Depran-L Tablet: Complete Guide to Uses, Side Effects, and Safety
Clinical Reference Standards: CDSCO (Central Drugs Standard Control Organisation), Indian Pharmacopoeia (IP) & WHO | Last Updated: September 2026
When to Call Your Doctor IMMEDIATELY
- Thoughts of harming yourself or others
- Severe allergic reaction (swelling of face, lips, throat, difficulty breathing)
- Irregular heartbeat or chest pain
- Severe confusion or hallucinations
- Seizures
- High fever with muscle rigidity and sweating (serotonin syndrome)
- Yellowing of skin or eyes
If experiencing severe symptoms, call emergency services immediately.
What is astawin h 0.25mg/5mg tablet used for?
This medicine is a combination of Clonazepam 0.25 mg and Escitalopram 5 mg used to treat anxiety and depression. It works by calming the brain and increasing serotonin. It should be taken exactly as prescribed and not stopped suddenly.
- Generic Name: Clonazepam + Escitalopram
- Manufacturer: Ishjas Pharma Pvt Ltd
- Form: Allopathy
- Pregnancy Category: Consult doctor
- Prescription Required: Yes
🇮🇳 astawin h 0.25mg/5mg tablet के बारे में (Hindi Summary)
उपयोग: यह दवा क्लोनाजेपाम 0.25 मिलीग्राम और एससिटालोप्राम 5 मिलीग्राम का संयोजन है, जिसका उपयोग चिंता विकार, पैनिक डिसऑर्डर और अवसाद के इलाज के लिए किया जाता है। यह मस्तिष्क में शांति प्रदान करने वाले रसायनों को बढ़ाकर काम करती है। इस दवा को डॉक्टर के निर्देशानुसार ही लें और अचानक बंद न करें।
साइड इफेक्ट्स: इस दवा के सामान्य दुष्प्रभावों में नींद आना, चक्कर आना, थकान, मुँह सूखना और जी मिचलाना शामिल हैं। गंभीर दुष्प्रभावों में सीरोटोनिन सिंड्रोम, एलर्जी और आत्महत्या के विचार शामिल हो सकते हैं। यदि आपको सांस लेने में कठिनाई, चेहरे या गले में सूजन, या दिल की धड़कन अनियमित लगे तो तुरंत डॉक्टर से मिलें।
सुरक्षा सलाह: इस दवा को डॉक्टर के बताए अनुसार ही लें। इसे चबाएं या तोड़ें नहीं। जब तक आपको पता न चले कि यह दवा आप पर कैसा असर करती है, तब तक वाहन न चलाएं। शराब का सेवन न करें। इस दवा को अचानक बंद न करें, इससे withdrawal के लक्षण हो सकते हैं। गर्भावस्था या स्तनपान के दौरान डॉक्टर से सलाह लें।
💊 astawin h 0.25mg/5mg tablet Uses & Benefits
[{"condition":"Generalized Anxiety Disorder","description":"This medicine helps reduce excessive worry, restlessness, and tension by combining the rapid calming effect of clonazepam with the mood-stabilizing action of escitalopram.","evidence":"Well-established for the combination in clinical practice, though fixed-dose combinations are used based on clinical judgment."},{"condition":"Panic Disorder","description":"It is used to decrease the frequency and intensity of panic attacks, with clonazepam providing immediate relief and escitalopram offering long-term control.","evidence":"Well-established for individual components; combination use is common in clinical settings."},{"condition":"Major Depressive Disorder with Anxiety","description":"This medicine is prescribed when depression is accompanied by significant anxiety symptoms, as escitalopram treats depression and clonazepam addresses acute anxiety.","evidence":"Supported by clinical experience and guidelines for combined therapy."}]
Off-label uses: [{"condition":"Irritable Bowel Syndrome with anxiety","description":"Sometimes prescribed off-label to manage anxiety-related gastrointestinal symptoms.","evidence":"Limited"},{"condition":"Premenstrual Dysphoric Disorder","description":"May be used off-label for severe premenstrual mood symptoms with anxiety.","evidence":"Limited"}]
Primary treatment for: Generalized Anxiety Disorder
Also treats: Panic Disorder, Major Depressive Disorder with anxiety, Social Anxiety Disorder
📋 Drug Information
| Generic Name(s) | Clonazepam + Escitalopram |
| Brand Name | Asiclopam Tablet |
| Manufacturer | Ishjas Pharma Pvt Ltd |
| Packaging / Form | Varies by brand (Allopathy) |
| Therapeutic Class | NEURO CNS |
| Action Class | Benzodiazepine + SSRI |
| Route of Administration | Oral |
| Storage | Store at room temperature between 15°C and 30°C (59°F to 86°F). Protect from moisture and light. Keep in the original container. |
| Shelf Life | 24 months from the date of manufacture. |
| WHO Guideline | Not established from the available information. Guidelines generally recommend SSRIs as first-line for anxiety disorders, with benzodiazepines used short-term for severe symptoms. |
| ICMR Guideline | Not established from the available information. ICMR guidelines for mental health may recommend similar approaches. |
👨⚕️ Doctor's Practical Tips
Evidence-based practical advice from experienced clinicians
🔍 Is This Medicine Right for Your Symptom?
Educational reference. Always consult a doctor for diagnosis.
🔬 How This Medicine Works (Pharmacology)
Pharmacokinetics
How It Works
This medicine combines two active ingredients with distinct mechanisms. Clonazepam, a benzodiazepine, binds to the benzodiazepine site on the GABA-A receptor, enhancing the inhibitory effect of GABA, which leads to increased chloride channel opening and neuronal hyperpolarization, resulting in anxiolytic, sedative, and muscle relaxant effects. Escitalopram, a selective serotonin reuptake inhibitor (SSRI), blocks the serotonin transporter (SERT) in the presynaptic neuron, increasing serotonin availability in the synaptic cleft, which enhances serotonergic neurotransmission and improves mood and anxiety over time.
Mechanism Steps
💡 How to Take astawin h 0.25mg/5mg tablet
Strength: Each tablet contains Clonazepam 0.25 mg and Escitalopram Oxalate 5 mg.
Dosage Information
| Adult Dosage | The usual adult dose of this medicine is one tablet taken orally once daily, preferably at bedtime to minimize daytime drowsiness. However, the exact dose and frequency must be individualized by a qualified clinician based on the indication, severity of symptoms, age, weight, renal and hepatic function, and response to therapy. Some patients may require a different dose or titration schedule. Do not self-adjust the dose. |
| Pediatric Dosage | Pediatric dosing is not established from available information. Consult a pediatrician. |
| Elderly Dosage | Elderly patients (above 65 years) are more sensitive to the effects of benzodiazepines and SSRIs. A lower starting dose is recommended, and dose titration should be done slowly. Close monitoring for sedation, falls, and hyponatremia is advised. |
| Renal Impairment | Dose adjustment may be necessary in patients with renal impairment. Clonazepam and escitalopram are excreted by the kidneys. Consult your doctor for appropriate dosing. |
| Hepatic Impairment | Use with caution in patients with hepatic impairment. Dose reduction may be required. Contraindicated in severe hepatic impairment. |
| Maximum Daily Dose | The maximum daily dose should not exceed the prescribed amount. Typically, the maximum recommended dose for escitalopram is 20 mg per day and for clonazepam is 20 mg per day, but in this fixed combination, the dose is limited by the formulation. Do not exceed the prescribed dose. |
Dosage Timeline
🍽️ Food Timing Guide
⏰ What to Do If You Miss a Dose
⚠️ Side Effects of astawin h 0.25mg/5mg tablet
✅ Common Side Effects
🚨 Serious Side Effects
⚠️ Rare Side Effects
Consult your doctor if you experience any unusual symptoms.
🔬 Drug Interactions
| Drug | Severity | Effect |
|---|---|---|
| MAO inhibitors | Major | |
| Opioids | Major | |
| Warfarin | Major | |
| Ketoconazole | Moderate | |
| Omeprazole | Moderate | |
| Ibuprofen | Moderate | |
| Antacids | Minor | |
| Grapefruit juice | Minor | |
| Caffeine | Minor | |
| St. John's Wort | Moderate |
🚨 Major Interactions
- MAO inhibitors (e.g., phenelzine, tranylcypromine)
- CNS depressants (e.g., opioids, alcohol, barbiturates)
- Warfarin
⚡ Moderate Interactions
- CYP3A4 inhibitors (e.g., ketoconazole, clarithromycin)
- CYP2C19 inhibitors (e.g., omeprazole, fluoxetine)
- NSAIDs (e.g., ibuprofen, aspirin)
🍷 Alcohol Interaction
Alcohol should be strictly avoided while taking this medicine. It can significantly increase drowsiness, dizziness, and the risk of respiratory depression. It may also worsen anxiety and depression symptoms.
🔎 Check Your Other Medicines
Educational tool. Always confirm with your doctor or pharmacist.
🛡️ Safety & Warnings
🚫 Contraindications
["Hypersensitivity to clonazepam, escitalopram, or any component of the formulation","Concurrent use with MAO inhibitors or within 14 days of stopping an MAO inhibitor","Severe hepatic impairment","Narrow-angle glaucoma","Untreated sleep apnea or severe respiratory insufficiency","Myasthenia gravis"]
⚠️ Warnings & Precautions
["This medicine may cause drowsiness and impair ability to drive or operate machinery.","Do not stop this medicine abruptly; withdrawal symptoms may occur.","Use with caution in elderly patients due to increased risk of falls and confusion.","May increase risk of suicidal thoughts, especially in young adults.","Avoid alcohol and other CNS depressants.","Inform your doctor if you have a history of substance abuse.","Use with caution in patients with cardiac disease or electrolyte imbalances."]
🤱 Lactation Safety
Clonazepam and escitalopram are excreted in breast milk. Breastfeeding is not recommended while taking this medicine unless the benefits outweigh the risks. Consult your doctor.
💊 Overdose Management
Overdose may cause severe drowsiness, confusion, respiratory depression, and serotonin syndrome. Seek immediate medical attention. Treatment is supportive and symptomatic. Activated charcoal may be considered if taken recently. Flumazenil may be used for benzodiazepine overdose but is contraindicated in mixed overdose with tricyclic antidepressants. There is no specific antidote for escitalopram overdose.
⏰ Missed Dose
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not double the dose to catch up.
Additional Safety Advice
Take this medicine exactly as prescribed by your doctor. Do not crush, chew, or break the tablet unless instructed. Avoid driving or operating heavy machinery until you know how this medicine affects you. Do not consume alcohol while taking this medicine, as it can increase drowsiness and impair judgment. Do not stop this medicine suddenly, as it can cause withdrawal symptoms such as anxiety, insomnia, and tremors. Inform your doctor if you are pregnant, planning to become pregnant, or breastfeeding. Keep this medicine out of reach of children. Store at room temperature away from moisture and heat. Regular follow-up with your doctor is important to monitor your response and adjust the dose if needed.
👴 Special Considerations for Elderly
💡 For Patients Above 65
Elderly patients are more sensitive to the sedative effects of clonazepam and may experience increased drowsiness, confusion, and falls. Escitalopram can cause hyponatremia in the elderly. Lower starting doses and close monitoring are recommended.
🤰 Pregnancy Planning (TTC)
If you are planning to become pregnant, consult your doctor before conception. This medicine may not be safe during pregnancy. Your doctor may switch you to a safer alternative or adjust the dose.
🏥 Post-Surgery Considerations
Inform your surgeon and anesthesiologist about this medicine before any surgery. It may interact with anesthetic agents and increase sedation. Your doctor may advise temporary discontinuation or dose adjustment.
🦷 Dental Procedures
Inform your dentist about this medicine before any dental procedure. It may interact with local anesthetics or sedatives used during dental work. Your dentist may need to adjust the treatment plan.
💚 Lifestyle Tips for Better Results
🏋️ Exercise Considerations
This medicine may cause drowsiness and dizziness, which can affect coordination. Avoid high-risk activities like swimming, cycling, or operating heavy machinery until you know how the medicine affects you. Light to moderate exercise is generally safe and beneficial.
🥗 Diet Recommendations
💼 Impact on Daily Work & Life
This medicine can cause drowsiness and impair concentration, especially when starting treatment or increasing the dose. Avoid driving or operating machinery until you know how it affects you. Inform your employer if your job involves safety-sensitive tasks. With time, most people adjust and can resume normal activities.
🛑 When to Stop This Medicine
Do not stop this medicine without consulting your doctor. If you experience severe side effects or wish to discontinue, your doctor will guide you through a gradual tapering schedule to prevent withdrawal symptoms and relapse.
📅 Long-Term Use Effects
Long-term use of this medicine may lead to tolerance to clonazepam, requiring dose adjustments. Dependence and withdrawal symptoms can occur upon abrupt discontinuation. Escitalopram may cause sexual dysfunction and weight changes with prolonged use. Regular monitoring of mood, liver function, and sodium levels is advised. Periodic review by your doctor is necessary to determine the need for continued therapy.
🌿 Non-Medicine Approaches
These can complement medicine but do not replace prescribed treatment.
Can be used alone or in combination with medicine for anxiety and depression.
Evidence: Well-establishedHelps reduce stress and anxiety symptoms.
Evidence: ModerateImproves mood and reduces anxiety.
Evidence: Well-established💉 Vaccination Considerations
💉 If You're Getting Vaccinated
No specific vaccine interactions are established. However, inform your doctor about this medicine before receiving any vaccine, especially live vaccines, as a precaution.
📦 Storage Guide
✅ DO
Store at room temperature (15-30°C)
❌ DON'T
Do not refrigerate unless specified
✅ DO
Keep in original container
❌ DON'T
Do not transfer to unmarked containers
✅ DO
Keep away from direct sunlight
❌ DON'T
Do not store in bathroom cabinet
✈️ Traveling with This Medicine
When traveling, carry this medicine in its original packaging with a copy of your prescription. Keep it in your carry-on luggage. If crossing time zones, consult your doctor about adjusting the timing. Store at room temperature and protect from moisture. Check customs regulations for controlled substances before traveling internationally.
💰 Cost Analysis & Savings
👥 Real Patient Stories
Educational, anonymized scenarios. Individual results may vary.
💬 Questions Patients Often Ask
A: Clonazepam starts working within 1-2 hours, providing rapid relief from anxiety. Escitalopram takes 1-2 weeks to show initial effects and 4-6 weeks for full benefits.
A: No, you should not stop this medicine suddenly. Always consult your doctor for a gradual tapering plan to avoid withdrawal symptoms and relapse.
A: The safety of this combination during pregnancy is not well established. Consult your doctor to weigh the benefits and risks.
🤔 Common Patient Concerns
🔄 Substitutes for astawin h 0.25mg/5mg tablet
View AllAlternative brands with exact same active ingredient:
-
estomin sf 0.25 mg/5 mg tabletPsycormedies ₹33.48 35.1% CHEAPER
-
nexsys ls 0.25mg/5mg tabletWinsys Lifescience ₹38.44 25.4% CHEAPER
-
ection ls 0.25mg/5mg tabletMission Research Laboratories Pvt Ltd ₹46.88 9.1% CHEAPER
-
erito-plus tabletEridanus Healthcare ₹48.75 5.4% CHEAPER
-
clotas eh 0.25mg/5mg tabletTas Med India Pvt Ltd ₹52.50 1.8% COSTLIER
Medical Note: Always consult your doctor before switching medications.
🛑 Myths vs. Facts
- Myth: This medicine is addictive and should never be taken.
Fact: When taken as prescribed and for the appropriate duration, the risk of addiction is low. However, dependence can occur, so it should be tapered gradually. - Myth: This medicine works immediately for panic attacks.
Fact: Clonazepam may provide rapid relief, but escitalopram takes weeks to work. This medicine is not for immediate relief of acute panic attacks. - Myth: You can stop this medicine once you feel better.
Fact: Stopping suddenly can cause withdrawal symptoms and relapse. Always consult your doctor before stopping.
🔄 Alternative Options
Generic Alternatives
- Clonazepam 0.25 mg + Escitalopram 5 mg tablet (generic)
Brand Alternatives
- Depran-L Tablet