Instructions for use of Tsipramil, reviews of the drug from patients and doctors, its analogues

There are restrictions during pregnancy

Has restrictions when breastfeeding

Has restrictions for children

Has limitations for liver problems

Has limitations for kidney problems

To eliminate the symptoms of depressive disorders, special medications are used in medical practice - antidepressants. Their action is aimed at the human central nervous system. Doctors often prefer the drug Cipramil, which, according to the instructions for use, is effective for depression, panic attacks, phobias and sleep disorders of various etiologies.

Packaging of medicine Tsipramil

Pharmacodynamics and pharmacokinetics

Pharmacodynamics

Selective serotonin reuptake blocker, antidepressant.

The antidepressant effect usually develops after 3-4 weeks of treatment. The drug Tsipramil has almost no ability to bind to many receptors, including m-cholinergic receptors, histamine and adrenergic receptors . Does not have a sedative effect.

Slightly inhibits cytochrome P450 IID6 , as a result of which it does not interact with drugs metabolized by this isoenzyme.

Tsipramil does not affect the rhythm conduction system, blood pressure, hematological parameters and the functioning of the kidneys and liver; does not cause weight gain.

Pharmacokinetics

The maximum plasma content is recorded on average 4 hours after oral administration. Bioavailability in this case is about 80%.

Equilibrium concentration is established after 1-2 weeks of treatment. Reaction with blood is less than 80%.

Metabolized through deamination, demethylation and oxidation . The half-life reaches 36 hours. The active substance is excreted in the urine and through the intestines.

Reviews from patients and doctors about Cipramil

Reviews of doctors and people who have tried it on themselves help you get an idea of ​​the drug Cipramil.

Doctors

Mikheev A., psychiatrist: “I often use Tsipramil in my practice. The product is very good and effective. When used correctly, there are no side effects. I definitely recommend it for the treatment of acute depressive episodes and in the complex treatment of phobias.”

Lisenkova O., neurologist: “The antidepressant Tsipramil is practically no longer used. It was replaced by drugs containing escitalopram. They have better tolerability and fewer side effects. Personally, I prefer to prescribe Cipralex. But in terms of price and quality they are the same.”

Patients taking the drug

Most reviews from patients who took this drug are positive:

Kira, 27 years old: “I rarely write reviews. But here I will make an exception. Tsipramil is an excellent tablet. I took them for about a year. There was no habituation, nor did I feel unwell. The doctor said to drink them before bed because they cause confusion (but I didn’t experience that). Both depression and anxiety went away. I’ve been without antidepressants for six months now.”

Valentina, 44 years old: “I was prescribed this antidepressant by a psychiatrist to treat panic attacks. It helped me a lot. After just 3 months, anxiety and worry disappeared. I like it. But I didn’t experience any negative symptoms, this drug was probably right for me.”

Cipramil is a well-known antidepressant from the SSRI group. It is prescribed to eliminate the negative symptoms of depressive and other mental disorders.

Side effects

• Reactions from nervous activity: tremor , drowsiness , weakness, insomnia , seizures, agitation .
• Circulatory reactions: slight decrease in heart rate.
• Digestive reactions: nausea , dry mouth, diarrhea .
• Other reactions: sexual dysfunction, increased sweating, extrapyramidal disorders, hyponatremia , signs of withdrawal syndrome, serotonin syndrome, purpura.

Side effects are mostly temporary, mild and observed during the first two weeks of therapy.

Instructions for use of Tsipramil (Method and dosage)

Instructions for use of Tsipramil recommend using the drug once a day, regardless of meals.

When treating depression, the drug is taken at a dose of 20 mg per day. Depending on the patient’s response, forms and severity of depression, the dosage can be increased to the maximum possible - 60 mg per day.

In the first week of therapy for panic disorders, the recommended dose is 10 mg per day, then it is usually increased to 20 mg per day. Depending on the patient’s response, the daily dosage can be increased to the maximum possible - 60 mg per day.

For obsessive-compulsive disorders, the initial dose of the drug is 20 mg per day and can also be increased to 60 mg per day if necessary.

In elderly patients, the recommended dose is 20 mg per day, and the maximum dose at this age is 40 mg per day.

For patients with severe liver disease, the medicine is prescribed in the lowest recommended doses.

General information about Cipramil

This is a medication that is used to treat various mental disorders, particularly depressive episodes.

Its manufacturer is the pharmaceutical company from Denmark A\S Lundbeck H.

Drug group, INN, scope of application

Tsipramil belongs to a large group of drugs - antidepressants from the category of serotonin reuptake inhibitors. Such drugs affect the neurotransmitters of the brain, affecting the activity of the central nervous system.

The international nonproprietary name of the drug depends on the content of the active substance in it, which affects the human body in one way or another. INN Tsipramil – Citalopram. It is used in psychiatric practice to treat depressive and other mental disorders.

Release form, cost

This product is available in the form of white oval tablets for internal use. They are taken orally. The tablets are packaged in aluminum foil blisters of 14 pieces. In total, a cardboard box contains 1, 2 or 4 blisters (14, 28 or 56 tablets).

The cost of the drug is determined by the content of the active ingredient in 1 tablet, as well as their quantity in the package. Also, the price may vary depending on where the medicine is purchased. Examples of prices for Cipramil in different pharmacies in large Russian cities:

Compound

In tablets, the active substance is presented in the form of citalopram hydrobromide. Each tablet may contain 20 or 40 mg.

Additionally, they contain auxiliary components - corn starch, lactose, glycerin, croscarmellose, cellulose, magnesium stearate and copolyvidone. The film coating of the tablet consists of hypromellose, titanium dioxide and macrogol 400.

Pharmacodynamics and pharmacokinetics

The active substance citalopram, which is part of Tsipramil, belongs to a special type of antidepressant - serotonin reuptake inhibitors (SSRIs). Its action is aimed at increasing the concentration of serotonin in the synaptic cleft of the brain, which is manifested by the following effects:

• elimination of depressive conditions;
• improvement of mood and emotional sphere;
• elimination of melancholy and melancholy;
• depression of the sleep phase, which is accompanied by rapid eye movement (it is a sign of depressive activity), increased slow-wave deep sleep;
• activation of motor activity and thought processes.

Moreover, the substance is a selective inhibitor, with virtually no effect on the reuptake of other neurotransmitters - dopamine, norepinephrine and gamma-aminobutyric acid (GABA).

With long-term use of the drug, the development of tolerance to it is not observed.

Also, its active substance does not have an affinity for other receptors, in particular dopamine, benzodiazepine, opioid, muscarinic, histamine, alpha and beta adrenergic receptors. As a result of its use, adverse reactions such as indigestion, urination, blurred vision, toxic effects on the cardiovascular system, and orthostatic hypotension rarely occur. Also, the medicine does not cause sedation and does not change cognitive and psychomotor activity.

Pharmacokinetic features of citalopram:

• almost complete and rapid absorption from the digestive tract;
• the largest amount of the substance in the blood is observed 3 hours after ingestion;
• equilibrium concentration is observed after 2 weeks of systematic use;
• total bioavailability is more than 75%;
• connection with blood proteins is high – up to 80%;
• the metabolic process occurs in the liver, where 3 active metabolites are formed (citalopram oxide, demethyl- and didemethylcitalopram), which have weaker SSRI properties;
• excreted by the kidneys and with feces;
• half-life lasts up to 36 hours.

In elderly patients and people with severely impaired renal or liver function, citalopram is excreted much longer (about 3 days). They also have twice the concentration of the substance in their blood when taking the same dose as is used for healthy young patients.

Analogs

To replace Tsipramil, its structural analogues are used - products containing the same active substance. The most popular of them:

1. Oprah. A well-known medicine produced by ACTAVIS. In terms of quality and price, it is practically no different from Tsipramil.
2. Pram. An Austrian drug that is available in tablet form, each containing 10, 20 or 40 mg of citalopram.
3. Siozam. A domestic antidepressant produced by Veropharm. The effect is identical, but the medicine is much cheaper.

Such drugs have the same mechanism of action on the body. They have identical indications, contraindications and side effects.

See also:

Instructions for use of Ceraxon in colas and tablets, reviews from patients who took the drug

Overdose

Signs of overdose: coma , drowsiness , articulation disorders, sinus tachycardia , increased sweating , seizures, junctional rhythm , nausea, cyanosis , vomiting, hyperventilation.

Treatment of overdose: gastric lavage, symptomatic and supportive treatment, constant monitoring of the patient's condition. specific antidote .

Contraindications

• congenital long QT interval or established prolongation of the QT interval;
• combination therapy with drugs that prolong the QT interval, pimozide, linezolid (if it is impossible to closely monitor the patient and monitor blood pressure), monoamine oxidase inhibitors (including selegiline at a dose higher than 0.01 g per day);
• impaired absorption of glucose and galactose, lactase deficiency, hereditary galactose intolerance;
• age under 18 years;
• individual intolerance to the components of Tsipramil.

Conditions/diseases for which tablets are used with caution:

• decompensated heart failure;
• recent acute myocardial infarction;
• significant bradycardia;
• ventricular arrhythmia, including torsade de pointes;
• history of QT prolongation;
• hypomagnesemia and (or) hypokalemia (electrolyte imbalances must be corrected before starting the drug);
• severe renal failure (creatinine clearance <30 ml per 1 min);
• severe liver failure;
• severe suicidal behavior (after several weeks from the start of therapy, patients must be carefully monitored until their condition improves);
• diabetes mellitus [dose adjustment of oral hypoglycemic agents and/or insulin may be required];
• tendency to bleeding (especially with combined treatment with drugs that affect platelet function or drugs that may increase the risk of bleeding);
• combined use of ethanol, drugs that are weak metabolites of the CYP2C19 isoenzyme, oral anticoagulants and drugs that affect blood clotting, drugs containing St. John's wort, tryptophan and lithium, metoprolol, cimetidine, drugs that lower the seizure threshold, selegiline, monoamine oxidase inhibitors, serotonergic drugs;
• electroconvulsive treatment;
• pregnancy;
• breastfeeding period;
• age over 65 years.

special instructions

Cipramil should not be prescribed while taking MAO inhibitors and for another two weeks after stopping their use. Therapy with MAO inhibitors is allowed to begin a week after stopping the use of Tsipramil.

For moderate changes in kidney function, dosage adjustments are not required.

If the phase of depression and a manic state , the drug should be discontinued.

When driving a vehicle while taking medication, you should remember that concentration and reaction speed may decrease.

Indications and restrictions for taking Cipramil

This medicine is prescribed by the attending physician if the patient has appropriate indications. It is used to eliminate the negative symptoms of such pathological conditions:

• different types and forms of depressive disorders of any nature;
• prevention of relapse of depression;
• obsessive-compulsive disorder (obsessive thoughts);
• social phobias;
• chronic anxiety disorder;
• panic attacks due to fear of open space.

It is strictly forbidden to prescribe the drug if the patient has the following contraindications:

• individual intolerance to the constituent components;
• lactase deficiency, glucose-galactose malabsorption;
• established or congenital heart defect – prolongation of the QT interval;
• presence or suspicion of serotonin syndrome.

Also, you should not take Tsipramil simultaneously with MAO inhibitors and drugs that affect the cardiovascular system (increase blood pressure, prolong the QT interval).

In some conditions, you should be careful when prescribing the drug. Limitations for its use are:

• advanced age;
• hypokalemia and hyponatremia;
• cardiac pathologies (arrhythmia, slow heartbeat, recent heart attack, severe heart failure);
• psychosis (possibly increased psychotic symptoms);
• conducting electroconvulsive therapy;
• tendency to bleed;
• diabetes;
• epilepsy, tendency to convulsive states;
• mania;
• suicidal tendencies.

The drug is not prescribed for the treatment of small children and adolescents until adulthood. They may experience suicidal tendencies when taking antidepressants.

Women during pregnancy should also not take Cipramil. Antidepressants from the SSRI group, which are taken by pregnant women (especially in later stages), can lead to unwanted reactions in the newborn. Most often they are associated with the development of serotonin syndrome or withdrawal syndrome and appear in the first 24 hours after birth. In this case, the child experiences the following symptoms:

• drowsiness;
• irritability, anxiety;
• vomit;
• feeding problems;
• cyanosis;
• increased blood pressure;
• respiratory depression;
• worsening sleep;
• the appearance of seizures;
• lethargy;
• increased neuromotor excitability;
• constant crying;
• increased body temperature;
• hypoglycemia;
• muscle hypotonia.

Citalopram passes into breast milk, but in small quantities. There is no data on its effects on children, so caution should be exercised when prescribing the drug to nursing women.

See also:

Instructions for use of the drug Noopept, indications, reviews from patients and doctors

Analogs

Level 4 ATC code matches:
Actaparoxetine

Plizil

Fluxen

Paroxin

Surlift

Asentra

Elycea

Fluoxetine

Lenuksin

Escitalopram

Adepress

Selectra

Stimuloton

Citalopram

Zoloft

Paroxetine

Prozac

Paxil

Rexetine

Fevarin

The closest analogues of Tsipramil in composition are: Pram, Oprah, Sedopram, Umorap, Siozam, Citalift, Tsitalek, Citalon, Citalorin, Citalopram, Tsitol.

Tsipramil price, where to buy

The price of Tsipramil 20 mg No. 28 in Russia is 1700-2010 rubles, and in Ukraine this form of release will cost an average of 790 hryvnia.

• Online pharmacies in RussiaRussia
• Online pharmacies in UkraineUkraine

ZdravCity

• Cipramil tablets 20 mg 28 pcs. Lundbeck
  2017 RUR order

Pharmacy Dialogue

• Cipramil (tablet p/o 20 mg No. 28) Lundbeck

  RUB 2,754 order

show more

Pharmacy24

• Cipramil 20 mg No. 28 tablets H. Lundbeck A/S, Denmark
  793 UAH.order

Release form and composition

The dosage form of Tsipramil is film-coated tablets: white, oval, with a score and symmetrical markings near the score (0.02 g each - “C” and “N”, 0.04 g each - “C” and “R”) , in blisters of 14 pcs., in a cardboard box 1, 2 or 4 blisters with tablets of 0.02 g or 2 blisters with tablets of 0.04 g.

1 tablet contains:

• active substance: citalopram hydrobromide – 0.02498 or 0.04996 g (corresponding to the content of citalopram – 0.02 or 0.04 g);
• auxiliary components: magnesium stearate – 0.00087 or 0.00174 g; croscarmellose sodium – 0.0025 or 0.005 g; microcrystalline cellulose – 0.0188 or 0.0375 g; glycerol 85% – 0.0025 or 0.005 g; copovidone – 0.00625 or 0.0125 g; lactose monohydrate – 0.0231 or 0.0461 g; corn starch – 0.0461 or 0.0922 g;
• shell: titanium dioxide (E 171) – 0.000679 or 0.00109 g; macrogol 400 – 0.000408 or 0.000652 g; hypromellose 5 – 0.00204 or 0.00326 g.