Epram Tablets 10 mg (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) 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 increasing the dose of this medicine to 20mg, the dose should be increased at intervals of at least 1 week. Generally, 2-4 weeks are needed for antidepressants to take effect. Even after symptoms have resolved, drug treatment for at least 6 months is required 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 reevaluate each patient to determine the need for continued treatment. (3) Social anxiety disorder: The usual dosage is 10mg once daily. Generally, 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. Social anxiety disorder is a chronic condition, and continued treatment for 12 weeks is recommended to ensure a 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 reevaluated regularly. (4) 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, with 20mg per day administered for at least 6 months. The physician should regularly reevaluate the usefulness of long-term treatment with this medicine for each patient. (5) 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, with 10mg or 20mg per day administered for at least 24 weeks. Obsessive-compulsive disorder is a chronic condition, so treatment should continue for a sufficient period to ensure symptom remission. If this medicine is administered long term, its usefulness and dosage should be reevaluated regularly 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 of treatment 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 used to treat 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, before 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, other interventions 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, for a particular patient, the benefits of treatment with linezolid or intravenous methylene blue are judged to outweigh the risk of serotonin syndrome, this medicine 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 receiving linezolid or intravenous methylene blue, or until 24 hours after the last dose, whichever comes first. Treatment with this medicine may be restarted 24 hours after the last dose of linezolid or intravenous methylene blue. The risks associated with administration of methylene blue by nonintravenous routes (oral tablets or local injection) or intravenous administration of this medicine at a dose of 1mg/kg or less are 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. Caution should be exercised when using it for children, adolescents, and young adults aged 18-24 due to the increased risk of suicidal thoughts and behaviors. This medication should not be taken with certain drugs, especially MAO inhibitors or pimozide, as this significantly raises the risk of serious side effects. Patients with glaucoma or a history of glaucoma should use it with caution as it may increase eye pressure. Common side effects such as dizziness, anxiety, nausea, and insomnia may occur in the first 1-2 weeks after starting treatment, but tend to decrease over time. This medication can affect heart rhythm, so patients with heart disease or prolonged QT interval should consult a physician. During treatment, mental state changes like suicidal thoughts, aggression, and anxiety should be closely monitored, and family members or caregivers should be involved in monitoring. Sudden discontinuation can cause withdrawal symptoms, so the dosage should be gradually reduced according to a physician's instructions. Pregnant or breastfeeding women should consult medical personnel before using this medication, as it may affect the fetus or newborn. Attention is required when driving or operating machinery, as this medication may impair alertness. In the case of overdose, symptoms such as dizziness, vomiting, and heart arrhythmias may occur, necessitating immediate medical attention. This medication is not recommended for children as safety and efficacy have not been established. For elderly patients, it is advisable to start with a lower dose than usual and administer it cautiously.

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, irritability, panic attack, confusion state, aggression, depersonalization, hallucination, mania, suicidal ideation, suicidal behavior, insomnia, drowsiness, dizziness, perceptual abnormalities, tremor, taste disorder, sleep disturbance, syncope, serotonin syndrome, movement disorders, dyskinesia, convulsion, psychomotor agitation, akathisia, mydriasis, visual impairment, tinnitus, tachycardia, bradycardia, QT interval prolongation, polymorphic ventricular tachycardia, ventricular arrhythmia, orthostatic hypotension, sinusitis, yawning, nosebleed, 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, ejaculation disorder, erectile dysfunction, uterine bleeding, menorrhagia, galactorrhea, postpartum hemorrhage, priapism, fatigue, fever, edema, headache, xerostomia, abdominal pain, indigestion, enteritis, sensory abnormalities, cough, asthma, shortness of breath, fracture, palpitations, hypertension, paralysis, extrapyramidal disorder, migraine, visual hallucination, sedation, frequent urination, tremor, chest pain, dry mouth, loss of appetite, insomnia, hallucination, anxiety, agitation, panic disorder, excitement, hostility, aggressiveness, impulsivity, akathisia, hypomania, mania, dizziness, sleep disturbance, confusion, sweating, headache, diarrhea, palpitations

This medication may be sensitive to air and moisture, so it should be stored in a tightly sealed container. The recommended storage temperature is room temperature between 1 and 30 degrees Celsius. Proper storage will help maintain the medication's efficacy safely.

Appearance

White oval film-coated tablets

Package unit

30 tablets/bottle, 100 tablets/bottle