Lexipram Tablets 20mg (Escitalopram Oxalate)

Adult administration

Safety has not been established for doses exceeding 20mg per day. 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 according to 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, antidepressants take 2-4 weeks to begin working. Even after symptoms have resolved, at least 6 months of drug treatment is required to ensure a 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. 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 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 for improvement in symptoms. 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 a therapeutic effect. Long-term treatment in responding patients has been studied for 6 months and should be considered individually 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. The dose may be increased to a maximum of 20mg per day according to the patient’s response, after at least 1 week of treatment. A long-term 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 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 according to the patient’s response. A long-term 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 recovery of symptoms. During long-term treatment with this medicine, the usefulness and dose should be regularly reassessed for each patient. 2) Patients with renal impairment No dose adjustment is necessary in patients with mild or moderate renal impairment. Caution is advised in patients with severe renal impairment (CLCR < 30mL/min). 3) Patients with hepatic impairment The recommended initial dose is 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 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 a psychiatric disorder and starting treatment with this medicine, an interval of at least 14 days must be allowed. Conversely, when starting an MAO inhibitor to treat a psychiatric disorder, 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 this medicine because of the increased risk of serotonin syndrome. Administration should be considered in patients requiring treatment for a more urgent psychiatric condition, including hospitalization or other interventional procedures. It may be necessary to urgently administer linezolid or intravenous methylene blue to a patient already receiving this medicine. If there are no alternative drugs for 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, discontinue this medicine immediately and administer linezolid or intravenous methylene blue. 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 occurs 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 non-intravenous routes (oral tablets or local injection) or intravenous administration of this medicine 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 used to treat psychiatric disorders such as depression, and there is an increased risk of suicidal thoughts or behaviors in children, adolescents, and young adults aged 18 to 24, requiring particular caution. This medication should not be taken in combination with certain drugs, such as MAO inhibitors or pimozide, and patients with certain genetic problems such as lactose intolerance should also avoid it. Patients with glaucoma or a history of glaucoma should use this medication carefully due to the risk of increased intraocular pressure. During the first 1-2 weeks of taking this medication, side effects such as nausea, anxiety, insomnia, and dizziness may commonly occur, but symptoms often decrease over time. This medication can particularly affect the heart, so patients with heart disease or QT interval prolongation should consult a doctor before use. Patients should be closely monitored for changes in mental state such as suicidal thoughts or behaviors, anxiety, and aggression by themselves and their family or caregivers. Abruptly discontinuing this medication can result in withdrawal symptoms such as dizziness, anxiety, and sleep disturbances, so dosage should be gradually reduced under medical supervision. Additionally, this medication may interact with other drugs, so inform your doctor or pharmacist of any other medications you are taking. Women who are pregnant or breastfeeding must consult a doctor before taking this medication, and it is recommended to stop breastfeeding while on this medication as it may be passed into breast milk. For elderly patients, it is recommended to start with a lower initial dose and monitor them closely while taking the medication. Caution may be required when driving or operating machinery, so it is important to assess your condition well. Overdosing on this medication may lead to serious side effects, and immediate medical attention should be sought.

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, neuroexcitation, panic attack, confusion, aggression, depersonalization, hallucinations, mania, suicidal ideation, suicidal behavior, insomnia, drowsiness, dizziness, perception disturbance, tremors, taste disorder, sleep disorder, syncope, serotonin syndrome, movement disorder, motor dysfunction, convulsions, 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 disorder, erectile dysfunction, uterine bleeding, menorrhagia, galactorrhea, postpartum hemorrhage, priapism, fatigue, fever, edema, headache, dry mouth, abdominal pain, dyspepsia, enteritis, sensory disturbance, cough, asthma, dyspnea, fracture, palpitations, hypertension, paralysis, extrapyramidal disorder, migraine, chest pain, frequent urination, tremor, emotional instability, hyperirritability, visual impairment, dizziness, sleep disorder, anxiety, agitation, nausea, vomiting, tremors, confusion, sweating, headache, diarrhea

This medication is sensitive to light and should be stored in a tightly closed container that is protected from light. It is best to maintain a storage temperature between 1 to 30 degrees Celsius to preserve its efficacy and safety.

Appearance

White oval film-coated tablet

Package unit

30 tablets/bottle, 100 tablets/bottle