AdultPediatricGeriatricDosage Forms & Strengths tablet 5mg 10mg 20mg oral solution 5mg/5mL Major Depressive Disorder Indicated for acute and maintenance treatment of major depressive disorder (MDD) 10 mg PO qDay; may increase to 20 mg/day after 1 week Generalized Anxiety Disorder Indicated for acute treatment of generalized anxiety disorder (GAD) 10 mg PO qDay; may increase to 20 mg/day after 1 week; maintain at lowest effective dose and assess need of therapy periodically if extended therapy required Obsessive-Compulsive Disorder (Off-label) 10 mg PO qDay; may increase to 20 mg/day after 1 week; maintain at lowest effective dose and assess need of therapy periodically if extended therapy required Insomnia (Off-label) Secondary to Depression: 5-20 mg PO over 8 week period Secondary to panic disorder in women: 5-10 mg PO over 8 week period Vasomotor Symptoms Associated with Menopause (Off-label) 10 mg PO qDay; may increase to 20 mg PO qDay after 4 weeks if symptoms not adequately controlled Dosage Modifications Renal impairment Mild-to-moderate: No dosage adjustment necessary Severe: Use with caution; insufficient number of patients have been evaluated during chronic escitalopram treatment Hepatic impairment Mild-to-severe: 10 mg/day; racemic citalopram clearance decreased resulting in increased plasma concentration Dosing Considerations For extended therapy, maintain at lowest effective dose and assess periodically the need for continued therapy Before initiating Before initiating treatment with antidepressants, screen patients for personal family history of bipolar disorder, mania, or hypomania Discontinuation of treatment Symptoms associated with discontinuation of SSRIs and SNRIs have been; monitor for symptoms when discontinuing treatment Gradual dose reduction rather than abrupt cessation is recommended If intolerable symptoms occur following a dose reduction or discontinuation of treatment, then consider resuming the previously prescribed dose; subsequently, continue decreasing the dose at a more gradual rate Switching to or from a monoamine oxidase inhibitor (MAOI) used to treat for psychiatric disorders At least 14 days should elapse between discontinuation of an MAOI intended to treat psychiatric disorders and initiation of escitalopram Conversely, allow at least 14 days after stopping escitalopram before starting an MAOI Dosage Forms & Strengths tablet 5mg 10mg 20mg oral solution 5mg/5mL Major Depressive Disorder <12 years: Safety and efficacy not established ≥12 years: 10 mg PO qDay; may increase dose after at least 3 weeks; not to exceed 20 mg/day Generalized Anxiety Disorder Indicated for generalized anxiety disorder (GAD) in patients aged ≥7 years Initial: 10 mg PO qDay Depending on clinical response and tolerability, may increase dose after at least 2 weeks to maximum of 20 mg qDay Dosage Modifications Renal impairment Mild-to-moderate: No dosage adjustment necessary Severe: Use with caution; insufficient number of patients have been evaluated during chronic escitalopram treatment Hepatic impairment Mild-to-severe: 10 mg/day; clearance of racemic citalopram was decreased and plasma concentration were increased. Dosing Considerations For extended therapy, maintain at lowest effective dose and assess periodically the need for continued therapy Before initiating Before initiating treatment with antidepressants, screen patients for personal family history of bipolar disorder, mania, or hypomania Discontinuation of treatment Symptoms associated with discontinuation of SSRIs and SNRIs have been; monitor for symptoms when discontinuing treatment Gradual dose reduction rather than abrupt cessation is recommended If intolerable symptoms occur following a dose reduction or discontinuation of treatment, then consider resuming the previously prescribed dose; subsequently, continue decreasing the dose at a more gradual rate Switching to or from a monoamine oxidase inhibitor (MAOI) used to treat for psychiatric disorders At least 14 days should elapse between discontinuation of an MAOI intended to treat psychiatric disorders and initiation of escitalopram Conversely, allow at least 14 days after stopping escitalopram before starting an MAOI Major Depressive Disorders/Generalized Anxiety Disorder 10 mg PO qDay; no additional benefits observed with 20 mg/day Dosing Considerations Older patients are more prone to SSRI/SNRI-induced hyponatremia; also, patients taking diuretics or are otherwise volume depleted may be at greater risk Interaction CheckerEnter a drug name and escitalopramNo Results No Interactions Found Interactions FoundContraindicatedSerious - Use AlternativeSignificant - Monitor CloselyMinorAll Interactions Sort By: SeverityName Contraindicated (13)cisaprideescitalopram increases toxicity of cisapride by QTc interval. Contraindicated.dronedaroneescitalopram increases toxicity of dronedarone by QTc interval. Contraindicated.goserelingoserelin increases toxicity of escitalopram by QTc interval. Contraindicated. Increases risk of torsades de pointes.isocarboxazidisocarboxazid and escitalopram both increase serotonin levels. Contraindicated.lefamulinlefamulin will increase the level or effect of escitalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Lefamulin is contraindicated with CYP3A substrates know to prolong the QT interval.leuprolideleuprolide increases toxicity of escitalopram by QTc interval. Contraindicated. Increases risk of torsades de pointes.phenelzinephenelzine and escitalopram both increase serotonin levels. Contraindicated.pimozideescitalopram and pimozide both increase QTc interval. Contraindicated.procarbazineprocarbazine and escitalopram both increase serotonin levels. Contraindicated. Combination is contraindicated within 2 weeks of MAOI use.selegilineselegiline and escitalopram both increase serotonin levels. Contraindicated. At least 14 days should elapse between discontinuation of selegiline and initiation of treatment with a serotonergic drug.thioridazineescitalopram increases toxicity of thioridazine by QTc interval. Contraindicated.tranylcyprominetranylcypromine and escitalopram both increase serotonin levels. Contraindicated.ziprasidoneescitalopram and ziprasidone both increase QTc interval. Contraindicated.ziprasidone and escitalopram both increase QTc interval. Contraindicated.Serious - Use Alternative (136)abametapirabametapir will increase the level or effect of escitalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. For 2 weeks after abametapir application, avoid taking drugs that are CYP3A4 substrates. If not feasible, avoid use of abametapir.adagrasibadagrasib, escitalopram. Either increases effects of the other by QTc interval. Avoid or Use Alternate Drug. Each drug prolongs the QTc interval, which may increased the risk of Torsade de pointes, other serious arryhthmias, and sudden death. If coadministration unavoidable, more frequent monitoring is recommended for such patients.alfentanilalfentanil, escitalopram. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.amiodaroneescitalopram increases toxicity of amiodarone by QTc interval. Avoid or Use Alternate Drug.amisulprideamisulpride and escitalopram both increase QTc interval. Avoid or Use Alternate Drug. ECG monitoring is recommended if coadministered.amitriptylineescitalopram and amitriptyline both increase serotonin levels. Avoid or Use Alternate Drug.escitalopram increases toxicity of amitriptyline by QTc interval. Avoid or Use Alternate Drug.amoxapineescitalopram and amoxapine both increase serotonin levels. Avoid or Use Alternate Drug.apalutamideapalutamide will decrease the level or effect of escitalopram by affecting hepatic enzyme CYP2C19 metabolism. Avoid or Use Alternate Drug. Coadministration of apalutamide, a strong CYP2C19 inducer, with drugs that are CYP2C19 substrates can result in lower exposure to these medications. Avoid or substitute another drug for these medications when possible. Evaluate for loss of therapeutic effect if medication must be coadministered.apalutamide will decrease the level or effect of escitalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Coadministration of apalutamide, a strong CYP3A4 inducer, with drugs that are CYP3A4 substrates can result in lower exposure to these medications. Avoid or substitute another drug for these medications when possible. Evaluate for loss of therapeutic effect if medication must be coadministered. Adjust dose according to prescribing information if needed.arsenic trioxideescitalopram increases toxicity of arsenic trioxide by QTc interval. Avoid or Use Alternate Drug.artemetherartemether and escitalopram both increase QTc interval. Avoid or Use Alternate Drug.artemether/lumefantrineescitalopram increases toxicity of artemether/lumefantrine by QTc interval. Avoid or Use Alternate Drug.asenapineescitalopram increases toxicity of asenapine by QTc interval. Avoid or Use Alternate Drug.asenapine transdermalasenapine transdermal and escitalopram both increase QTc interval. Avoid or Use Alternate Drug.azithromycinescitalopram increases toxicity of azithromycin by QTc interval. Avoid or Use Alternate Drug.buprenorphinebuprenorphine and escitalopram both increase QTc interval. Avoid or Use Alternate Drug.buprenorphine buccalbuprenorphine buccal and escitalopram both increase QTc interval. Avoid or Use Alternate Drug.buprenorphine subdermal implantbuprenorphine subdermal implant and escitalopram both increase QTc interval. Avoid or Use Alternate Drug.buprenorphine transdermalbuprenorphine transdermal and escitalopram both increase QTc interval. Avoid or Use Alternate Drug.buprenorphine, long-acting injectionbuprenorphine, long-acting injection and escitalopram both increase QTc interval. Avoid or Use Alternate Drug.bupropionescitalopram increases toxicity of bupropion by unspecified interaction mechanism. Avoid or Use Alternate Drug. May lower seizure threshold; keep bupropion dose as low as possible.buspironeescitalopram and buspirone both increase serotonin levels. Avoid or Use Alternate Drug.ceritinibceritinib and escitalopram both increase QTc interval. Avoid or Use Alternate Drug.ceritinib will increase the level or effect of escitalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.chlorpromazineescitalopram increases toxicity of chlorpromazine by QTc interval. Avoid or Use Alternate Drug.citalopramcitalopram and escitalopram both increase serotonin levels. Avoid or Use Alternate Drug. Combination may increase risk of serotonin syndrome or neuroleptic malignant syndrome-like reactions. ECG monitoring is recommended, along with drugs that may prolong the QT interval.clarithromycinclarithromycin, escitalopram. Either increases toxicity of the other by QTc interval. Avoid or Use Alternate Drug. To monitor for the prolongation of QT/QTc and/or development of ventricular tachyarrhythmias the labeling recommends monitoring QT interval or ECG.escitalopram increases toxicity of clarithromycin by QTc interval. Avoid or Use Alternate Drug.clarithromycin will increase the level or effect of escitalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.clomipramineescitalopram and clomipramine both increase serotonin levels. Avoid or Use Alternate Drug.crizotinibescitalopram increases toxicity of crizotinib by QTc interval. Avoid or Use Alternate Drug.cyclobenzaprineescitalopram and cyclobenzaprine both increase serotonin levels. Avoid or Use Alternate Drug.desfluranedesflurane and escitalopram both increase QTc interval. Avoid or Use Alternate Drug.desipramineescitalopram and desipramine both increase serotonin levels. Avoid or Use Alternate Drug.desvenlafaxineescitalopram and desvenlafaxine both increase serotonin levels. Avoid or Use Alternate Drug.dextromethorphanescitalopram and dextromethorphan both increase serotonin levels. Avoid or Use Alternate Drug.disopyramideescitalopram increases toxicity of disopyramide by QTc interval. Avoid or Use Alternate Drug.dofetilidedofetilide increases toxicity of escitalopram by QTc interval. Avoid or Use Alternate Drug.escitalopram increases toxicity of dofetilide by QTc interval. Avoid or Use Alternate Drug.dosulepinescitalopram and dosulepin both increase serotonin levels. Avoid or Use Alternate Drug.doxepinescitalopram and doxepin both increase serotonin levels. Avoid or Use Alternate Drug.doxepin and escitalopram both increase QTc interval. Avoid or Use Alternate Drug.droperidolescitalopram increases toxicity of droperidol by QTc interval. Avoid or Use Alternate Drug.encorafenibescitalopram increases toxicity of encorafenib by QTc interval. Avoid or Use Alternate Drug.entrectinibescitalopram and entrectinib both increase QTc interval. Avoid or Use Alternate Drug.enzalutamideenzalutamide will decrease the level or effect of escitalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.eribulinescitalopram increases toxicity of eribulin by QTc interval. Avoid or Use Alternate Drug.erythromycin baseescitalopram increases toxicity of erythromycin base by QTc interval. Avoid or Use Alternate Drug.erythromycin ethylsuccinateescitalopram increases toxicity of erythromycin ethylsuccinate by QTc interval. Avoid or Use Alternate Drug.erythromycin lactobionateescitalopram increases toxicity of erythromycin lactobionate by QTc interval. Avoid or Use Alternate Drug.erythromycin stearateescitalopram increases toxicity of erythromycin stearate by QTc interval. Avoid or Use Alternate Drug.fentanylfentanyl, escitalopram. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.fentanyl intranasalfentanyl intranasal, escitalopram. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.fentanyl transdermalfentanyl transdermal, escitalopram. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.fentanyl transmucosalfentanyl transmucosal, escitalopram. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.fexinidazolefexinidazole and escitalopram both increase QTc interval. Avoid or Use Alternate Drug. Avoid coadministration of fexinidazole with drugs known to block potassium channels or prolong QT interval.fexinidazole will increase the level or effect of escitalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Fexinidazole inhibits CYP3A4. Coadministration may increase risk for adverse effects of CYP3A4 substrates. flecainideescitalopram increases toxicity of flecainide by QTc interval. Avoid or Use Alternate Drug.fluoxetinefluoxetine will increase the level or effect of escitalopram by affecting hepatic enzyme CYP2C19 metabolism. Avoid or Use Alternate Drug.escitalopram and fluoxetine both increase serotonin levels. Avoid or Use Alternate Drug.fluvoxaminefluvoxamine and escitalopram both increase serotonin levels. Avoid or Use Alternate Drug.foscarnetescitalopram increases toxicity of foscarnet by QTc interval. Avoid or Use Alternate Drug.gilteritinibgilteritinib will decrease the level or effect of escitalopram by Other (see comment). Avoid or Use Alternate Drug. Coadministration of gilteritinib with drugs that inhibit 5HT2B or sigma nonspecific receptors. Avoid use of these drugs with gilteritinib unless coadministration is necessary.gilteritinib and escitalopram both increase QTc interval. Avoid or Use Alternate Drug.glasdegibescitalopram and glasdegib both increase QTc interval. Avoid or Use Alternate Drug. If coadministration unavoidable, monitor for increased risk of QTc interval prolongation.granisetrongranisetron, escitalopram. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.histrelinhistrelin increases toxicity of escitalopram by QTc interval. Avoid or Use Alternate Drug. Increases risk of torsades de pointes.hydromorphonehydromorphone, escitalopram. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.hydroxychloroquine sulfatehydroxychloroquine sulfate and escitalopram both increase QTc interval. Avoid or Use Alternate Drug.escitalopram increases toxicity of hydroxychloroquine sulfate by QTc interval. Avoid or Use Alternate Drug.ibutilideescitalopram