Drug
Escitalopram
Pronounced
"ES-sye-TAL-oh-pram"
Drug Interactions
Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.
Some products that may interact with this drug are: other drugs that can cause bleeding/bruising (including antiplatelet drugs such as clopidogrel, NSAIDs such as ibuprofen/naproxen, "blood thinners" such as dabigatran/warfarin).
Aspirin can increase the risk of bleeding when used with this medication. However, if your doctor has told you to take low-dose aspirin to prevent heart attack or stroke (usually 81-162 milligrams a day), you should keep taking the aspirin unless your doctor tells you not to. Ask your doctor or pharmacist for more details.
Taking MAO inhibitors with this medication may cause a serious (possibly fatal) drug interaction. Avoid taking MAO inhibitors (isocarboxazid, linezolid, metaxalone, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, safinamide, selegiline, tranylcypromine) during treatment with this medication. Most MAO inhibitors should also not be taken for two weeks before and after treatment with this medication. Ask your doctor when to start or stop taking this medication.
The risk of serotonin syndrome/toxicity increases if you are also taking other drugs that increase serotonin. Examples include street drugs such as MDMA/"ecstasy," St. John's wort, certain antidepressants (including other SSRIs such as fluoxetine/paroxetine, SNRIs such as duloxetine/venlafaxine), tryptophan, among others. The risk of serotonin syndrome/toxicity may be more likely when you start or increase the dose of these drugs.
Tell your doctor or pharmacist if you are taking other products that cause drowsiness including alcohol, marijuana (cannabis), antihistamines (such as cetirizine, diphenhydramine), drugs for sleep or anxiety (such as alprazolam, diazepam, zolpidem), muscle relaxants, and opioid pain relievers (such as codeine).
Check the labels on all your medicines (such as allergy, pain/fever reducers, or cough-and-cold products) because they may contain ingredients that cause drowsiness or increase the risk of bleeding. Ask your pharmacist about using those products safely.
Many drugs besides escitalopram may affect the heart rhythm (QT prolongation), including amiodarone, pimozide, procainamide, quinidine, sotalol, among others.
Escitalopram is very similar to citalopram. Do not use medications containing citalopram while using escitalopram.
This medication may interfere with certain medical/lab tests (such as brain scan for Parkinson's disease), possibly causing false test results. Make sure lab personnel and all your doctors know you use this drug.
Negative Interactions
3- Potential Negative Interaction
Escitalopram
5-HTP
Escitalopram increases serotonin activity in the brain. 5-HTP and L-tryptophan are converted to serotonin in the brain, and taking either of these compounds with escitalopram may increase escitalopram-induced side effects. Dietary supplements of L-tryptophan (available only by prescription from special compounding pharmacists) taken with paroxetine (a drug that has similar actions as escitalopram) caused headache, sweating, dizziness, agitation, restlessness, nausea, vomiting, and other symptoms.
Some doctors have used small amounts of L-tryptophan in combination with SSRIs, to increase their effectiveness. However, because of the potential for side effects, 5-HTP and L-tryptophan should never be taken in combination with escitalopram or other SSRIs, unless a doctor is closely monitoring the combination. Foods rich in L-tryptophan do not appear to interact with escitalopram or other SSRIs.
5-HTPEscitalopram- Threlkeld DS, ed. Central Nervous System Drugs, Antidepressants, Selective Serotonin Reuptake Inhibitors. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, 1997.
- Potential Negative Interaction
Escitalopram
L-Tryptophan
Escitalopram increases serotonin activity in the brain. 5-HTP and L-tryptophan are converted to serotonin in the brain, and taking either of these compounds with escitalopram may increase escitalopram-induced side effects. Dietary supplements of L-tryptophan (available only by prescription from special compounding pharmacists) taken with paroxetine (a drug that has similar actions as escitalopram) caused headache, sweating, dizziness, agitation, restlessness, nausea, vomiting, and other symptoms.
Some doctors have used small amounts of L-tryptophan in combination with SSRIs, to increase their effectiveness. However, because of the potential for side effects, 5-HTP and L-tryptophan should never be taken in combination with escitalopram or other SSRIs, unless a doctor is closely monitoring the combination. Foods rich in L-tryptophan do not appear to interact with escitalopram or other SSRIs.
L-TryptophanEscitalopram- Threlkeld DS, ed. Central Nervous System Drugs, Antidepressants, Selective Serotonin Reuptake Inhibitors. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, 1997.
- Potential Negative Interaction
Escitalopram
St. John’s Wort
This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.
There have been no published reports about negative consequences of combining St. John’s wort (Hypericum perforatum) (Hypericum perforatum) (Hypericum perforatum) and fluoxetine. One case has been reported of an interaction between St. John’s wort and a weak serotonin reuptake inhibitor drug known as trazodone that is vaguely similar to fluoxetine. In another case, a patient experienced grogginess, lethargy, nausea, weakness, and fatigue after taking one dose of paroxetine (Paxil®, another SSRI drug) after ten days of St. John’s wort use. Nevertheless, some doctors are concerned about the possibility of an interaction between St. John’s wort and fluoxetine causing side effects (e.g., mental confusion, muscle twitching, sweating, flushing) known collectively as serotonin syndrome. Until more is known about interactions and adverse actions, people taking any SSRI drugs, including fluoxetine, should avoid St. John’s wort, unless they are being closely monitored by a doctor.
St. John’s WortEscitalopram- Demott K. St. John's wort tied to serotonin syndrome. Clinical Psychiatry News 1998;26:28.
- Gordon JB. SSRIs and St. John's wort: possible toxicity? Am Fam Physician 1998;57:950.
- Bekman SE, Sommi RW, Switzer J. Consumer sue of St. John's wort: A survey on effectiveness, safety, and tolerability. Pharmacotherapy 2000;20:568-74.
- Lantz MS, Buchalter E, Giambanco V. St. John's wort and antidepressant drug interaction in the elderly. J Geriatr Psychiatry Neurol 1999;12:7-10.