What Celexa is and what it is used for
How does Cipramil work? Cipramil is a Selective Serotonin Reuptake Inhibitor (SSRI) and belongs to a group of medicines known as antidepressants. These medicines help to correct certain chemical imbalances in the brain that are causing the symptoms of your illness. What is Cipramil used for? Cipramil contains citalopram and is used for the treatment of depression and, when you feel better, to help prevent these symptoms recurring. Cipramil is also used for long-term treatment to prevent the occurrence of new episodes of depression or if you have recurrent depression. Cipramil is also beneficial in relieving symptoms if you tend to suffer from panic attacks.
How to take Celexa
How much to take
Always take this medicine exactly as your doctor or pharmacist has told you. Check with
your doctor or pharmacist if you are not sure.
The usual dose is 16 mg (8 drops) per day. This may be increased by your doctor to a
maximum of 32 mg (16 drops) per day.
The starting dose is 8 mg (4 drops) per day for the first week before increasing the dose to
between 16 –24 mg (8 to 12 drops) per day. The dose may be increased by your doctor to a
maximum of 32 mg (16 drops) per day.
Elderly patients (above 65 years of age)
The starting dose should be decreased to half of the recommended dose, e.g. 8-16 mg per day.
Elderly patients should not usually receive more than 16 mg (8 drops) per day.
Children and adolescents (less than 18 years of age)
Cipramil should not be given to children or adolescents under 18 years of age. For further
information, please see section 2, What you need to know before you take Cipramil
Patients with special risks
Patients with liver complaints should not receive more than 16 mg (8 drops) per day.
If you have previously taken Cipramil tablets, you will find that the dose of your medicine in
mg given as drops is a bit lower than that of tablets. This is because your body more easily
absorbs the drops than the tablets, so you do not need as many mg to have the same effect.
The doses of tablets correspond to doses of drops as follows:
10 mg 8 mg (4 drops)
20 mg 16 mg (8 drops)
30 mg 24 mg (12 drops)
40 mg 32 mg (16 drops)
How and when to take Cipramil
The drops are for oral use and can be taken in a drink of water, or orange or apple juice.
Cipramil is taken every day as one dose at any time of the day.
Duration of treatment
Like other medicines for depression and panic disorder these drops may take a few weeks
before you feel any improvement. Continue to take Cipramil even if it takes some time before
you feel any improvement in your condition.
The duration of treatment is individual, usually at least 6 months. Continue to take the drops
for as long as your doctor recommends. Do not stop taking them even if you begin to feel
better, unless you are told to do so by your doctor. The underlying illness may persist for a
long time and if you stop your treatment too soon your symptoms may return.
Patients who have recurrent depression benefit from continued treatment, sometimes for
several years, to prevent the occurrence of new depressive episodes.
Never change the dose of the medicine without talking to your doctor first.
If you take more Cipramil than you should
If you think that you or anyone else may have taken too many Cipramil drops, contact your
doctor or nearest hospital emergency department immediately. Do this even if there are no
signs of discomfort or poisoning. Take the Cipramil box/container with you if you go to a
doctor or hospital. Some of the signs of an overdosage could be life-threatening.
Symptoms of overdosage may include:
• Irregular heart beat
• Changes in heart rhythm
• Feeling sick (nausea)
• Fast heart beats
• Changes in blood pressure
• Serotonin syndrome (see Section 4)
• Enlarged eye pupils
• Bluish skin
• Breathing too quickly If you forget to take Cipramil If you forget to take a dose, take the next dose at the usual time. Do not take a double dose. Effects when treatment with Cipramil is stopped Stopping this medicine quickly may cause symptoms such as dizziness, nausea and numbness or tingling in hands or feet, sleep disturbances (vivid dreams, nightmares, inability to sleep), feeling anxious, headaches, feeling or being sick, sweating, feeling restless or agitated, tremor, feeling confused or disorientated, feeling emotional or irritable, (loose stools), visual disturbances, fluttering or pounding heartbeat (palpitations). These are usually non-serious and disappear within a few days. When you have completed your course of treatment, the dose of Cipramil is usually reduced gradually over a couple of weeks. If you have any further questions on the use of this product, ask your doctor or pharmacist.
Possible side effects
Like all medicines this medicine can cause side effects, although not everybody gets them.
Several of the effects listed below can also be symptoms of your illness and may disappear as
you start to get better.
Serious side effects
Stop taking Cipramil and seek medical advice immediately if you have any of the following
• Difficulty in breathing.
• Swelling of the face, lips, tongue or throat that causes difficulty in swallowing or breathing.
• Severe itching of the skin (with raised lumps).
• Fast, irregular heart beat, fainting which could be symptoms of a life-threatening condition known as torsades de pointes. If you notice any of the following you should contact your doctor immediately as your dose may need to be reduced or stopped:
• You start having fits for the first time or fits that you have suffered from in the past before become more frequent.
• Your behaviour changes because you feel elated or over excited.
• You experience high fever, agitation, confusion, and trembling or abrupt contractions of muscles. These may be signs of a rare condition called serotonin syndrome.
• Tiredness, confusion and twitching of your muscles. These may be signs of a low blood level of sodium (hyponatraemia). If you have thoughts of harming or killing yourself at any time, contact your doctor or go to a hospital straight away.
The following side effects are often mild and usually disappear after a few days’ treatment.
Very common side effects (may affect more than 1 in 10 people)
• Difficulty in sleeping
• Changes in your sleeping pattern
• Loss of body strength, weakness
• Increased sweating
• Dry mouth (a dry mouth increases the risk of tooth decay, so be sure to clean your teeth more often than usual)
• Feeling sick (nausea)
Common side effects (may affect up to 1 in 10 people)
• Lack of appetite
• Decreased sex drive
• Abnormal dreams
• Reduced emotions, indifference (apathy)
• Tingling or numbness in the hands or feet
• Problems concentrating
• Loss of memory (amnesia)
• Ringing in the ears (tinnitus)
• Blocked or runny nose (rhinitis)
• Stomach pain
• Flatulence (wind)
• Increase in saliva (drooling)
• Pain in muscles and joints
• For men, problems with ejaculation and erection
• For women, failing to reach an orgasm
• Prickling of the skin
• Loss of weight
Uncommon (may affect up to 1 in 100 people)
• Bruising easily
• Increased appetite
• Large pupils (the dark centre of the eye)
• Fast heart beat
• Slow heart beat
• Nettle rash
• Loss of hair
• Sensitivity to sunlight
• Difficulties urinating
• Excessive menstrual bleeding
• Swelling of the arms or legs
• Increased weight
Rare (may affect up to 1 in 1000 people)
• Increased sex drive
• Involuntary movements
• Taste disturbances
• Feeling unwell (malaise) Some patient have reported (frequency not known)
• Thoughts of harming or killing themselves, see also section 2. “What you need to know before you take Cipramil Drops”
• An increase in bleeding or bruising caused by a decrease in blood platelets (thrombocytopenia)
• Rash (hypersensitivity)
• Low potassium levels in the blood (hypokalaemia), which can cause muscle weakness, twitching or abnormal heart rhythms
• Panic attack
• Grinding teeth
• Unusual muscle movements or stiffness
• Involuntary movements of the muscles (akathisia)
• Low blood pressure
• Bleeding disorders including skin and mucosal bleeding (ecchymosis)
• Sudden swelling of skin or mucosa
• In men, painful erections
• Flow of breast milk in men or in women who are not breast-feeding (galactorrhoea)
• Irregular menstrual periods
• Abnormal liver function tests
• An increased risk of bone fractures has been observed in patients taking this type of medicines
• Abnormal heart rhythm SSRIs can, very rarely, increase the risk of bleeding, including stomach or intestinal bleeding. Let your doctor know if you vomit blood or develop black or blood stained stools. Also let your doctor know if you continue to have other symptoms associated with your depression. This might include hallucinations, anxiety, mania or confusion. Any side effects that do occur will usually disappear after a few days. If they are troublesome or persistent, or if you develop any other unusual side effects while taking Cipramil, please tell your doctor.
Reporting of side effects If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in this leaflet. You can also report side effects directly Via the Yellow Card Scheme at: www.mhra.gov.uk/yellowcard By reporting side effects you can help provide more information on the safety of this medicine.
How to Store Celexa
Always keep this medicine out of the sight and reach of children.
• After breaking the seal for the first time, the drops can be used for 16 weeks if stored below 25°C (room temperature).
• Do not use this medicine after the expiry date which is stated on the label or carton. The expiry date refers to the last day of that month. Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help to protect the environment.
2 to 3 weeks on average
The average shipping time is 2 weeks in North America and 4 weeks internationally. We offer free shipping on all orders shipped to North America. Shipping is a flat rate of $20.00 for all other countries.
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About Medix Pharmacy
Medix Pharmacy is a fully licensed pharmacy in the United Kingdom who provides competitive pricing on brand and generic medications with international shipping.
We are regulated by a number of executive government agencies in the United Kingdom including the Medicines and Healthcare products Regulatory Agency and the GPhC to ensure we offer our customers the highest level of service and peace of mind knowing that the medicines that you receive are safe, effective and authentic.
Drug prices for Celexa vary throughout the world with the highest prices generally in the United States. Patients can save significantly on their prescriptions drugs when purchasing them from a licensed pharmacy in the United Kingdom and other countries such as Canada, Australia, and New Zealand.