Gunpram Tablets 5 mg (Escitalopram Oxalate)

Adult administration

Safety has not been established for doses exceeding 20mg per day. This drug is administered once daily in the morning or evening, regardless of meals. 1) Adults (1) Major depressive disorder: The usual dose is 10mg once daily. The dose may be increased to a maximum of 20mg per day according to the patient's response. If the dose of this drug is to be increased to 20mg, it should be increased at intervals of at least 1 week. In general, 2-4 weeks are needed for antidepressant effects to occur. Even after symptoms have resolved, drug treatment for at least 6 months is required to ensure the treatment effect. (2) Panic disorder with or without agoraphobia: It is recommended to administer an initial dose of 5mg per day for 1 week, then increase to 10mg per day. The dose may be increased to a maximum of 20mg per day according to the patient's response. The maximum effect appears after approximately 3 months. The safety and efficacy of administration of this drug for longer than 10 weeks in the treatment of panic disorder have not been systematically studied. The physician should periodically reassess each patient to determine the need for continued treatment. (3) Social anxiety disorder: The usual dose is 10mg once daily. In general, 2-4 weeks are needed for symptoms to improve. Thereafter, the dose may be reduced to 5mg per day or increased to a maximum of 20mg per day according to the patient's response. Social anxiety disorder is a condition with a chronic course, and continued treatment for 12 weeks is recommended to ensure the treatment effect. Long-term treatment in responding patients has been studied for 6 months and should be considered on an individual patient basis to prevent relapse. The usefulness of long-term treatment should be reassessed regularly. Social anxiety disorder is a well-defined diagnostic term for a specific disorder and should not be confused with excessive shyness. Drug treatment should be given only when social anxiety disorder significantly interferes with occupational and social activities. Drug treatment has not been compared with cognitive behavioral therapy. Drug treatment is one part of an overall treatment strategy. (4) Generalized anxiety disorder: The initial dose is 10mg once daily. According to the patient's response, the dose may be increased to a maximum of 20mg per day after administration for at least 1 week. A long-term administration study was conducted in patients who responded to 12 weeks of open-label treatment, with 20mg per day administered for at least 6 months. The physician should regularly reassess the usefulness of long-term treatment with this drug for each patient. (5) Obsessive-compulsive disorder: The usual dose is 10mg once daily. The dose may be increased to a maximum of 20mg per day according to the patient's response. A long-term administration study was conducted in patients who responded to 16 weeks of open-label treatment, with 10mg or 20mg per day administered for at least 24 weeks. Obsessive-compulsive disorder is a chronic condition; treatment should be continued for a sufficient period to ensure symptom recovery. If this drug is administered long term, the usefulness and dose for each patient should be reassessed regularly. 2) Patients with renal impairment No dose adjustment is necessary in patients with mild or moderate renal impairment. Caution should be exercised in patients with severe renal impairment (CLCR < 30㎖/min). 3) Patients with hepatic impairment It is recommended to administer an initial dose of 5mg per day for the first 2 weeks. The dose may be increased to 10mg per day according to the patient's response. 4) Discontinuation When discontinuing this drug, the dose should be gradually reduced over at least 1-2 weeks to avoid the possibility of withdrawal symptoms. 5) Switching from MAO inhibitors used to treat psychiatric disorders When discontinuing an MAO inhibitor used to treat psychiatric disorders and initiating treatment with this drug, an interval of at least 14 days should be allowed. Conversely, when initiating an MAO inhibitor to treat psychiatric disorders, at least 14 days should have elapsed after discontinuing this drug. 6) Other MAO inhibitors such as linezolid or methylene blue Patients receiving linezolid or intravenous methylene blue should not start this drug because of the increased risk of serotonin syndrome. For patients who require treatment for a more urgent psychiatric condition, including hospitalization or other interventions, administration should be considered. It may be necessary to urgently administer linezolid or intravenous methylene blue to a patient already receiving this drug. If there is no alternative to linezolid or intravenous methylene blue and, for a particular patient, the benefits of treatment with linezolid or intravenous methylene blue are judged to outweigh the risk of serotonin syndrome, this drug may be discontinued immediately and linezolid or intravenous methylene blue administered. The patient should be monitored for symptoms of serotonin syndrome for 2 weeks after administration of linezolid or intravenous methylene blue, or until 24 hours after the last dose, whichever occurs first. Treatment with this drug may be restarted 24 hours after the last dose of linezolid or intravenous methylene blue. The risk associated with administration of methylene blue by a non-intravenous route (oral tablets or local injection) or with intravenous administration of this drug at 1mg/kg or less is unclear. Nevertheless, clinicians should be aware of the possibility of emergency symptoms of serotonin syndrome with such use.

This medication is primarily used as an antidepressant to treat psychiatric conditions such as depression. While taking this medication, there may be instances of suicidal thoughts or behaviors, so special caution is required, especially in young individuals aged 18 to 24. This medication can be dangerous when taken with certain drugs, especially monoamine oxidase inhibitors (MAOIs), pimozide, and drugs that prolong the QT interval, and should not be combined with them. Patients with closed-angle glaucoma or a history of glaucoma should use this medication with caution due to its mydriatic effects potentially increasing intraocular pressure. During the initial 1-2 weeks of treatment, various side effects such as insomnia, dizziness, nausea, and changes in appetite may occur, but these symptoms often improve over time. This medication may increase the risk of seizures in patients with epilepsy, and if seizures start or increase in frequency, use should be stopped immediately. Diabetic patients may find it difficult to control blood glucose levels while taking this medication, so blood sugar levels must be closely monitored. Suddenly stopping this medication can lead to withdrawal symptoms such as dizziness, anxiety, and sleep disturbances; therefore, it should be gradually reduced according to a doctor’s instructions. Patients with heart disease or prolonged QT intervals should undergo an ECG before taking this medication and monitor for arrhythmia symptoms during treatment. Pregnant or nursing women should consult a doctor before taking this medication as it may affect the fetus or newborn, and nursing should be discontinued or avoided during treatment. Caution is necessary as mental alertness may be impaired when operating vehicles or machinery. It is recommended not to use this medication in children or adolescents, as safety and efficacy have not been established. Family members or caregivers should carefully observe any changes in the patient’s behavior while taking this medication and consult medical staff immediately if abnormal symptoms occur.

Thrombocytopenia, anaphylactic reaction, inappropriate secretion of antidiuretic hormone, hyperprolactinemia, decreased appetite, increased appetite, weight gain, weight loss, hyponatremia, loss of appetite, anxiety, restlessness, abnormal dreams, decreased libido, sexual dysfunction, bruxism, agitation, irritability, panic attack, confusion, aggression, depersonalization, hallucination, mania, suicidal thoughts, suicidal behavior, insomnia, drowsiness, dizziness, perceptual disturbances, tremor, taste disorders, sleep disorders, fainting, serotonin syndrome, movement disorders, motor dysfunction, seizures, psychomotor agitation, akathisia, mydriasis, visual impairment, tinnitus, tachycardia, bradycardia, prolonged QT interval on ECG, polymorphic ventricular tachycardia, ventricular arrhythmia, orthostatic hypotension, sinusitis, yawning, epistaxis, nausea, diarrhea, constipation, vomiting, thirst, gastrointestinal bleeding, hepatitis, abnormal liver function tests, increased sweating, urticaria, alopecia, rash, pruritus, petechiae, angioedema, arthralgia, myalgia, rhabdomyolysis, urinary retention, ejaculation disorder, erectile dysfunction, uterine bleeding, menorrhagia, galactorrhea, postpartum hemorrhage, priapism, fatigue, fever, edema, headache, xerostomia, abdominal pain, dyspepsia, enteritis, sensory disturbances, cough, asthma, dyspnea, fracture, palpitations, hypertension, paralysis, extrapyramidal disorders, migraine, hallucination, asthma, dyspnea, fracture, arthralgia, hypertension, xerostomia, tremor, weight gain, abdominal discomfort, anxiety, insomnia, visual hallucinations, frequent urination, sedation, heartburn, nausea, vomiting, diarrhea, headache, dizziness, drowsiness, gastrointestinal disturbances, sweating, decreased libido, decreased appetite, sexual dysfunction, palpitations, emotional instability, hyperactivity, visual impairment, dizziness, sleep disorders, anxiety, tremor, confusion, sweating, headache, diarrhea

This medication may be sensitive to light, so it should be stored in a tightly closed container that blocks light. Additionally, it is best to store it at room temperature between 1 degree and 30 degrees Celsius. Storing it this way helps maintain the medication’s effectiveness and prevent degradation.

Appearance

White round film-coated tablets

Package unit

30 tablets/bottle, 100 tablets/bottle