C-Pram S Plus

Composition of C-Pram S Plus

C-Pram S Plus contains Clonazepam + Escitalopram. It belongs to the Benzodiazepine / sedative-hypnotic and Antidepressant class of medicines.

Uses of C-Pram S Plus

• This medicine is used in the treatment of anxiety
• insomnia
• panic disorder
• seizures
• muscle spasm
• depression
• obsessive compulsive disorder
• nerve pain and migraine prevention.

Key benefits

• Rapid relief of severe anxiety
• Short-term help with sleep
• Controls acute seizures
• Effective for depression and anxiety disorders
• Also relieves nerve pain and prevents migraine
• Usually taken once a day

How C-Pram S Plus works

This medicine combines 2 active ingredients: Clonazepam and Escitalopram. Clonazepam calms over-activity in the brain, which relieves anxiety and helps sleep come more easily. Escitalopram restores the balance of the chemical messengers in the brain that regulate mood, sleep and the way pain is felt.

How to take C-Pram S Plus

Use this medicine as your doctor has directed. Follow the dose and the duration written on your prescription.

Take it exactly as your doctor prescribed. Do not change the dose or stop early on your own.

Missed dose and overdose

If you miss a dose

Take it as soon as you remember. If your next dose is almost due, skip the one you missed — never take two doses together to catch up.

If you take too much

An overdose of this medicine can cause deep unconsciousness and dangerously slow breathing, particularly with alcohol or an opioid. It can cause fits, dangerous heart rhythm disturbance and coma, and is particularly dangerous with the older tricyclic medicines. Do not wait for symptoms to appear — go to the nearest emergency department and take the pack or strip with you.

Side effects of C-Pram S Plus

Most side effects of C-Pram S Plus are mild and settle as the body adjusts. Reported side effects include:

• Drowsiness
• Dizziness
• Unsteadiness
• Poor concentration
• Memory lapses
• Dry mouth
• Nausea
• Drowsiness or difficulty sleeping
• Headache
• Weight change
• Reduced sexual desire
• Constipation

Stop the medicine and seek help immediately for a rash, swelling of the face or lips, wheezing or difficulty breathing. Tell your doctor about any side effect that persists or worries you.

Safety advice for C-Pram S Plus

Warnings and precautions

These medicines cause dependence. They are intended for the shortest possible course — usually two to four weeks — and are not a long-term treatment for anxiety or sleeplessness. Never stop a regular course suddenly. Withdrawal can cause severe anxiety, tremor and fits. Your doctor will taper it slowly. Do not drive or operate machinery. Drowsiness and slowed reactions can continue into the next day. Never combine with alcohol or with opioid painkillers — together they can stop your breathing. Older people are far more likely to fall, become confused or have memory problems on these medicines. Several of these are Schedule H1 medicines and must be dispensed against a prescription and entered in the pharmacy register. These medicines take two to four weeks to begin working, and longer for the full effect. Stopping at two weeks because nothing has changed is the commonest mistake. Never stop suddenly. Abrupt withdrawal causes dizziness, electric-shock sensations, irritability and flu-like symptoms — your doctor will reduce the dose gradually. Tell your doctor or go to hospital immediately if thoughts of harming yourself appear or worsen, particularly in the first weeks or after a dose change, and especially in anyone under twenty-five. Seek urgent care for agitation with fever, shivering, a racing heart, muscle twitching or confusion, particularly if more than one medicine affecting serotonin is being taken. Side effects are usually worst in the first fortnight and then settle.

Do not take C-Pram S Plus if

Not for anyone with a known allergy to this medicine or to any ingredient in the pack. Not for people with severe breathing problems, sleep apnoea, or severe liver disease. Not for anyone with a history of dependence, except under specialist supervision. Must not be combined with a monoamine oxidase inhibitor, or started within the gap your doctor specifies after one.

Interactions with other medicines

Alcohol, opioids, antihistamines, muscle relaxants and other sedatives all deepen the sedation, sometimes fatally. Tramadol, triptans for migraine, linezolid, St John's wort and other antidepressants can together raise serotonin dangerously. Anti-inflammatory painkillers and blood thinners increase the bleeding risk when combined with this group.

How to store C-Pram S Plus

Store below 30°C in the original pack, away from direct sunlight and moisture. Keep out of the reach of children.

Expert advice for C-Pram S Plus

Use it for the shortest course, and ask your doctor about talking therapy and sleep routine, which work without dependence. Take it only at bedtime if it is for sleep, and allow a full night before driving. Never share these medicines, and keep them secured. Give it a fair trial of several weeks, and keep your review appointments. Take it at the same time each day — at night if it makes you drowsy, in the morning if it disturbs sleep. Talking therapy alongside medicine works better than either alone for most people.

Manufacturer and class

Manufacturer:

TORRENT PHARMACEUTICALS

Therapeutic class:

Anxiolytic and hypnotic and Antidepressant

Drug class:

Benzodiazepine / sedative-hypnotic and Antidepressant