use of MAO inhibitors (reversible) and in 14 days after cancellation of treatment with use of MAO inhibitors (irreversible). It is possible to appoint MAO inhibitors (non-selective) not earlier than in 7 days after the end of reception of an estsitalopram.

At treatment of panic states by Selektra, at some patients the strengthening of alarm which is taking place for 14 days of further therapy can be shown. For decrease in probability of forming of alarm, it is necessary to apply the lowest initial dosages.

At a diabetes mellitus, to estsitalopra can increase the content of glucose in blood that demands review of doses of hypoglycemic means.

Selektra's tablets should be cancelled at: manifestation or increase of epileptic seizures, forming of a maniacal state, serotoninovy syndrome.

Clinical trials of an estsitalopram proved a possibility of increase in risk of implementation by patients of suicide attempts, in particular in initial weeks of treatment. During this period it is extremely important to watch closely mood of patients.

At Selektra's reception occasionally observed forming of a hyponatremia, because of reduction of secretion of ADG which usually takes place after treatment cancellation.

When passing therapy by Selektra, it is better to avoid driving of transport, and also delicate and dangerous works.

Analogs

Zdravzona

  • Selector 10 of mg No. 10 of a tablet
  • Selector 10 of mg No. 28 of a tablet
  • Selector 10 of mg No. 56 of a tablet

Drugstore of IFC

  • The selector tbl a payment order / about 10 mg No. 28, Actavis ht.islandiya
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Section: For a nervous system
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Education: Graduated from the Vinnytsia national medical university of N. I. Pirogov, pharmaceutical faculty, the higher pharmaceutical education – the specialty "Pharmacist".

Experience: Work in Koneks and Bios-Media pharmacy chains as "Druggist". Work as "Pharmacist" in Avicenna pharmacy chain of the city of Vinnytsia.

PAY ATTENTION! Information on drugs on the website is help generalizing, collected from public sources and can form the basis for making decision on use of medicines it is not aware of treatment. Before medicine use of Selektr surely consult with the attending physician.