Escitalopram oral tablet interactions: A detailed guide

This article describes possible interactions with escitalopram oral tablet. Interactions can cause a drug to have a different effect on the body than expected. Interactions can occur due to medications, alcohol, or certain health conditions.

To find coupon options for escitalopram and to learn more about the drug, including its uses, see this article.

Escitalopram comes as a tablet that you’ll swallow. It’s also available as a liquid solution that you’ll swallow. But interactions don’t differ based on the form of escitalopram you use.

Boxed warning: Risk of suicidal thoughts and behaviors

Escitalopram has a boxed warning for the risk of suicidal thoughts and behaviors in certain people. A boxed warning is the most serious warning from the Food and Drug Administration (FDA).

Similar to other antidepressant drugs, taking escitalopram may temporarily increase the risk of suicidal thoughts and behaviors in certain people. This includes children under 18 years and adults under 25 years. Escitalopram is an antidepressant drug.

See the end of this article for more information about this warning.

Other drugs and escitalopram

Drugs that may interact with escitalopram oral tablet are listed below. This article doesn’t include all drugs that may interact with escitalopram.

Drugs that may interact with escitalopram oral tablet include:

• monoamine oxidase inhibitors (MAOIs):*
  • drug examples: selegiline (Emsam, Zelepar), phenelzine (Nardil)
  • what might happen: can increase the risk of side effects from escitalopram and MAOIs
• nonsteroidal anti-inflammatory drugs (NSAIDs):
  • drug examples: ibuprofen (Advil), naproxen (Naprosyn, Aleve)
  • what might happen: can increase the risk of bleeding as a side effect from escitalopram or NSAIDs
• anticoagulants:
  • drug examples: warfarin (Jantoven), apixaban (Eliquis)
  • what might happen: can increase the risk of bleeding as a side effect from escitalopram or anticoagulants
• antiplatelets:
  • drug examples: clopidogrel (Plavix), aspirin
  • what might happen: can increase the risk of bleeding as a side effect from escitalopram or antiplatelets
• other antidepressant drugs:
  • drug examples: duloxetine (Cymbalta), fluoxetine (Prozac)
  • what might happen: can increase the risk of side effects from escitalopram and other antidepressants
• antiarrhythmic drugs:
  • drug examples: sotalol (Betapace, Sotylize), amiodarone (Pacerone)
  • what might happen: can increase the risk of irregular heart rhythm as a side effect from escitalopram and antiarrhythmic drugs
• certain antipsychotics:
  • drug examples: haloperidol (Haldol), risperidone (Risperdal, others)
  • what might happen: can increase the risk of irregular heart rhythm as a side effect from escitalopram and antipsychotics
• sumatriptan (Imitrex, others):
  • what might happen: can experience weakness, increased muscle reflex response, and problems with coordination
• pimozide:*
  • what might happen: can increase the risk of side effects from pimozide and escitalopram

* For more information on this interaction, see the “When to avoid escitalopram” section of this article.

When to avoid escitalopram

Certain health conditions or other factors could increase some risks with escitalopram oral tablet. Because of this, doctors may not prescribe escitalopram in these cases. These health conditions or other factors are called contraindications.

Here’s a list of contraindications for escitalopram oral tablet:

• If you take a monoamine oxidase inhibitor drug (MAOI). If you take an MAOI, taking escitalopram oral tablet may cause serotonin syndrome (high amount of serotonin in your system). You should not take escitalopram within 14 days of taking an MAOI drug.
• If you take pimozide. If you take the drug pimozide, taking escitalopram oral tablet may cause an irregular heart rhythm. This can be serious or even life threatening.
• Past allergic reaction to escitalopram. If you’ve had an allergic reaction to escitalopram oral tablet in the past, taking escitalopram oral tablet may cause another allergic reaction.

Before starting treatment with escitalopram, tell your doctor if anything listed above relates to you. They can recommend whether you should take escitalopram.

Alcohol and escitalopram

Escitalopram oral tablet is known to interact with alcohol.

Taking escitalopram oral tablet and drinking alcohol may cause:

• problems with coordination or thinking
• fatigue (low energy)
• nausea

If you drink alcohol, talk with your doctor about whether it’s safe to consume it during your treatment
with escitalopram oral tablet.

Other interactions and escitalopram

Interactions can occur with supplements, foods, vaccines, and some lab tests. Below you can learn whether escitalopram oral tablet has these interactions.

The information below doesn’t include all other possible interactions with escitalopram.

Escitalopram and supplements

Before taking escitalopram oral tablet, tell your doctor and pharmacist about any herbs you take, as well as vitamins and supplements. Doing so may help you avoid possible interactions.

Escitalopram oral tablet may interact with tryptophan, also called L-tryptophan. This supplement is often used to support mood or sleep.

Taking escitalopram and tryptophan may lead to serotonin syndrome. This is a serious condition caused by too much serotonin in your system.

If you have questions about interactions that may affect you, talk with your doctor or pharmacist.

Escitalopram interactions with herbs

Escitalopram oral tablet may interact with valerian, also called valerian root. This herb is often used to help with sleep.

Taking escitalopram and valerian may lead to drowsiness and fatigue (low energy). It could also cause difficulty concentrating.

Because of this, you should ask your doctor or pharmacist before taking a product that contains valerian during treatment with escitalopram oral tablet.

Escitalopram interactions with vitamins

Escitalopram oral tablet isn’t known to interact with any vitamins. But this doesn’t mean interactions with vitamins can’t happen or won’t be identified later.

Because of this, you should ask your doctor or pharmacist before taking any of these products during treatment with escitalopram oral tablet.

Escitalopram and food

Escitalopram oral tablet isn’t known to interact with foods. But this doesn’t mean interactions with foods can’t happen or won’t be identified later.

Because of this, talk with your doctor or pharmacist about what foods you should avoid during treatment with escitalopram oral tablet.

Escitalopram and vaccines

Escitalopram oral tablet isn’t known to interact with any vaccines. But this doesn’t mean interactions with vaccines can’t happen or won’t be identified later.

Because of this, you should talk with your doctor or pharmacist before receiving any vaccines during treatment with escitalopram oral tablet.

Escitalopram and lab tests

Escitalopram oral tablet isn’t known to interact with lab tests. But this doesn’t mean interactions with lab tests can’t happen or won’t be identified later.

Because of this, you should talk with your doctor or pharmacist before having any tests during treatment with escitalopram oral tablet.

Escitalopram and cannabis or CBD

Escitalopram oral tablet isn’t known to interact with cannabis (commonly called marijuana) or cannabis products such as cannabidiol (CBD). But this doesn’t mean interactions can’t happen or won’t be identified later.

As with any drug or supplement, tell your doctor before taking cannabis with escitalopram.

Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.

Health factors and escitalopram

Certain medical conditions or other health factors may increase the risk of interactions with escitalopram oral tablet. Before taking escitalopram, tell your doctor about your health history. They’ll determine whether escitalopram is right for you.

Here’s a list of health conditions or other factors that might interact with escitalopram oral tablet:

• bleeding problems
• low blood sodium level
• glaucoma
• heart conditions
• liver conditions
• kidney conditions
• bipolar disorder or mania
• epilepsy or seizures
• pregnancy or breastfeeding
• past allergic reaction to escitalopram

Questions about escitalopram and interactions

Here you’ll find answers to some common questions about escitalopram and possible interactions.

Does escitalopram have similar interactions with Prozac?

Yes, escitalopram and fluoxetine (Prozac) have similar interactions. Fluoxetine is the generic version of Prozac.

Escitalopram and Prozac are both selective serotonin reuptake inhibitor drugs. They work in similar ways and have similar interactions. For example, both escitalopram and Prozac interact with aspirin.

Talk with your doctor or pharmacist if you’d like to know more about how interactions of escitalopram compare with those of Prozac.

Is it safe to take buspirone together with escitalopram?

Maybe, if your doctor recommends you take both drugs. Buspirone is prescribed to treat anxiety, which escitalopram may also be used to treat.

Serotonin syndrome is a rare but serious side effect of escitalopram. It’s caused by having too much serotonin in your system. When taken on its own, buspirone isn’t likely to cause serotonin syndrome. But buspirone can cause a slight increase in serotonin. This may be enough to cause serotonin syndrome if you’re also taking escitalopram.

Talk with your doctor to learn more about whether it’s safe for you to take escitalopram and buspirone together.

Preventing escitalopram interactions

You may be able to help avoid certain interactions with escitalopram oral tablet. Before taking this drug, you may want to discuss possible interactions with your doctor and pharmacist.

Things to consider include:

• Whether you drink alcohol or use cannabis.
• Other medications you take, as well as any vitamins, supplements, and herbs. Your doctor or pharmacist can help you fill out a medication list.
• What to do if you’re prescribed a new drug during your escitalopram oral tablet treatment.

Taking escitalopram exactly as prescribed can also help prevent interactions.

What to ask your doctor

If you have questions about escitalopram and possible interactions, talk with your doctor.

Questions you may want to ask your doctor include:

• Does my escitalopram dosage affect my risk of interactions?
• Are interactions with escitalopram similar to other drugs that can treat my condition?
• If I take escitalopram and have certain health conditions, will I be monitored more closely during treatment?

Boxed warning for escitalopram

Escitalopram has a boxed warning for the risk of suicidal thoughts and behaviors. A boxed warning is the most serious warning from the Food and Drug Administration (FDA).

Similar to other antidepressant drugs, escitalopram treatment may temporarily increase the risk of suicidal thoughts and behaviors in certain people. This includes children under 18 years and adults under 25 years.

Signs of suicidal thoughts and behaviors include:

• expressing that others would be better off without you
• avoiding social contact and staying away from others
• making plans to give away your possessions

This risk is believed to be the highest when you first begin treatment and any time your escitalopram dosage is changed. It’s thought this risk may decrease as you continue taking escitalopram.

It’s important to note that depression is also a risk factor for suicidal thoughts and behaviors. Escitalopram is prescribed to treat depression.

To learn more, talk with your doctor.

Suicide prevention

If you or someone you know is in crisis and considering suicide or self-harm, please seek support:

• Call the 988 Suicide and Crisis Lifeline at 988.
• Text HOME to the Crisis Textline at 741741.
• Not in the United States? Find a helpline in your country with Befrienders Worldwide.
• Call 911 or your local emergency services number if you feel safe to do so.

If you’re calling on behalf of someone else, stay with them until help arrives. You may remove weapons or substances that can cause harm if you can do so safely.

If you are not in the same household, stay on the phone with them until help arrives.

Disclaimer: Optum Perks has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.