What to Do If You Vomit After Taking Escitalopram 5mg
If you vomit within 3 hours of taking escitalopram 5mg, take another dose; if vomiting occurs more than 3 hours after ingestion, skip the dose and resume your regular schedule the next day. 1
Timing-Based Decision Algorithm
The critical factor is how soon after ingestion the vomiting occurred:
Vomiting Within 3 Hours of Dose
- Repeat the full 5mg dose because insufficient medication was likely absorbed 1
- The 3-hour window is based on emergency contraceptive pill guidelines, which establish this timeframe as the standard for medication re-dosing after vomiting 1
- Consider taking an antiemetic (anti-nausea medication) before the replacement dose to prevent repeat vomiting 1
Vomiting After 3 Hours of Dose
- Do not repeat the dose 1
- Escitalopram reaches maximum plasma concentrations approximately 3-4 hours after oral administration, meaning substantial absorption has already occurred 2
- Resume your regular dosing schedule the next day 3
- Missing a single dose is unlikely to cause significant clinical consequences given escitalopram's 27-33 hour half-life 2
Important Pharmacokinetic Context
- Escitalopram absorption is not affected by food, so you can take the replacement dose with or without meals 2
- The medication reaches steady-state concentrations within 7-10 days of regular administration 2
- A single missed or vomited dose will not significantly disrupt therapeutic levels once you've been on the medication for over a week 2
Monitoring for Withdrawal Symptoms
If vomiting causes you to miss doses repeatedly:
- Watch for discontinuation symptoms within 24-48 hours, including dizziness, nausea, headache, fatigue, anxiety, irritability, or sensory disturbances 4, 5
- These withdrawal symptoms typically resolve within 1-3 weeks if the medication is restarted 4
- Contact your healthcare provider if you experience persistent vomiting that prevents you from keeping doses down 3
When Nausea Is Medication-Related
If the vomiting itself appears to be caused by escitalopram (not an unrelated illness):
- Nausea is the most common side effect of escitalopram, occurring in >10% of patients 6
- This medication-induced nausea is typically mild to moderate and transient, improving within the first 1-2 weeks of treatment 7
- Taking escitalopram with food may reduce nausea, even though food doesn't affect absorption 3, 2
- If nausea persists beyond 2 weeks, consult your prescriber about management strategies or dose adjustment 3
Critical Safety Note
Do not take extra doses beyond the replacement dose described above. Escitalopram overdoses up to 300mg have been studied and generally result in mild symptoms (lethargy being most common), but intentional overdosing should always be avoided 8