{"id":56161,"date":"2024-02-07T05:55:19","date_gmt":"2024-02-07T05:55:19","guid":{"rendered":"https:\/\/medsname.com\/citapad\/"},"modified":"2026-04-30T10:24:40","modified_gmt":"2026-04-30T10:24:40","slug":"citapad","status":"publish","type":"product","link":"https:\/\/medsbase.com\/cs\/product\/citapad\/","title":{"rendered":"Citapad"},"content":{"rendered":"

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\u26a1 Rychl\u00e1 odpov\u011b\u010f<\/h3>\n

Citapad (Citalopram 10 \/ 20 \/ 40 mg) je selektivn\u00ed inhibitor zp\u011btn\u00e9ho vychyt\u00e1v\u00e1n\u00ed serotoninu pou\u017e\u00edvan\u00fd k l\u00e9\u010db\u011b deprese, \u00fazkosti a souvisej\u00edc\u00edch poruch. N\u00e1stup antidepresivn\u00edho \u00fa\u010dinku je postupn\u00fd \u2014 pro \u0159\u00e1dn\u00e9 vyhodnocen\u00ed je pot\u0159eba 4\u20136 t\u00fddn\u016f.<\/p>\n<\/div>\n

\nCo z\u00edsk\u00e1te s MedsBase:<\/strong> V\u00fdrobce certifikovan\u00fd WHO-GMP \u00b7 Diskr\u00e9tn\u00ed balen\u00ed \u00b7 Celosv\u011btov\u00e1 doprava \u00b7 V\u00edce ne\u017e 1 400 ov\u011b\u0159en\u00fdch recenz\u00ed z\u00e1kazn\u00edk\u016f<\/a>\n<\/div>\n

\ud83d\udce6 Ka\u017ed\u00e1 objedn\u00e1vka je pokryta na\u0161\u00ed Z\u00e1rukou op\u011btovn\u00e9ho odesl\u00e1n\u00ed<\/strong><\/a> \u2014 pokud va\u0161e z\u00e1silka nedoraz\u00ed do 20 pracovn\u00edch dn\u016f, p\u0159epos\u00edl\u00e1me ji.<\/p>\n

Pro\u010d objedn\u00e1vat z MedsBase<\/h3>\n

Citapad na MedsBase je dod\u00e1v\u00e1n p\u0159\u00edmo od v\u00fdrobce certifikovan\u00e9ho WHO-GMP v prost\u00e9m, diskr\u00e9tn\u00edm balen\u00ed. Ka\u017ed\u00e1 objedn\u00e1vka je pokryta na\u0161\u00ed Z\u00e1rukou op\u011btovn\u00e9ho odesl\u00e1n\u00ed<\/a> \u2014 20pracovn\u00edchdenn\u00ed lh\u016fta pro doru\u010den\u00ed, nebo v\u00e1m z\u00e1silku zdarma p\u0159epo\u0161leme \u2014 a oprav\u0148uje v\u00e1s k \u00fa\u010dasti v na\u0161em v\u011brnostn\u00edm programu<\/a>. Dod\u00e1v\u00e1me do v\u011bt\u0161iny zem\u00ed po cel\u00e9m sv\u011bt\u011b.<\/p>\n

Jak Citapad funguje<\/h2>\n

Citapad<\/strong> je SSRI tableta obsahuj\u00edc\u00ed Citalopram, dod\u00e1van\u00e1 spole\u010dnost\u00ed Cipla. Dostupn\u00e9 s\u00edly: 10 \/ 20 \/ 40 mg<\/strong>. U\u017e\u00edvejte s j\u00eddlem nebo bez j\u00eddla, ve stejnou dobu ka\u017ed\u00fd den pro stabiln\u00ed hladinu v plazm\u011b.<\/p>\n

SSRI blokuj\u00ed zp\u011btn\u00e9 vychyt\u00e1v\u00e1n\u00ed serotoninu (5-HT) na presynaptick\u00e9m serotoninov\u00e9m transport\u00e9ru (SERT), \u010d\u00edm\u017e zvy\u0161uj\u00ed dostupnost synaptick\u00e9ho serotoninu. Terapeutick\u00fd \u00fa\u010dinek se objevuje se zpo\u017ed\u011bn\u00edm 2\u20136 t\u00fddn\u016f po blok\u00e1d\u011b transport\u00e9ru \u2014 toto zpo\u017ed\u011bn\u00ed odr\u00e1\u017e\u00ed n\u00e1sledn\u00e9 adaptace v citlivosti 5-HT autoreceptor\u016f, expresi BDNF a neurogenezi v hippocampu, nikoli p\u0159\u00edm\u00e9 \u00fa\u010dinky na receptory. Pacienti, kte\u0159\u00ed po 2 t\u00fddnech \u201cnec\u00edt\u00ed nic\u201d, by nem\u011bli l\u00e9\u010dbu p\u0159ed\u010dasn\u011b ukon\u010dovat; vyhodno\u0165te odpov\u011b\u010f po 4\u20136 t\u00fddnech adekv\u00e1tn\u00ed d\u00e1vky.<\/p>\n

Citalopram je racemick\u00e9 SSRI<\/strong> \u2014 R-enantiomer p\u0159id\u00e1v\u00e1 malou antidepresivn\u00ed aktivitu, ale p\u0159isp\u00edv\u00e1 v\u011bt\u0161inou k sign\u00e1lu QT intervalu. Escitalopram (Lexaheal, S-enantiomer) dosahuje stejn\u00e9ho terapeutick\u00e9ho \u00fa\u010dinku p\u0159i polovi\u010dn\u00ed d\u00e1vce s v\u00fdrazn\u011b ni\u017e\u0161\u00edm rizikem QT prodlou\u017een\u00ed.<\/p>\n

Indikace a d\u00e1vkov\u00e1n\u00ed<\/h2>\n\n\n\n\n\n\n\n
Indikace<\/th>\nPo\u010d\u00e1te\u010dn\u00ed d\u00e1vka<\/th>\nC\u00edlov\u00e1 d\u00e1vka<\/th>\nMaxim\u00e1ln\u00ed d\u00e1vka<\/th>\n<\/tr>\n<\/thead>\n
Hlavn\u00ed deprese<\/td>\n20 mg 1\u00d7 denn\u011b<\/td>\n20\u201340 mg 1\u00d7 denn\u011b<\/td>\n40 mg (20 mg u pacient\u016f >60 let)<\/td>\n<\/tr>\n
Generalizovan\u00e1 \u00fazkost \/ panika<\/td>\n10 mg 1\u00d7 denn\u011b po dobu 1 t\u00fddne<\/td>\n20 mg 1\u00d7 denn\u011b<\/td>\n40 mg<\/td>\n<\/tr>\n
Star\u0161\u00ed pacienti \/ CYP2C19 PM \/ inhibitory CYP2C19<\/td>\n10 mg 1\u00d7 denn\u011b<\/td>\n10\u201320 mg 1\u00d7 denn\u011b<\/td>\n20 mg<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

D\u016fle\u017eit\u00e9 bezpe\u010dnostn\u00ed aspekty<\/h2>\n
\nFDA limit d\u00e1vkov\u00e1n\u00ed \u2014 prodlou\u017een\u00ed QT intervalu<\/strong><\/p>\n

V roce 2011 FDA omezila maxim\u00e1ln\u00ed denn\u00ed d\u00e1vku citalopramu na 40 mg\/den<\/strong> u b\u011b\u017en\u00e9 populace a 20 mg\/den<\/strong> u dosp\u011bl\u00fdch nad 60 let, u pacient\u016f s pomal\u00fdm metabolismem CYP2C19 a u pacient\u016f u\u017e\u00edvaj\u00edc\u00edch inhibitory CYP2C19 (omeprazol, esomeprazol, flukoxamin, cimetidin). D\u00e1vky nad 40 mg zp\u016fsobuj\u00ed d\u00e1vkov\u011b z\u00e1visl\u00e9 prodlou\u017een\u00ed QT intervalu. Pokud m\u00e1te vrozen\u00fd dlouh\u00fd QT interval, hypokal\u00e9mii, hypomagnez\u00e9mii, ned\u00e1vn\u00fd infarkt myokardu nebo dekompenzovan\u00e9 srde\u010dn\u00ed selh\u00e1n\u00ed, citalopram nen\u00ed vhodn\u00e9 SSRI<\/strong> \u2014 sertralin je nejbli\u017e\u0161\u00ed farmakologick\u00e1 alternativa bez rizika prodlou\u017een\u00ed QT intervalu.<\/p>\n<\/div>\n

\n\u010cern\u00e9 varov\u00e1n\u00ed ohledn\u011b sebevra\u017eednosti (u osob do 25 let)<\/strong><\/p>\n

V\u0161echna SSRI nesou varov\u00e1n\u00ed FDA (\u010dern\u00fd r\u00e1me\u010dek) ohledn\u011b zv\u00fd\u0161en\u00e9ho rizika sebevra\u017eedn\u00fdch my\u0161lenek u pacient\u016f mlad\u0161\u00edch 25 let, zejm\u00e9na v prvn\u00edch 4 t\u00fddnech a p\u0159i zm\u011bn\u00e1ch d\u00e1vkov\u00e1n\u00ed. To neznamen\u00e1, ne<\/em> \u017ee SSRI jsou pro mlad\u00e9 lidi celkov\u011b \u0161kodliv\u00e1 \u2014 metaanal\u00fdzy ukazuj\u00ed \u010dist\u00fd benefit \u2014 ale vy\u017eaduje to pe\u010dliv\u00e9 klinick\u00e9 sledov\u00e1n\u00ed b\u011bhem zah\u00e1jen\u00ed l\u00e9\u010dby a titrace u dosp\u00edvaj\u00edc\u00edch a mlad\u00fdch dosp\u011bl\u00fdch.<\/p>\n<\/div>\n

\nSerotoninov\u00fd syndrom<\/strong><\/p>\n

Kombinace Citapadu s dal\u0161\u00edmi serotonergn\u00edmi l\u00e1tkami m\u016f\u017ee zp\u016fsobit serotoninov\u00fd syndrom (t\u0159es, hyperreflexie, klonus, hypertermie, agitovanost). Vyvarujte se sou\u010dasn\u00e9ho u\u017e\u00edv\u00e1n\u00ed: MAOI (14denn\u00ed vynech\u00e1n\u00ed v obou sm\u011brech; fluoxetin vy\u017eaduje 5 t\u00fddn\u016f), tramadol, petidin, dextrometorfan, linezolid, methylenov\u00e1 mod\u0159, t\u0159ezalka te\u010dkovan\u00e1, MDMA. Kombinace triptan\u016f + SSRI je obecn\u011b tolerov\u00e1na u migr\u00e9ny \u2014 absolutn\u00ed riziko je n\u00edzk\u00e9.<\/p>\n<\/div>\n

\u010cast\u00e9 ne\u017e\u00e1douc\u00ed \u00fa\u010dinky<\/h2>\n