Ipram Tablet 20 mg (Escitalopram Oxalate)

Adult administration

The safety of doses exceeding 20mg per day has not been established. This drug is administered once daily, in the morning or evening, regardless of meals. Major depressive disorder: The usual dosage 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 become apparent. Even after symptoms have resolved, at least 6 months of drug therapy is needed to ensure a sustained treatment effect. Panic disorder with or without agoraphobia: It is recommended to start with 5mg once daily for 1 week and then increase the dose to 10mg once daily. The dose may be increased to a maximum of 20mg per day, depending on the patient's response. The maximum effect is seen after approximately 3 months. The safety and efficacy of long-term administration of this drug 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. Social anxiety disorder: The usual dosage 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, depending on the patient's response. Continued treatment for 12 weeks is recommended to ensure a treatment 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. Generalized anxiety disorder: The initial dosage 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 study was conducted in patients who responded to 12 weeks of open-label treatment, in which 20mg per day was administered for at least 6 months. The physician should regularly reassess the usefulness of long-term treatment with this drug for each patient. Obsessive-compulsive disorder: The usual dosage 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 study was conducted in patients who responded to 16 weeks of open-label treatment, in which 10mg or 20mg per day was administered for at least 24 weeks. Obsessive-compulsive disorder is a chronic condition; treatment should be continued for a sufficient period to ensure symptom remission. When this drug is used long term, its usefulness and dosage should be reassessed regularly for each patient. 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). Patients with hepatic impairment: An initial dose of 5mg per day is recommended for the first 2 weeks. The dose may be increased to 10mg per day, depending on the patient's response. 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. 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 must be allowed. Conversely, at least 14 days must elapse after discontinuing this drug before starting an MAO inhibitor for the treatment of psychiatric disorders. Other MAO inhibitors, such as linezolid or methylene blue: Patients receiving linezolid or intravenous methylene blue preparations should not start this drug because of the increased risk of serotonin syndrome. For patients who require other interventional procedures, including hospitalization, or treatment for a more urgent psychiatric condition, use should be considered. It may be necessary to urgently administer linezolid or an intravenous methylene blue preparation to a patient already receiving this drug. If no alternative to linezolid or intravenous methylene blue is available and, for a specific patient, the benefits of treatment with linezolid or intravenous methylene blue are judged to outweigh the risk of serotonin syndrome, this drug may be stopped 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 drug may be restarted 24 hours after the last dose of linezolid or intravenous methylene blue. The risk associated with methylene blue administered by a nonintravenous route (oral tablets or local injection) or with intravenous administration of this drug at a dose 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 an antidepressant that treats psychiatric disorders such as major depression. There is an increased risk of suicidal thoughts or behaviors in children, adolescents, and young adults aged 18 to 24, so careful judgment and close observation by a physician are necessary during administration. This medication may cause dangerous side effects if used with certain medications, so it should not be used especially with MAO inhibitors or Pimoxizine. Patients with a history of glaucoma or those with closed-angle glaucoma need to be cautious as this medication may dilate the pupils and increase intraocular pressure. During the initial 1-2 weeks of treatment, various side effects such as anxiety, insomnia, dizziness, nausea, and headaches may occur, but most will decrease over time. This medication may affect heart rate and prolong the QT interval, so caution is required for patients with heart disease or those taking certain medications. During treatment, mental changes such as suicidal thoughts or behavior, aggression, and anxiety may occur, so both patients and caregivers should monitor for these carefully. Abrupt discontinuation can lead to withdrawal symptoms such as dizziness, anxiety, and sleep disturbances, so it must be gradually tapered down according to a physician's instructions. Pregnant or breastfeeding women should consult a physician as the medication may affect the newborn. Older adults should start at lower doses than regular adults and be monitored closely for adverse reactions. Additionally, it is advisable not to take this medication with alcohol, and caution is needed when driving or operating machinery. Store this medication safely out of the reach of children.

Thrombocytopenia, anaphylactic reaction, inappropriate antidiuretic hormone secretion, hyperprolactinemia, decreased appetite, increased appetite, weight gain, weight loss, hyponatremia, anorexia, anxiety, restlessness, abnormal dreams, decreased libido, sexual dysfunction, bruxism, agitation, nervousness, 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 disturbances, tinnitus, tachycardia, bradycardia, prolonged QT interval, 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, hair loss, rash, itching, petechiae, angioedema, arthralgia, myalgia, rhabdomyolysis, urinary retention, ejaculation disorders, erectile dysfunction, uterine bleeding, heavy menstruation, galactorrhea, postpartum bleeding, priapism, fatigue, fever, edema, headache, dry mouth, abdominal pain, dyspepsia, enteritis, sensory disturbances, cough, asthma, dyspnea, fracture, hypertension, paralysis, extrapyramidal symptoms, migraine, chest pain, palpitations, frequent urination, tremor, dry mouth, heartburn, sedation, emotional instability, hypersensitivity, visual hallucinations, insomnia, agitation, nausea, tremor, confusion, sweating, diarrhea

This medication is sensitive to light, so it should be stored in a container that blocks light. Also, it is important to keep the temperature between 1°C and 30°C when storing the medication. This helps maintain the medication's effectiveness for a longer duration.

Appearance

White oval film-coated tablet

Package unit

30 tablets/bottle, 100 tablets/bottle