Last Updated April 24th, 2019
Nexito plus is classified as a benzodiazepine. When taken it calms the nerves and brain lowering anxiety and enhancing moods. It is also an anti-epileptic and an anti-seizure drug. The drug is used for the treatment and management of a number of conditions that include:
- Panic disorder
- Skin rash
- Mental disorder
- Major depressive disorder
- Seizure disorder
- Absence infantile spasms
- Sleep disorders, REM Sleep Behaviour Disorder.
- Comorbid depression
- Alcohol withdrawal
- Post-traumatic stress
- Obsessive-compulsive disorder
Do I need a prescription?
Nexito plus tablets can be bought from the local pharmaceuticals shops and from online drug stores. A doctor’s prescription is mandatory.
The dosage for Nexito Plus is determined by the condition being treated, the severity, the age and how you respond to the initial dose. The dosage begins with the smallest dose that is effective, this lowers the occurrence of the drugs side effects. To get the best results from the drug, the dose is increased. The following are recommended doses for Nexito Plus for a number of conditions.
Adults: An initial dose of not more than 1.5 mg/day that is divided into three times in a day. The dose is adjusted with increments of 0.5 mg to 1 mg after every 3 days until there is control of the seizures. The maintenance dose differs for every patient because of the differences in patient response but the maximum daily dose should not be more than 20 mg. Depressant adverse effects may increase if you use multiple anticonvulsants, thus this should be considered before adding Nexito Plus to the normal existing regime.
Pediatric Patients: For children and infants up to 10 years of age and body weight of 30 kg, to reduce drowsiness the dose should lie between 0.01 mg/kg/day and 0.03 mg/kg/day that is given in two or three doses. It should not exceed 0.05mg/kg/day. Increase in the dosage should not exceed 0.25 mg to 0.5 mg every three days until a maintenance daily dose of 0.1 mg/kg to 0.2 mg/kg of the body weight until the seizures are under control. The dose for a day should be divided equally three times. If not the largest dose should be administered while retiring for the day.
Geriatric Patients: For the elderly 65 years and older, the initial dose should be a low dose and the patients are observed closely.
Adults: the initial dose is 0.25 mg twice a day a target dose of 1 mg/day can be achieved by increasing the dose after 3 days. This dose is recommended from results that show optimum effects at 1 mg/day. Higher doses of 2 mg/day to 4 mg /day have been shown be to be less effective and have more adverse side effects. In the cases that benefits are better at 4 mg/day, the dose should be increased by 0.125mg to 0.25 mg twice a day after 3 days until the panic disorder is under control. The dose is reduced gradually until it is discontinued, a decrease of 0.125 mg twice a day.
Pediatric Patients: no clinical trial in panic disorder in patients below 18 years old.
Geriatric Patients: no clinical trial in panic disorder in patients above 65 years. In patients that are elderly, the dose should be low and the patients closely observed.
Nexito Plus is composed of two active ingredients. The ingredients include:
- Escitalopram – 5 mg
- Clonazepam – 0.5 mg
Mechanism of Action (MOA)
Of the two active ingredients, escitalopram reduces sleep when taken alone while clonazepam increases sleep. When the two ingredients are used combined, they balance out sleep and thus used to cure sleep problems.
The action of GABA is increased by clonazepam. GABA is a chemical messenger that reduces the abnormal activity of nerve cells in the brain. Escitalopram is an inhibitor of the reuptake of serotonin (selective serotonin reuptake inhibitor (SSRI)), as a result, the levels of serotonin increases which improves the mood.
Facts on Nexito Plus
- Nexito Plus is commonly used for the treatment of anxiety.
- It can cause withdrawal symptoms when stopped suddenly and when used for a long time.
- Nexito Plus, when used during pregnancy, may cause birth defects in the fetus.
- Nexito Plus being a benzodiazepine is among the drugs that are associated with increased fall risk according to Medication Linked to Falls CDC flyer.
- It should not be used in children and patients under the age of 18 years.
- It is one of the most prescribed antidepressants with a very first growing rate in market share.
Nexito Plus is contraindicated for use in a number of conditions. Inform your doctor if you have any of the following conditions:
- Hypersensitive to any of the active ingredients, the benzodiazepines, and SSRI. Allergic reactions symptoms include rashes or itching of the skin, loss of consciousness, shortness of breath, swelling of the throat, face, tongue, and lips.
- Diseases related to the liver
- Narrow-angle glaucoma
- Monoamine oxidase inhibitors. If you are being treated with monoamine oxidase inhibitors then you should not use Nexito Plus tablets. The drug should be stopped at least two weeks before using Nexito Plus.
- If you are taking pimozide you should avoid the use of Nexito Plus due to increased risk of heart rhythm disorder.
- Alcohol intoxication
- Do not take Nexito Plus tablets if you are pregnant or planning to be pregnant.
- Do not take Nexito Plus tablets if you are nursing as they may harm the nursing baby.
- Heart diseases
- If you have had or have abnormal heart rhythm
- Severe kidney disease
- Low sodium levels in the blood
- Nexito Plus should not be taken if you are 18 years and below.
Nexito Plus may cause a number of undesired effects apart from the required ones. The side effects depend on the dosage and the duration of use. Some side effects are common but not serious while others are rare and very serious. Call and inform your doctor of any side effects more so if they do not go away.
Very common side effects include:
- Skin rash
- A dull headache
- Loss or gain of weight
- Dry mouth
- Back pain
- Hair loss
- Reduced intellectual abilities
- A decrease in sexual urge
- Joint pain
- Loss of appetite or increased appetite
- Abnormal dreams
- Increased sweating
- Decreased orgasm
Rare and serious side effects include:
- Ejaculation disorder
- Weight gain
- Abnormal eye movements
- Nasal congestion
- Slurred speech
- Chest congestion
- Shortness of breath
- Reduced urine output
- Fast heartbeat
- Blurred vision
- Muscle pain
- New or seizures that keep worsening
- Aggression and hallucinations
- Suicidal thoughts
Nexito Plus is known to interact with a number of products and drugs. Inform your doctor if you on any medication whether over the counter drugs or prescription drugs, herbal medicines, and vitamin supplements. Drug interactions may lower the effectiveness of Nexito Plus or increase the chances of adverse side effects occurring. Nexito Plus interacts the following drugs and products.
- Use of Nexito Plus together with alcohol increases the chances of serious side effects.
- Non-selective monoamine oxidase inhibitors (MAOIs), with active ingredients being nialamide, tranylcypromine, phenelzine, isocarboxazid, and iproniazid.
- John’s Wort
- Antipsychotics such as risperidone,haloperidol, and thioridazine
- Flecainide, metoprolol, and propafenone that are used in cardiovascular disorders
- Neuroleptics used for psychosis and schizophrenia
- Acetylsalicylic acid and non-steroid anti-inflammatory drugs.
- Medicines that lower levels of magnesium and potassium in the blood.
What to do if you skip a dose?
If a dose is skipped it should be taken immediately you realize it. If it is close to the next dose, the dose can be skipped and the normal schedule continued. Do not take double the dose to compensate for the skipped dose. If you frequently ski doses, you can set a reminder or have a family member remind you when it is time to take the next dose as frequently missed doses will lower the effectiveness of the drug.
When using Nexito Plus a number of precautions should be taken into considerations. The precautions include:
- Nexito Plus should not be taken with alcohol as it may cause more adverse side effects and excessive drowsiness.
- The tablets should not be used if you are pregnant or planning to be pregnant as Nexito Plus has been shown to harm the fetus.
- Nexito Plus should not be used if you are breastfeeding as there is limited information on the effects it could have on the nursing baby.
- Nexito Plus may cause drowsiness or dizziness and thus you should not drive or operate heavy machinery while using it.
- It should not if you are 18 years and below.
- It should not be used if you suffer from severe liver and kidney diseases. Dose adjustment is recommended in such cases.
- Do not take the tablets if the package has been tampered with or if the expiry date of the medication has been reached.
- Always store the tablets away from direct sunlight and avoid exposing them to heat.
- Do not stop taking Nexito Plus tablets suddenly if you have been taking the medication for an extended time. This would result in withdrawal symptoms that include mood swings and muscle cramps.
- Nexito Plus may cause thoughts of suicide, contact your doctor once you have thoughts of harming yourself.
- Nexito Plus should be used with caution if you are diabetic as it may alertglucose levels in blood thus close monitoring of the sugar levels is required.
- If you have a history of a bleeding disorder or being treated with aspirin, NSAIDs, and anticoagulants, this drug may increase the risk for abdominal bleeding.
Different brands and manufacturing companies of the drug
Nexito Plus tablets are manufactured by Sun Pharmaceutical Laboratories Ltd. Nexito Plus is a 5 mg tablet that contains 0.5 mg clonazepam and 5 mg escitalopram. Other tablets manufactured by Sun Pharmaceuticals include:
- Nexito 10 mg tablet
- Nexito Forte tablet
- Nexito LS tablet
Substitutes of the drug
A number of drugs that have the same strength and composition as Nexito Plus. They include:
- Camdem 0.5 mg/ 5 mg tablet – Sinsan Pharmaceuticals
- Citajoy C 0.5 mg/5 mg tablet – wings Biotech Ltd
- Escirise Cz 0.5 mg/5 mg tablet – Carise Pharmaceuticals Pvt Ltd
- Es Ok Plus 0.5 mg/5 mg tablet – Eisai Pharmaceuticals India Pvt Ltd
- Escepam 0.5 mg/5 mg tablet –Carise Pharmaceuticals Pvt Ltd
- Xtaz 5 mg tablet – Medley Pharmaceuticals
- S Citadep Plus 0.5 mg/5 mg tablet – Cipla Ltd
- Rexipra Plus tablet – Intas Pharmaceuticals Ltd
- Stalopam Miniplus tablet – Lupin Ltd
- S Vocita H tablet – Shine Pharmaceuticals Ltd
- Ezeepam Plus 0.5 mg/5 mg tablet – Eris Life Sciences Pvt Ltd
- Feliz S Plus 0.5mg/5 mg tablet – Torrent Pharmaceuticals Ltd
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