Gunpram Tablets 10mg (Escitalopram Oxalate)

Adult administration

The safety of doses exceeding 20mg per day has not been established. This medicine 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 depending on the patient's response. If the dose 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 resolve, drug treatment for at least 6 months is needed to ensure a therapeutic 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 depending on the patient's response. The maximum effect appears after approximately 3 months. The safety and efficacy of long-term administration of this medicine for more 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 to improve symptoms. Thereafter, the dose may be reduced to 5mg per day or increased to a maximum of 20mg per day depending on the patient's response. Social anxiety disorder is a condition with a chronic course, and continued treatment for 12 weeks is recommended to ensure a therapeutic effect. Long-term treatment of 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. Depending on the patient's response, the dose may be increased to a maximum of 20mg per day after at least 1 week of treatment. A long-term treatment trial 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 medicine 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 depending on the patient's response. A long-term treatment trial 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 recovery of symptoms. For long-term use of this medicine, the usefulness and dose should be regularly reassessed for each patient. 2) Patients with renal impairment No dosage 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 An initial dose of 5mg per day for the first 2 weeks is recommended. The dose may be increased to 10mg per day depending on the patient's response. 4) Discontinuation When discontinuing this medicine, the dose should be gradually reduced over at least 1-2 weeks to avoid the possibility of withdrawal symptoms. 5) Switching from MAO inhibitors for the treatment of psychiatric disorders When discontinuing an MAO inhibitor used to treat psychiatric disorders and starting treatment with this medicine, an interval of at least 14 days should be allowed. Conversely, when starting an MAO inhibitor to treat psychiatric disorders, at least 14 days must have elapsed after discontinuing this medicine. 6) Other MAO inhibitors, such as linezolid or methylene blue Patients receiving linezolid or intravenous methylene blue should not start treatment with this medicine because of the increased risk of serotonin syndrome. For patients requiring treatment for a more urgent psychiatric condition, including hospitalization or other interventional procedures, treatment should be considered. It may be necessary to urgently administer linezolid or intravenous methylene blue to a patient already receiving this medicine. If no alternative to linezolid or intravenous methylene blue is available and the benefits of treatment with linezolid or intravenous methylene blue are judged to outweigh the risk of serotonin syndrome in a particular patient, this medicine may be discontinued immediately and linezolid or intravenous methylene blue administered. Patients 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 comes first. Treatment with this medicine may be resumed 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 intravenous administration of this medicine 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 may increase the risk of suicidal thoughts or behavior in children, adolescents, and young adults with major depressive disorder or psychiatric illnesses, so a doctor should carefully assess before administration. This medication should not be used in patients with allergies to its components or those taking certain medications, particularly monoamine oxidase inhibitors (MAOIs) or pimoxetine. Patients with closed-angle glaucoma or a history of glaucoma should be cautious as it may dilate pupils and increase intraocular pressure. Anxiety, insomnia, dizziness, and nausea may often occur during the first 1-2 weeks after initial use, but these symptoms tend to decrease over time. This medication can cause various reactions in blood, mental, nervous, gastrointestinal, skin, and other areas, so patients should consult a doctor if symptoms appear. Particularly, this medication may worsen mental symptoms such as suicidal thoughts or behavior, aggression, and anxiety, so both patients and families should observe carefully. Sudden discontinuation of this medication may result in withdrawal symptoms such as dizziness, anxiety, and sleep disturbances, so dosage should be gradually reduced according to the doctor's instructions. Patients with heart-related diseases or QT prolongation should undergo cardiac examination prior to administration as this medication may affect heart rhythm. There is a risk of life-threatening serotonin syndrome if this medication is taken with other serotonergic drugs, so caution is advised for concomitant administration. Pregnant or breastfeeding women should only use this medication under a doctor's discretion as it may affect the fetus or newborn, and during breastfeeding, use should be avoided or breastfeeding should be discontinued. Elderly patients should start at a lower dose than younger adults and be monitored carefully. This medication may impair judgment or reaction time, so caution is needed when driving or operating machinery. Overdose may lead to central nervous system symptoms, gastrointestinal disturbances, or cardiac arrhythmias, so the prescribed dosage must be followed, and in case of overdose, medical attention should be sought immediately. This medication should be kept out of reach of children and not transferred to other containers.

Thrombocytopenia, anaphylactic reaction, inappropriate secretion of antidiuretic hormone, hyperprolactinemia, decreased appetite, increased appetite, weight gain, weight loss, hyponatremia, anorexia, anxiety, restlessness, abnormal dreams, decreased libido, sexual dysfunction, bruxism, agitation, irritability, panic attacks, altered mental status, aggression, depersonalization, hallucinations, mania, suicidal ideation, suicidal behavior, insomnia, drowsiness, dizziness, perceptual disturbances, tremors, taste disturbances, sleep disorders, syncope, serotonin syndrome, dyskinesia, movement disorders, seizures, psychomotor agitation, akathisia, mydriasis, visual impairment, tinnitus, tachycardia, bradycardia, prolonged QT interval, polymorphic ventricular tachycardia, ventricular arrhythmias, orthostatic hypotension, sinusitis, yawning, epistaxis, nausea, diarrhea, constipation, vomiting, dry mouth, gastrointestinal bleeding, hepatitis, abnormal liver function tests, increased sweating, urticaria, hair loss, rash, itching, petechiae, angioedema, arthralgia, myalgia, rhabdomyolysis, urinary retention, ejaculatory dysfunction, erectile dysfunction, uterine bleeding, menorrhagia, galactorrhea, postpartum hemorrhage, priapism, fatigue, fever, edema, headache, xerostomia, abdominal pain, dyspepsia, enteritis, sensory disturbances, cough, asthma, dyspnea, fractures, hypertension, paralysis, extrapyramidal disorders, migraine, chest pain, palpitations, sedation, tremors, dry mouth, frequent urination, abdominal discomfort, anxiety, insomnia, visual hallucinations, retrograde amnesia, epileptic seizures, mania, self-harm, hostility, aggression, impulsivity, akathisia, hypomania, withdrawal symptoms, dizziness, sleep disorders, anxiety, tremors, confusion, sweating, headache, diarrhea, palpitations, emotional instability, irritability, visual impairment, hypokalemia, hypomagnesemia, increased risk of fractures, neonatal behavioral disorders, neonatal withdrawal effects, neonatal respiratory distress, cyanosis, apnea, seizures, temperature instability, feeding difficulties, vomiting, hypoglycemia, hypertonia, hypotonia, hyperreflexia, tremors, restlessness, irritability, narcolepsy, persistent crying, drowsiness, sleep disturbances

This medication is sensitive to light and should be stored in a container that prevents light exposure. It is also recommended to keep it at a temperature between 1 and 30 degrees Celsius.

Appearance

White oval film-coated tablet

Package unit

30 tablets/bottle, 100 tablets/bottle