Escitalopram Oxalate Tablets 20 mg (Escitalopram Oxalate)

Adult administration

Safety has not been established for doses exceeding 20mg per day. This medication is administered once daily in the morning or evening, with or without food. 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 medication 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 become apparent. Even after symptoms have resolved, at least 6 months of drug treatment is needed to ensure the 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 the dose to 10mg per day. The dose may be increased to a maximum of 20mg per day according to the patient's response. Maximum effects appear after approximately 3 months. The safety and efficacy of long-term administration of this medication for more than 10 weeks in the treatment of panic disorder have not been systematically studied. The physician should periodically reevaluate 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 therapeutic effect. Long-term treatment in patients who responded was studied for 6 months, and should be considered on an individual patient basis to prevent relapse. The usefulness of long-term treatment should be regularly reevaluated. 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. The dose may be increased to a maximum of 20mg per day according to the patient's response, 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, administering 20mg per day for at least 6 months. The physician should regularly reevaluate the usefulness of long-term treatment with this medication 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, administering 10mg or 20mg per day for at least 24 weeks. Obsessive-compulsive disorder is a chronic condition, so treatment should be continued for a sufficient period to ensure symptom recovery. When this medication is administered long term, its usefulness and dose should be regularly reevaluated for each patient. 2) Patients with renal impairment No dose adjustment is necessary for 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 according to the patient's response. 4) Discontinuation of treatment When discontinuing this medication, 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 medication, an interval of at least 14 days must be observed. Conversely, when starting an MAO inhibitor for the treatment of psychiatric disorders, at least 14 days must have elapsed after discontinuing this medication. 6) Other MAO inhibitors such as linezolid or methylene blue Patients receiving linezolid or intravenous methylene blue should not start this medication because of the increased risk of serotonin syndrome. For patients requiring treatment of a more urgent psychiatric condition, including hospitalization and 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 medication. 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 medication 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 medication 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 medication 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 should be used very cautiously in children, adolescents, and young adults with major depression or other psychiatric disorders as it may increase the risk of suicidal thoughts or behaviors. This medication should not be used alongside certain drugs, especially MAO inhibitors or pimozide, as serious side effects may occur. Patients with glaucoma or a history of glaucoma should use this medication with caution as it may dilate the pupils and increase intraocular pressure. During the initial 1-2 weeks of treatment, various adverse reactions such as anxiety, insomnia, and dizziness may occur; however, these symptoms often reduce over time. If during the use of this medication the symptoms of depression worsen or if there are thoughts of suicide, aggression, or unusual behavioral changes such as anger, the doctor should be consulted immediately. Patients with epilepsy should be monitored closely as this medication may increase the risk of seizures. Diabetics should frequently check their blood sugar levels, as this medication may affect blood sugar control and dosage adjustment may be necessary. This medication may cause withdrawal symptoms such as dizziness, anxiety, and sleep disturbances if stopped abruptly, so the dosage should be gradually reduced according to the physician's instructions. Patients with heart disease or a prolonged QT interval should be carefully observed, as this medication may induce cardiac arrhythmias and an ECG should be performed prior to and during treatment. Pregnant or breastfeeding women should use this medication only after consulting a physician, as it may affect the newborn. During breastfeeding, this medication should be avoided or breastfeeding should be discontinued. When used in combination with other serotonergic drugs, this medication may lead to severe side effects known as serotonin syndrome, so extreme caution is required. While this medication is known to have little effect on mental functions during driving or operation of machinery, individual responses may vary, and caution is advised. Dosage adjustments may be necessary for children and the elderly, particularly starting lower doses in older adults. This medication is not recommended for use in children and adolescents as its safety and efficacy have not been sufficiently established. When storing this medication, keep it out of reach of children and 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 ideation, suicidal behavior, insomnia, drowsiness, dizziness, perceptual disturbances, tremors, taste disorders, sleep disturbances, syncope, serotonin syndrome, movement disorders, motor disturbances, seizures, psychomotor agitation, akathisia, mydriasis, visual impairment, tinnitus, tachycardia, bradycardia, prolonged QT interval on ECG, polymorphic ventricular tachycardia, ventricular arrhythmias, orthostatic hypotension, sinusitis, yawning, epistaxis, nausea, diarrhea, constipation, vomiting, polydipsia, gastrointestinal bleeding, hepatitis, abnormal liver function tests, increased sweating, urticaria, alopecia, rashes, itching, petechiae, angioedema, arthralgia, myalgia, rhabdomyolysis, urinary retention, ejaculatory dysfunction, erectile dysfunction, uterine bleeding, menorrhagia, galactorrhea, postpartum hemorrhage, priapism, fatigue, fever, edema, headache, dry mouth, abdominal pain, dyspepsia, enteritis, sensory disturbances, cough, asthma, dyspnea, fractures, hypertension, paralysis, extrapyramidal disorders, migraines, chest pain, palpitations, insomnia, aggressive reactions, anorexia, hallucinations, sedation, frequent urination, tremors, abdominal discomfort, anxiety, visual hallucinations, retroactive anxiety, epileptic seizures, mania, changes in blood sugar control, anxiety, agitation, panic disorder, excitement, hostility, aggression, impulsivity, akathisia, hypomania, mania, withdrawal symptoms (dizziness, sleep disturbances, anxiety, nausea, vomiting, tremors, confusion, sweating, headache, diarrhea, palpitations, emotional instability, irritability, visual impairment)

This medication is sensitive to light and should be stored in containers that block light. It is also recommended to store the medicine at room temperature between 1°C and 30°C. This will help maintain the medication's effectiveness and safety.

Appearance

White oval film-coated tablet

Package unit

30 tablets/bottle, 100 tablets/bottle