Citalopram Tablet 20 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. Depending on the patient's response, the dose may be increased to a maximum of 20mg per day. If the dose of this drug is to be increased to 20mg, the increase should be made at intervals of at least 1 week. In general, 2-4 weeks are required for antidepressant effects to appear. Even after symptoms have resolved, drug treatment for at least 6 months is required to ensure the therapeutic effect. (2) Panic disorder with or without agoraphobia: The recommended initial dose is 5mg per day for 1 week, followed by an increase to 10mg per day. Depending on the patient's response, the dose may be increased to a maximum of 20mg per day. 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 required for symptoms to improve. Thereafter, depending on the patient's response, the dose may be reduced to 5mg per day or increased to a maximum of 20mg per day. Social anxiety disorder is a disease with a chronic course, and continued treatment for 12 weeks is recommended to ensure the therapeutic effect. Long-term treatment of patients who respond 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. A comparison of drug treatment with cognitive behavioral therapy has not been evaluated. 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, after at least 1 week of treatment, the dose may be increased to a maximum of 20mg per day. A long-term treatment study was conducted in patients who responded to 12 weeks of open-label treatment, administering 20mg per day 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. Depending on the patient's response, the dose may be increased to a maximum of 20mg per day. A long-term treatment study was conducted in patients who responded to 16 weeks of open-label treatment, administering 10mg or 20mg per day for at least 24 weeks. Obsessive-compulsive disorder is a chronic disease, so 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 An initial dose of 5mg per day for the first 2 weeks is recommended. Depending on the patient's response, the dose may be increased to 10mg per day. 4) Discontinuation of treatment 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 for the treatment of psychiatric disorders When discontinuing an MAO inhibitor used to treat psychiatric disorders and starting treatment with this drug, an interval of at least 14 days should be allowed. Conversely, when starting an MAO inhibitor for the treatment of psychiatric disorders, at least 14 days must have elapsed since discontinuation of 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 requiring treatment for a more urgent psychiatric condition, including hospitalization or other interventional procedures, 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 the benefits of treatment with linezolid or intravenous methylene blue are judged to outweigh the risk of serotonin syndrome in a particular patient, 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 starting linezolid or intravenous methylene blue, or until 24 hours after the last dose, whichever comes 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 non-intravenous routes (oral tablets or local injection) or intravenous administration of this drug at doses of 1mg/kg or less is unclear. Nevertheless, clinicians should be aware of the possibility of emergency symptoms of serotonin syndrome with these uses.

This medication is primarily used to treat psychiatric disorders such as depression. This medication is not approved for use in children and adolescents under the age of 18, and should be used with caution in young adults aged 18 to 24 as the risk of suicidal thoughts or behaviors may increase. This medication should not be taken with certain drugs, particularly MAO inhibitors, as it may increase the risk of life-threatening serotonin syndrome, and must be avoided. Patients with closed-angle glaucoma or a history of glaucoma should use this medication with caution as it may dilate the pupils and increase intraocular pressure. In the initial 1 to 2 weeks of treatment, various side effects such as insomnia, dizziness, anxiety, changes in appetite, nausea, and fatigue may occur, but most will resolve over time. This medication may lower sodium levels in the blood, and patients with bleeding tendencies or those taking anticoagulants should exercise caution. Additionally, sudden discontinuation of this medication may lead to withdrawal symptoms such as dizziness, anxiety, and sleep disturbances, so it is crucial to consult a physician and gradually reduce the dosage. Pregnant or breastfeeding women should consult a physician before taking this medication as it may affect the fetus or newborn, and caution should be exercised in the third trimester, with careful monitoring for any anomalies in the newborn. Elderly patients are recommended to start at a lower initial dosage and to reduce the maximum dosage. Caution is necessary when driving or operating machinery as this medication may affect mental or physical response. In case of overdose, symptoms may involve the central nervous system, gastrointestinal, and cardiovascular systems, requiring immediate medical attention, as there are no specific antidotes and treatment depends on the symptoms. This medication should be kept out of the reach of children and it is advisable to avoid transferring it 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, confusion, aggression, depersonalization, hallucinations, mania, suicidal thoughts, suicidal behavior, insomnia, drowsiness, dizziness, perceptual disturbances, tremors, taste disorders, sleep disorders, syncope, serotonin syndrome, dyskinesia, movement disorders, seizures, psychomotor agitation, akathisia, mydriasis, visual impairment, tinnitus, tachycardia, bradycardia, QT interval prolongation, polymorphic ventricular tachycardia, ventricular arrhythmias, orthostatic hypotension, sinusitis, yawning, epistaxis, nausea, diarrhea, constipation, vomiting, thirst, gastrointestinal bleeding, hepatitis, abnormal liver function tests, increased sweating, urticaria, hair loss, rash, itching, petechiae, angioedema, arthralgia, myalgia, rhabdomyolysis, urinary retention, ejaculation disorders, erectile dysfunction, uterine bleeding, menorrhagia, galactorrhea, postpartum hemorrhage, fatigue, fever, edema, headache, dry mouth, abdominal pain, dyspepsia, enteritis, sensory disturbances, cough, sexual dysfunction, palpitations, paralysis, extrapyramidal disorders, migraine, asthma, shortness of breath, fractures, hypertension, dry mouth, tremors, nausea, drowsiness, sexual dysfunction, dizziness, decreased libido, weight gain, headache, polyuria, heartburn, sedation, sweating, polyuria, dry mouth, dyspepsia, sweating, polyuria, sexual dysfunction, tremors, weight gain, abdominal discomfort, anxiety, insomnia, visual hallucinations, retroactive anxiety, epileptic seizures, mania, suicidal impulses, abnormal behavioral changes, anxiety, agitation, panic disorder, insomnia, excitement, hostility, aggression, impulsivity, akathisia, hypomania, mania, withdrawal symptoms, dizziness, sleep disorders, anxiety, tremors, confusion, sweating, headache, diarrhea, palpitations, emotional instability, irritability, visual impairment, QT interval prolongation, polymorphic ventricular tachycardia, ventricular arrhythmias, persistent sexual dysfunction

This medication is sensitive to light and should be stored in a container that blocks light. Additionally, it is best kept at room temperature, between 1 to 30 degrees Celsius. Proper storage will help maintain the effectiveness of the medication for longer.

Appearance

White oval film-coated tablet

Package unit

30 tablets/bottle, 100 tablets/bottle