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Introduction About PRIDEP PLUS TABLET

PRIDEP PLUS TABLETcontains a combination of Clonazepam and Escitalopram which belongs to the group of medicines called Antidepressants. It is indicated for the management of comorbid depression and anxiety disorder.

Comorbid depression and anxiety disorder is condition in which the person has anxiety and depression together at the same time. Symptoms are persistent feeling of sadness or loss of interest, changes in sleep, appetite, energy level, concentration or daily behavior, feeling nervous or restless, fast heartrate, heavy breathing.

Avoid consumption of alcohol during management with PRIDEP PLUS TABLET. PRIDEP PLUS TABLET is not recommended to use in patients having liver or heart diseases, acute narrow-angle glaucoma (increased pressure within the eye) or if you are taking MAO inhibitors such as isocarboxazid or moclobemide (to manage depression), selegiline (used to manage Parkinson’s disease) or linezolid (an antibiotic).

Before taking PRIDEP PLUS TABLET inform your doctor if you have kidney, liver or, lung diseases, epilepsy, low levels of sodium, tendency of bleeding and bruising and diabetes. Patients should be monitored for signs of suicidal ideation and behaviors and advised to seek immediate medical advice if any such signs occur.

PRIDEP PLUS TABLET should be used with caution in pregnant and breastfeeding women only if clearly advised by the doctor. Consult your doctor before taking it. PRIDEP PLUS TABLET is not recommended for use in children and adolescents (18 years and below).PRIDEP PLUS TABLET should be used with caution in elderly patients (above 65 years of age).

The most common side effects of taking PRIDEP PLUS TABLET are nausea, headache, diarrhea, constipation, dry mouth, increased sweating, increased or decreased appetite, etc. Consult your doctor if any of the symptoms worsen or persists.

Uses Of PRIDEP PLUS TABLET

Manage comorbid depression and anxiety disorder

How PRIDEP PLUS TABLET Works

PRIDEP PLUS TABLET is a combination of Clonazepam and Escitalopram, where Clonazepam is a benzodiazepine that increases the action of gamma-aminobutyric acid (GABA), a chemical messenger that suppresses the abnormal activity of the nerve cells in the brain. Escitalopram is a selective serotonin reuptake inhibitor (SSRI) that increases the levels of serotonin, a chemical messenger that improves mood.

How to use PRIDEP PLUS TABLET

Take PRIDEP PLUS TABLET as advised by your physician. Swallow the medicine with water. Do not crush or chew the medication. Your physician will decide the correct dose and duration of PRIDEP PLUS TABLET for you depending on your age, body weight and disease condition.

Side Effects Of PRIDEP PLUS TABLET

Common

nausea
headache
blocked runny nose
increased or decreased appetite
restlessness, anxiety, abnormal dreams, difficulties falling asleep, feeling sleepy, dizziness, tremors, yawning, prickling of the skin
diarrhea, constipation
vomiting
dry mouth
increased sweating
pain in muscles and joints
sexual problems (problems with erection, delayed ejaculation, decreased sexual drive and women may experience difficulties achieving orgasm)
fatigue, fever
increased weight

Uncommon

rash and itching
grinding teeth, agitation, nervousness, panic attacks, confused state
disturbed sleep
taste disturbance
fainting
enlarged pupils, visual disturbance
ringing in the ears
hair loss
menstrual problems (excessive bleeding or irregular menstrual period)
vaginal bleeding
decreased weight
fast heartbeat
swelling of the arms or legs
nosebleeds

Rare

aggression, depersonalization, hallucination
slow heartbeat

Stop taking PRIDEP PLUS TABLET and contact your doctor immediately if you experience any of the following side effects:

thoughts of killing or harming yourself
allergic reactions (symptoms include skin rash, flaking skin, boils, swelling of the face, sore lips and mouth, fever, sudden wheezing, fluttering or tightness in the chest or collapse)
signs of heart-related problems (breathlessness, swelling of the ankles, cough, tiredness and a racing heart, chest pain which may spread to neck and shoulders or left arm)
change in behavior (aggressiveness, irritability, excitement, agitation, nervousness, hostile, anxiousness, sleeping problems, nightmares or vivid dreams)
mental problems (like seeing or hearing things that are not there (hallucinations), believing in things that are not real (delusions) or problems with speech)
seizures
unusual bleeding (including gastrointestinal bleeding)
serotonin syndrome (signs include high fever, agitation, confusion, trembling and abrupt contractions of muscles)
liver problems (like hepatitis signs include yellowing of the skin or whitish of the eye)
difficulty in urination

How To Manage Side Effects

Nausea:

Take PRIDEP PLUS TABLET with or after meals. Stick to simple meals upon taking this medicine. Avoid eating rich or spicy food. Do not take any medication for nausea without your doctor’s consultation. Ask for your doctor’s advice if the nausea doesn’t improve.

Vomiting:

Get adequate rest. Drink lots of fluids, especially water. Have small sips if you feel sick. Do not take any medicine for vomiting without your doctor's consultation. Contact your doctor if vomiting does not go or worsen.

Dizziness:

Lie or sit down especially when you feel dizzy. If you're feeling a severe episode of spinning(vertigo), lie in a dark and quiet place with your eyes closed. Try to avoid vehicle driving. Discuss with your doctor if the dizziness worsens.

Dry mouth:

A dry mouth can be managed by chewing sugar-free gum or sucking on sugar-free hard candies to stimulate the flow of saliva. Sip water at regular intervals of time. Do not use mouthwashes having alcohol because they can be drying. Consult your physician for advice if your dry mouth doesn’t improve.

Loss of appetite:

Eat when you are hungry. Eat a nutritious snack rich in calories and protein, such as dried fruit and nuts. If the symptom does not improve, consult your doctor.

Constipation:

Eat more fiber-rich foods like fresh fruits, vegetables and cereals and drink plenty of water. Exercise more regularly. If the symptom does not improve, consult your doctor.

Headache:

Try to take rest and don’t involve yourself in exertive activities. Rest in a quiet and dark room. Apply a pain-relieving balm on your forehead. Ask for your doctor’s advice if headache doesn’t improve.

Diarrhea:

Drink more fluids such as water or fruit juice to keep yourself hydrated. Do not consume any medicine on your own without your doctor’s consultation.

Warning & Precautions

Pregnancy

PRIDEP PLUS TABLET should only be used in pregnant women if considered clearly necessary by the doctor. If PRIDEP PLUS TABLET is taken in the third trimester (last 3 months), it may cause trouble with breathing, body temperature changes, bluish skin, fits, feeding difficulties, vomiting, low blood sugar, stiff or floppy muscles, irritability, lethargy, vivid reflexes, tremor, jitteriness, constant crying, sleepiness and sleeping difficulties Consult your doctor before taking PRIDEP PLUS TABLET.

Breastfeeding

PRIDEP PLUS TABLET should only be used in breastfeeding women if considered clearly necessary by the doctor as it may pass through the breast milk. Consult your doctor before taking PRIDEP PLUS TABLET.

Driving and Using Machines

Do not drive or operate any machines if you feel having impaired ability to judge or think after taking PRIDEP PLUS TABLET.

Alcohol

Avoid consumption of alcohol while taking PRIDEP PLUS TABLET as it may cause unpredictable side effects.

Kidney

PRIDEP PLUS TABLET should be used with caution in patients with kidney diseases. Consult your doctor before taking it.

Liver

PRIDEP PLUS TABLET is not recommended to use in patients with significant liver disease and should be used with caution in other liver diseases. Consult your doctor before taking it.

Allergy

Do not take PRIDEP PLUS TABLET if you are allergic to Clonazepam, Escitalopram, other Benzodiazepines or any other ingredients of this medicine.

Lungs

PRIDEP PLUS TABLET should be used with caution in patients with lung disease. Consult your doctor before taking it.

Heart Disease

PRIDEP PLUS TABLET is not recommended to use in patients heart diseases such as abnormal heart rhythm. PRIDEP PLUS TABLET should be used with caution in patients with coronary heart disease, recent heart attacks, low heartrate and fast or irregular heartbeat. Consult your doctor before taking PRIDEP PLUS TABLET.

Others

PRIDEP PLUS TABLET is not recommended for use if you have:

acute narrow-angle glaucoma (increased pressure within the eye)
alcohol or drug abuse

Before taking PRIDEP PLUS TABLET, inform your doctor if you have:

epilepsy
diabetes
bleeding or bruisers
or have had mood problems, depression or suicidal thoughts or behavior
decreased level of sodium in the blood
salt depletion because of prolonged severe diarrhea, vomiting or water tablets
collapse or dizziness on standing up
to receive electroconvulsive management (psychiatric management)

Use in pediatrics:

PRIDEP PLUS TABLET is not recommended for use in children and adolescents (18 years of age and below). Consult your child’s doctor before giving PRIDEP PLUS TABLET to your child.

Use in geriatrics:

PRIDEP PLUS TABLET should be used with caution in elderly patients (above 65 years of age). Consult your doctor before taking it.

Interactions

A. Drug-Drug interactions:

Before taking PRIDEP PLUS TABLET, inform your doctor if you are taking any of the following medicine:

phenelzine, iproniazid, isocarboxazid, nialamide, tranylcypromine, bupropion, tryptophan, fluvoxamine, moclobemide, clomipramine, nortriptyline imipramine and desipramine, St. John’s Wort (herbal) (used to manage depression), lithium (used to manage maniac disorders), risperidone, pimozide, thioridazine and haloperidol (used to manage psychoses)
selegiline (used to manage Parkinson’s disease)
tramadol (used to manage moderate to severe pain), aspirin (used to relieve pain)
sumatriptan (used to manage migraine or cluster headaches)
omeprazole, cimetidine (used to manage stomach problems)
ticlopidine (used to reduce the risk of stroke), flecainide, propafenone and metoprolol (used to manage heart diseases)
warfarin, dipyridamole, phenprocoumon (used to manage blood clots)
mefloquine (used to manage malaria)
sparfloxacin, moxifloxacin, erythromycin IV, pentamidine (used to manage infections)
astemizole, mizolastine (used to manage allergies)
medicines that cause lower potassium and magnesium levels (Ex. cisplatin, gentamycin, furosemide)

Overdosage:

If you or anyone else accidentally take too much of PRIDEP PLUS TABLET, consult your doctor immediately or visit the nearby hospital. The symptoms of overdosage are excessive sleepiness, confusion, dizziness and tremor.

Synopsis

Drug	:	Clonazepam and Escitalopram
Pharmacological Category	:	Benzodiazepines and Selective serotonin reuptake inhibitors (SSRIs)
Therapeutic Indication	:	Comorbid depression and anxiety disorder
Dosage Forms	:	Tablet

More Information

Keep PRIDEP PLUS TABLET out of reach of children
Store PRIDEP PLUS TABLET at a temperature not exceeding 30°C

FAQs About PRIDEP PLUS TABLET

Can PRIDEP PLUS TABLET be used in children?

PRIDEP PLUS TABLET is not recommended for use in children and adolescents (18 years of age and below). Consult your child’s doctor before giving PRIDEP PLUS TABLET to your child.

Can PRIDEP PLUS TABLET be used in patients with liver problems?

PRIDEP PLUS TABLET should be used with caution in patients with liver problems. The dose will be adjusted by your doctor depending on your age and disease condition. Consult your doctor before taking PRIDEP PLUS TABLET.

Can I stop taking PRIDEP PLUS TABLET on my own?

No. You should not stop taking PRIDEP PLUS TABLET until and unless your doctor advises you to. Quick or abrupt discontinuation of the medicine may cause dizziness, sensory disturbances sleep disturbances, agitation or anxiety, nausea and/or vomiting, tremor, confusion, sweating, headache, diarrhea, palpitations, emotional instability, irritability and visual disturbances. If you wish to discontinue using PRIDEP PLUS TABLET, as for your doctor’s advice.

Is PRIDEP PLUS TABLET a habit-forming medicine?

PRIDEP PLUS TABLET is generally considered to be non-habit-forming medicine when taken as prescribed by the doctor. However, PRIDEP PLUS TABLET may cause physical dependence. You must discuss with your doctor if you feel any unusual symptoms while being managed with PRIDEP PLUS TABLET.

What if I forget to take a dose of PRIDEP PLUS TABLET?

If you forget to take a dose of PRIDEP PLUS TABLET, take it as soon as you remember. However, ignore the missed dose if it's almost time for the next one. Do not take PRIDEP PLUS TABLET two times to make up for the missed dose.

References

1. KD Tripathi. Antiepileptic Drugs, Antidepressant and Antianxiety Drugs. Essentials of medical pharmacology. Eighth Edition. 2019. Page –445, 489.

2. Sheng-Min Wang, Jung-Bum Kim, Jeong Kyu Sakong, Ho-Suk Suh, Kang Seob Oh, Jong-Min Woo, Sang-Woo Yoo, Sang Min Lee, Sang-Yeol Lee, Se-Won Lim, Seong Jin Cho, Ik-Seung Chee, Jeong-Ho Chae, Jin Pyo Hong, Kyoung-Uk Lee. The Efficacy and Safety of Clonazepam in Patients with Anxiety Disorder Taking Newer Antidepressants: A Multicenter Naturalistic Study. NIH National Library of Medicine National Centre for Biotechnology Information. Pubmed Central. Journal of Clinical Psychopharmacology and Neuroscience. May 2016 [Accessed on 17th October 2022]. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4857865/

3. Guanjun Li, MD, Yifeng Shen, MD, Jianfeng Luo, MD and Huafang Li, MD. Efficacy of escitalopram monotherapy in the treatment of major depressive disorder. NIH National Library of Medicine National Centre for Biotechnology Information. Pubmed Central. Journal of Medicines September 2017 [Accessed on 17th October 2022]. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5626292/

4. Torrent Pharmaceutical. Clonazepam and Escitalopram. [Revised in March 2022] [Accessed on 17th October 2022]. https://www.torrentian.com/pisheet/Upload/PI_Sheet/3014.pdf

5. Major Pharmaceuticals. Escitalopram Oxalate. Dailymed. [Revised in May 2022]. [Accessed on 17th October 2022]. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=f4a12048-181e-45ed-a382-f53096d1b689

6. Laboratorios Lesvi S.L. Electronic Medicine Compendium (EMC). [Revised in October 2021]. [Accessed on 17th October 2022]. https://www.medicines.org.uk/emc/files/pil.13633.pdf

7. Tasmed Pvt. Ltd. Clonazepam + Escitalopram. [Accessed on 17th October 2022]. https://tasmedlab.com/allproduct/clotas-range/#contr

8. Sanix Formulation Pvt. Ltd. Escibliss-LS (Clonazepam + Escitalopram). [Accessed on 17th October 2022]. http://www.sanixformulation.com/pd/phychiatry/escibliss-ls-escitalopram-5-clonazepam-0-25mg-tablet

9. Leeford Healthcare. Ascilopram (Clonazepam + Escitalopram). [Accessed on 17th October 2022]. https://www.leeford.in/product/549/asiclopam

10. Cipla Ltd. S-Citadep Plus, S-Citadep Forte (Clonazepam + Escitalopram). Ciplamed. [Revised in January 2016]. [Accessed on 17th October 2022]. https://www.ciplamed.com/content/s-citadep-plus-s-citadep-forte-tablets

11. La Renon Healthcare Pvt. Ltd. Escigress – CZ (Clonazepam + Escitalopram). [Accessed on 17th October 2022]. https://www.larenon.com/wp-content/uploads/2016/08/ESCIGRESS-CZ.pdf

12. Lupichem Healthcare. Lupipram – LS. (Clonazepam + Escitalopram). [Accessed on 17th October 2022]. http://www.lupichemhealthcare.com/lupipramls/

13. St. Jude Pharma. Klonzep +5 (Clonazepam + Escitalopram). [Accessed on 17th October 2022]. https://www.stjudepharma.com/product/klonzep-5-tablet/

14. Tripada Healthcare. S-Citapad Forte. (Clonazepam + Escitalopram). [Accessed on 17th October 2022]. http://tripadahealthcare.co.in/antidepressants-antimanics/

15. Psycogen Captab. Elpram C. (Clonazepam + Escitalopram). [Accessed on 17th October 2022]. https://www.psycogen.in/product/elpram-c/

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Author Details

Written By Dr. Priyanka Goel - BDS

Reviewed For Accuracy By Dr. Aravindan Balachandran - MBBS, MD (Psychiatry)

Last updated on 07 Nov 2022 | 02:03 PM(IST)