Feliz S Plus Tablet: Complete Medicine Guide
When to Call Your Doctor IMMEDIATELY
- Thoughts of harming yourself or others
- Severe allergic reaction (rash, swelling, difficulty breathing)
- Signs of serotonin syndrome (agitation, hallucinations, rapid heart rate, fever)
- Unusual bleeding or bruising
- Severe drowsiness or slow, shallow breathing
- Yellowing of skin or eyes
- Seizures or severe confusion
If experiencing severe symptoms, call emergency services immediately.
What is esicalm plus 0.5mg/10mg tablet used for?
This medicine is a prescription combination of clonazepam (a benzodiazepine) and escitalopram (an SSRI) used to treat anxiety and mood disorders. It provides rapid anxiety relief from clonazepam and long-term mood stabilization from escitalopram. It can cause drowsiness, dependence, and serious interactions, so it must be used under strict medical supervision.
- Generic Name: Clonazepam (0.5mg) + Escitalopram Oxalate (10mg)
- Manufacturer: Biokind Healthcare Pvt Ltd
- Form: Allopathy
- Pregnancy Category: Consult doctor
- Prescription Required: Yes
🇮🇳 esicalm plus 0.5mg/10mg tablet के बारे में (Hindi Summary)
उपयोग: यह दवा क्लोनाजेपम और एस्सिटालोप्राम का संयोजन है, जिसका उपयोग चिंता विकार, पैनिक डिसऑर्डर और अवसाद के इलाज के लिए किया जाता है। क्लोनाजेपम तुरंत चिंता और घबराहट को कम करता है, जबकि एस्सिटालोप्राम मूड को संतुलित करने में मदद करता है। यह दवा केवल डॉक्टर की सलाह पर लेनी चाहिए और इसे अचानक बंद नहीं करना चाहिए।
साइड इफेक्ट्स: इस दवा के सामान्य दुष्प्रभावों में नींद आना, चक्कर आना, थकान, मुँह सूखना, जी मिचलाना और कब्ज शामिल हैं। गंभीर दुष्प्रभावों में सीरोटोनिन सिंड्रोम, एलर्जी, रक्तस्राव और आत्महत्या के विचार शामिल हो सकते हैं। यदि आपको कोई असामान्य लक्षण दिखे तो तुरंत डॉक्टर से संपर्क करें।
सुरक्षा सलाह: इस दवा को डॉक्टर के बताए अनुसार ही लें। शराब और अन्य नींद लाने वाली दवाओं से बचें। गाड़ी चलाने या मशीन चलाने से बचें जब तक आपको पता न चल जाए कि यह दवा आप पर कैसे असर करती है। दवा अचानक बंद न करें, इससे withdrawal symptoms हो सकते हैं। नियमित रूप से डॉक्टर से जाँच कराते रहें।
💊 esicalm plus 0.5mg/10mg tablet Uses & Benefits
- [{"condition":"Generalized Anxiety Disorder (GAD)","description":"This combination helps reduce excessive worry, tension, and physical symptoms of anxiety.
- Clonazepam provides rapid relief while escitalopram addresses underlying serotonin imbalance.","evidence":"Well-established for short-term use; long-term combination use requires careful monitoring."},{"condition":"Panic Disorder","description":"Used to prevent panic attacks and reduce anticipatory anxiety.
- Clonazepam acts quickly to abort attacks, while escitalopram reduces frequency over time.","evidence":"Well-established for individual components; combination use is common in clinical practice."},{"condition":"Major Depressive Disorder with Anxiety","description":"Escitalopram treats depression, and clonazepam provides short-term relief from anxiety symptoms that often accompany depression.","evidence":"Escitalopram is well-established for depression; clonazepam is used adjunctively for anxiety."},{"condition":"Social Anxiety Disorder","description":"May be prescribed to reduce anxiety in social situations, though SSRIs are first-line and benzodiazepines are used cautiously.","evidence":"Escitalopram has evidence; clonazepam use is limited due to dependence risk."}]
Off-label uses: [{"condition":"Insomnia associated with anxiety","description":"Clonazepam component may help with sleep, but this is not a primary indication and carries dependence risk.","evidence":"Limited; not recommended for routine use."},{"condition":"Premenstrual dysphoric disorder (PMDD)","description":"SSRIs like escitalopram are sometimes used for PMDD, but the combination with clonazepam is not standard.","evidence":"Limited for combination; escitalopram alone has some evidence."}]
Primary treatment for: Generalized Anxiety Disorder
Also treats: Panic Disorder, Major Depressive Disorder, Social Anxiety Disorder
📋 Drug Information
| Generic Name(s) | Clonazepam (0.5mg) + Escitalopram Oxalate (10mg) |
| Brand Name | esicalm plus 0.5mg/10mg tablet |
| Manufacturer | Biokind Healthcare Pvt Ltd |
| Packaging / Form | Varies by brand (Allopathy) |
| Therapeutic Class | NEURO CNS |
| Action Class | |
| Route of Administration | Oral |
| Storage | Store at room temperature between 15°C and 30°C (59°F to 86°F). Keep away from moisture, heat, and direct sunlight. Do not refrigerate. Keep in the original container, tightly closed. |
| Shelf Life | 24 months from the date of manufacture. |
| WHO Guideline | Not established from the available information. The World Health Organization does not specifically recommend this fixed-dose combination for any condition. Treatment guidelines generally recommend SSRIs as first-line for anxiety and depressive disorders, with benzodiazepines used short-term or as adjuncts. |
| ICMR Guideline | Not established from the available information. The Indian Council of Medical Research has not published specific guidelines for this combination. Standard Indian psychiatric practice follows international guidelines for individual components. |
👨⚕️ 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 enhances the inhibitory neurotransmitter GABA at GABA-A receptors, leading to increased chloride ion influx, hyperpolarization of neurons, and reduced neuronal excitability. This produces anxiolytic, sedative, muscle relaxant, and anticonvulsant effects. Escitalopram oxalate selectively inhibits the reuptake of serotonin (5-HT) at the presynaptic membrane by blocking the serotonin transporter (SERT), increasing serotonin availability in the synaptic cleft. This leads to downregulation of serotonin receptors over time, which is thought to underlie its antidepressant and anxiolytic effects. The combination provides rapid symptom relief from clonazepam and sustained mood improvement from escitalopram.
Mechanism Steps
💡 How to Take esicalm plus 0.5mg/10mg tablet
Strength: Tablet containing Clonazepam 0.5 mg and Escitalopram Oxalate 10 mg.
Dosage Information
| Adult Dosage | The usual adult dose 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 treatment. Some patients may require a lower starting dose or gradual titration. Do not adjust the dose without medical advice. This medicine is not recommended for initial therapy in all patients; it is typically used when monotherapy is insufficient. |
| 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 clonazepam and escitalopram. Start with a lower dose and titrate slowly. Monitor for increased sedation, falls, cognitive impairment, and hyponatremia. Dose must be individualized by a qualified clinician. |
| Renal Impairment | No specific dose adjustment is established for mild to moderate renal impairment. Use with caution in severe renal impairment. Escitalopram may accumulate; monitor for side effects. Dose must be individualized by a qualified clinician. |
| Hepatic Impairment | Clonazepam and escitalopram are extensively metabolized in the liver. In mild to moderate hepatic impairment, reduce the dose and titrate slowly. In severe hepatic impairment, the combination is contraindicated. Dose must be individualized by a qualified clinician. |
| Maximum Daily Dose | The maximum recommended daily dose for this fixed-dose combination is not established from available information. The maximum daily dose of escitalopram is 20 mg, and clonazepam should not exceed 20 mg per day in adults. However, for this combination, the dose must be individualized by a qualified clinician. |
Dosage Timeline
🍽️ Food Timing Guide
⏰ What to Do If You Miss a Dose
⚠️ Side Effects of esicalm plus 0.5mg/10mg 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 | |
| NSAIDs | Moderate | |
| Ketoconazole | Major | |
| Omeprazole | Moderate | |
| Tramadol | Moderate | |
| Sumatriptan | Moderate | |
| Fluconazole | Moderate | |
| Ritonavir | Major |
🚨 Major Interactions
- MAO inhibitors (e.g., phenelzine, tranylcypromine)
- Other CNS depressants (e.g., opioids, alcohol, barbiturates)
- Anticoagulants (e.g., warfarin) and antiplatelets (e.g., aspirin, NSAIDs)
- CYP3A4 inhibitors (e.g., ketoconazole, ritonavir)
- CYP2C19 inhibitors (e.g., omeprazole, fluoxetine)
⚡ Moderate Interactions
- Tricyclic antidepressants (e.g., amitriptyline)
- Triptans (e.g., sumatriptan)
- Diuretics
- Cimetidine
🍷 Alcohol Interaction
Alcohol should be strictly avoided while taking this medicine. Both clonazepam and escitalopram can cause CNS depression, and alcohol amplifies these effects, leading to severe drowsiness, impaired coordination, respiratory depression, and increased risk of accidents. Alcohol can also worsen anxiety and depression, undermining treatment. If you have alcohol use disorder, discuss with your doctor before starting this medicine.
🔎 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 or within 14 days of MAO inhibitors","Severe hepatic impairment","Narrow-angle glaucoma","Myasthenia gravis","Severe respiratory insufficiency","Sleep apnea syndrome","Pregnancy (unless clearly needed and under specialist care)"]
⚠️ Warnings & Precautions
["May cause physical and psychological dependence; use with caution in patients with history of substance abuse.","Do not stop abruptly; withdrawal symptoms may occur.","May impair ability to drive or operate machinery.","Increased risk of suicidal thoughts in patients under 25 years.","May cause severe skin reactions (e.g., Stevens-Johnson syndrome); seek immediate care if rash develops.","Use with caution in elderly due to increased risk of falls, cognitive impairment, and hyponatremia.","May worsen depression or cause mania in patients with bipolar disorder.","Avoid alcohol and other CNS depressants."]
🤱 Lactation Safety
Both clonazepam and escitalopram are excreted in breast milk. Clonazepam may cause sedation and poor feeding in the infant. Escitalopram may cause irritability and poor weight gain. Breastfeeding is not recommended unless the benefits outweigh the risks, as determined by a doctor.
💊 Overdose Management
Overdose of this combination can cause severe drowsiness, confusion, coma, respiratory depression, and cardiac arrhythmias. If overdose is suspected, seek emergency medical attention immediately. Treatment is supportive and may include activated charcoal, gastric lavage, and flumazenil for benzodiazepine toxicity (used with caution due to seizure risk). There is no specific antidote for escitalopram; management includes monitoring vital signs, ECG, and supportive care. Contact a poison control center for guidance.
⏰ 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 take two doses at once to make up for a missed dose. If you miss multiple doses, consult your doctor before resuming.
Additional Safety Advice
Always take this medicine exactly as prescribed by your doctor. Do not crush, chew, or break the tablet unless instructed. Avoid alcohol and other central nervous system depressants as they can increase drowsiness and respiratory depression. Do not drive or operate heavy machinery until you know how this medicine affects you. Inform your doctor about all other medications, supplements, and herbal products you are taking, especially MAO inhibitors, NSAIDs, blood thinners, and other antidepressants. Do not stop this medicine abruptly as it can cause withdrawal symptoms; your doctor will taper the dose gradually. Keep this medicine out of reach of children and pets. Store at room temperature away from moisture and heat. If you miss a dose, follow your doctor's instructions; do not double the dose. Regular follow-up with your doctor is essential 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 effects of clonazepam and escitalopram. They are at higher risk of falls, confusion, cognitive impairment, and hyponatremia. Start with a lower dose and titrate slowly. Regular monitoring of renal function, electrolytes, and mental status is recommended. Avoid concurrent use of other CNS depressants.
🤰 Pregnancy Planning (TTC)
If you are planning pregnancy, consult your doctor before conceiving. Both clonazepam and escitalopram may pose risks to the fetus. Your doctor may recommend switching to a safer alternative or tapering the dose. Do not stop the medicine abruptly without medical advice. Use effective contraception while taking this medicine unless you are planning pregnancy under medical supervision.
🏥 Post-Surgery Considerations
Inform your surgeon and anesthesiologist that you are taking this medicine before any surgery. Clonazepam can interact with anesthetic agents and increase sedation. Escitalopram may increase bleeding risk. Your doctor may advise you to temporarily stop or adjust the dose before surgery. Do not make changes without medical advice.
🦷 Dental Procedures
Inform your dentist that you are taking this medicine before any dental procedure. Clonazepam can cause dry mouth, increasing the risk of dental problems. It may also interact with sedatives used in dentistry. Escitalopram may increase bleeding risk. Your dentist may take precautions or coordinate with your doctor.
💚 Lifestyle Tips for Better Results
🏋️ Exercise Considerations
This medicine can cause drowsiness and dizziness, which may affect your coordination. Avoid activities that require mental alertness, such as driving or operating machinery, until you know how the medicine affects you. Light to moderate exercise is generally safe, but avoid strenuous activities if you feel unsteady. Consult your doctor before starting any new exercise program.
🥗 Diet Recommendations
💼 Impact on Daily Work & Life
This medicine can cause drowsiness and impair concentration, especially during the first few days. Avoid driving, operating heavy machinery, or performing hazardous tasks until you know how it affects you. Inform your employer if your job requires such activities. With time, your body may adjust, but always prioritize safety. Discuss any work-related concerns with your doctor.
🛑 When to Stop This Medicine
Do not stop this medicine without consulting your doctor. Your doctor will decide when and how to stop based on your response and the risk of withdrawal. If you experience severe side effects or allergic reactions, seek immediate medical attention. Abrupt discontinuation can cause withdrawal symptoms such as anxiety, insomnia, tremors, and seizures.
📅 Long-Term Use Effects
Long-term use of this medicine can lead to tolerance, dependence, and withdrawal symptoms, especially with the clonazepam component. Escitalopram may cause sexual dysfunction, weight changes, and emotional blunting. Regular monitoring is required to assess the need for continued treatment and to manage side effects. Do not stop the medicine without medical supervision. Long-term use should be periodically reviewed by your doctor.
🌿 Non-Medicine Approaches
These can complement medicine but do not replace prescribed treatment.
A type of talk therapy that helps change negative thought patterns and behaviors. It is effective for anxiety and depression.
Evidence: Well-establishedPractices that promote relaxation and present-moment awareness, reducing anxiety and improving mood.
Evidence: ModeratePhysical activity releases endorphins and improves mood. It can be a helpful adjunct to medication.
Evidence: Well-establishedSome people use herbal remedies for depression, but they can interact with prescription medicines. Consult your doctor before use.
Evidence: Limited and variable💉 Vaccination Considerations
💉 If You're Getting Vaccinated
There are no specific vaccine interactions with this medicine. However, if you are scheduled for any vaccination, inform your healthcare provider about all medications you are taking. Live vaccines should be avoided if you are immunocompromised, but this medicine does not typically cause immunosuppression.
📦 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
✅ DO
Keep out of reach of children
❌ DON'T
Do not use after expiry date
✈️ 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 to avoid loss. Store at room temperature and protect from extreme heat or cold. If crossing time zones, consult your doctor about adjusting the timing of your dose. Carry enough supply for your entire trip. Check local laws regarding controlled substances, as clonazepam may be regulated. Always declare your medication at customs if required.
💰 Cost Analysis & Savings
👥 Real Patient Stories
Educational, anonymized scenarios. Individual results may vary.
💬 Questions Patients Often Ask
A: Clonazepam starts working within 30-60 minutes, providing rapid relief from anxiety. Escitalopram takes 1-2 weeks for initial effects and 4-6 weeks for full therapeutic benefit.
A: No, stopping suddenly can cause withdrawal symptoms such as anxiety, insomnia, tremors, and seizures. Your doctor will taper the dose gradually.
A: Both components may pose risks to the fetus. Use only if clearly needed under specialist care. Discuss with your doctor if you are pregnant or planning pregnancy.
A: No, alcohol increases the risk of severe drowsiness, respiratory depression, and other serious side effects. Avoid alcohol completely.
A: Escitalopram may cause weight changes in some people. Clonazepam is less likely to affect weight. Monitor your weight and consult your doctor if concerned.
🤔 Common Patient Concerns
🔄 Substitutes for esicalm plus 0.5mg/10mg tablet
View AllAlternative brands with exact same active ingredient:
-
estaram es forte 0.5mg/10mg tabletZeelab Pharmacy Pvt Ltd ₹14.06 55% CHEAPER
-
losarum h 0.5mg/10mg tabletZeelab Pharmacy Pvt Ltd ₹15.00 52% CHEAPER
-
asiclopam tabletLeeford Healthcare Ltd ₹23.20 25.7% CHEAPER
-
clonzy plus 0.5mg/10mg tabletVega Laboratories Pvt Ltd ₹35.00 12.1% COSTLIER
-
acopram-plus tabletAcmedix Pharma LLP ₹45.94 47.1% COSTLIER
Medical Note: Always consult your doctor before switching medications.
🛑 Myths vs. Facts
- Myth: This medicine is a sleeping pill.
Fact: It is not a sleeping pill. It is a combination of an anti-anxiety medicine and an antidepressant, used for specific psychiatric conditions. - Myth: I can stop this medicine whenever I feel better.
Fact: Stopping abruptly can cause withdrawal symptoms and relapse. Always taper under medical supervision. - Myth: This medicine is addictive for everyone.
Fact: Clonazepam can cause dependence, but the risk is managed with careful prescribing and monitoring. Escitalopram is not addictive. - Myth: Taking this medicine means I am weak.
Fact: Mental health conditions are medical conditions. Taking prescribed medicine is a responsible step toward recovery.
🔄 Alternative Options
Generic Alternatives
- Clonazepam + Escitalopram Oxalate (generic)
Brand Alternatives
- Feliz S Plus Tablet