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Home > Drug Category > Antidepressant Drugs > Cipralex and Equivalent

BigMountainDrugs.com supplies only genuine Cipralex from Canada shipped in Canadian packaging. The brand Cipralex is manufactured by Lundbeck, the worldwide manufacturer of Cipralex. This offer is neither endorsed nor authorized by Lundbeck A/S (the United States and Canadian distributor of Cipralex). BigMountainDrugs.com has no affiliation whatsoever with Cipralex or Lundbeck A/S.

Cipralex (Escitalopram) Information

Cipralex (escitalopram oxalate) is a prescription medication belonging to the class of Selective Serotonin Reuptake Inhibitors (SSRIs). It is widely used for the treatment of various mental health conditions, including Major Depressive Disorder (MDD), Generalized Anxiety Disorder (GAD), Social Anxiety Disorder (SAD), Panic Disorder, and Obsessive-Compulsive Disorder (OCD). Escitalopram is the S-enantiomer (the active mirror-image form) of the older SSRI, citalopram, which means it provides the full therapeutic effect at half the dose of citalopram. This high purity and selectivity are often associated with a favourable tolerability profile. As with all antidepressants, Cipralex must be taken consistently every day, and it requires continuous therapy, often for several weeks, before the full therapeutic benefit is realized. The mechanism of action for escitalopram is its potent and highly selective inhibition of the Serotonin Transporter (SERT) in the brain. By blocking this transporter, escitalopram prevents the reuptake of the neurotransmitter serotonin (5-HT) back into the presynaptic nerve cell. This action leads to an increased concentration and prolonged presence of serotonin in the synaptic cleft, which enhances serotonergic activity. This enhanced signalling is believed to mediate its mood-elevating and anxiolytic effects. Because escitalopram is the active enantiomer, it is particularly effective at targeting the serotonin reuptake mechanism while exhibiting minimal activity on other receptors (such as adrenergic, histaminergic, or cholinergic), contributing to its high degree of selectivity and relatively low rate of off-target side effects compared to older classes of drugs.

Cipralex is available in Canada as a prescription-only medication in tablet and oral solution forms. The standard starting dose for adults is typically 10 mg once daily, taken with or without food. The maximum recommended dose for most patients is 20 mg once daily. However, due to the risk of a severe heart rhythm abnormality, the maximum dose is strictly limited to 10 mg once daily for patients over 65 years of age and those with hepatic impairment. It is approved for use in adults and, for specific indications, in adolescents aged 12 to 17 years.

Cipralex Side Effects

Common side effects of Cipralex are generally mild and often occur during the initial phase of treatment, before typically resolving with continued use. The most common effects reported are usually related to gastrointestinal or central nervous system activity and include nausea, insomnia, somnolence (drowsiness), increased sweating, dry mouth, headache, and fatigue. Sexual dysfunction is also a widespread side effect associated with escitalopram and other SSRIs, manifesting as decreased libido, delayed ejaculation, or anorgasmia.

However, more serious side effects can occur, although they are rare. If any of the following symptoms are experienced, the patient should stop taking the medication and seek immediate medical attention:

• Abnormal Bleeding: Increased risk of bleeding events, including bruising (ecchymosis) and hemorrhage, due to the drug's potential to impair platelet aggregation, especially when taken with other medications that affect clotting.

• Cardiac Arrhythmias (QT Prolongation and Torsade de Pointes): Escitalopram can cause a dose-dependent prolongation of the QT interval in the heart. This carries the risk of a potentially fatal irregular heart rhythm called Torsade de Pointes. Symptoms may include a fast or irregular heartbeat, severe dizziness, or fainting.

• Hyponatremia: A rare but serious condition of low sodium in the blood, often due to the Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH). Symptoms can include headache, difficulty concentrating, confusion, weakness, and unsteadiness.

• Seizures and Activation of Mania: Escitalopram may lower the seizure threshold, requiring careful monitoring in patients with a history of seizures. Like other antidepressants, it can also precipitate a manic or hypomanic episode in patients with undiagnosed bipolar disorder. • Serotonin Syndrome: A potentially life-threatening reaction caused by excessive serotonin levels, typically when Cipralex is combined with other serotonergic drugs (e.g., MAOIs, triptans, tramadol). Symptoms include agitation, hallucinations, rapid heart rate, fever, muscle rigidity, and incoordination.

• Suicidality and Worsening of Depression (Boxed Warning): Antidepressants, including Cipralex, carry a warning for increasing the risk of suicidal thoughts and behaviour, particularly in children, adolescents, and young adults (under 25), especially at the start of treatment or after a dose change.

Cipralex Precautions

Before starting Cipralex, it is essential to have a thorough discussion with a healthcare provider about your medical history and any other medications you are currently taking. Cipralex is absolutely contraindicated for use with Monoamine Oxidase Inhibitors (MAOIs) due to the severe risk of Serotonin Syndrome and is also contraindicated with the antipsychotic pimozide due to the combined risk of QT prolongation. To mitigate the risk of severe cardiac arrhythmia, the maximum recommended dose should not exceed 10 mg per day for patients over 65 and those with hepatic impairment. Caution is required in any patient with pre-existing heart conditions, congenital long QT syndrome, or uncorrected electrolyte abnormalities (low potassium or magnesium). Patients with a history of seizure disorder should be monitored carefully, as escitalopram may lower the seizure threshold. The drug should be used with caution in individuals with a history of bleeding disorders or those concurrently taking anticoagulants (e.g., warfarin) or NSAIDs, as escitalopram can impair platelet aggregation. Furthermore, Cipralex should be used with caution in patients with a history of mania/hypomania due to the risk of activating a manic episode. If you are pregnant or breastfeeding, the risks and benefits must be carefully weighed with your doctor. Finally, treatment should never be stopped abruptly; the dose must be tapered slowly under medical supervision to avoid the signs and symptoms of discontinuation syndrome.

Do I need a prescription to order Cipralex?

Yes, a prescription is required from your physician to order Cipralex.