Dipurojeong 20 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, without regard to meals. (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 medicine is to be increased to 20mg, it should be increased at intervals of at least 1 week. Generally, 2-4 weeks are required for antidepressant effects to develop. Even after symptoms have resolved, drug treatment for at least 6 months is required to ensure a sustained 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 it 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 is reached 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 dose is 10mg once daily. Generally, 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 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 on an individual patient basis to prevent relapse. The usefulness of long-term treatment should be reevaluated regularly. (4) Generalized anxiety disorder: The initial dose 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 administration 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 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 administration 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 be continued for a sufficient period to ensure symptom recovery. If this medicine is administered long term, its usefulness and dosage should be regularly reevaluated for each patient. 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 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 for the treatment of psychiatric disorders and starting treatment with this medicine, 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 should 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. 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 administration of linezolid or intravenous methylene blue, or until 24 hours after the last dose, whichever comes 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 nonintravenous routes (oral tablets or local injection), or with intravenous administration of this medicine 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 doctors should use this medication with caution in these populations. This medication should not be taken with certain other medications, particularly MAO inhibitors, pimavanserin, or drugs that prolong the QT interval, as this could be dangerous. Patients with angle-closure glaucoma or a history of glaucoma should use this medication cautiously as it may increase eye pressure. Anxiety or agitation may occur early in treatment, and patients with epilepsy may have an increased risk of seizures, so monitoring is necessary. If depression symptoms worsen or if there are behavioral changes such as suicidal thoughts, aggression, or anger during treatment, it is essential to consult healthcare providers immediately. Diabetic patients may experience blood sugar control issues, therefore blood sugar status should be monitored carefully. This medication may cause withdrawal symptoms such as dizziness, insomnia, anxiety, and nausea if stopped suddenly, so doses should be gradually decreased when discontinuing. Due to the risk of cardiac arrhythmias associated with QT interval prolongation, patients with heart disease or electrolyte imbalances may need an ECG prior to administration. During pregnancy, especially in the later stages, it may affect the newborn, so the decision to use this medication should be made carefully by the pregnant individual, and breastfeeding should be avoided or the medication should be discontinued if breastfeeding. Caution is required when driving or operating machinery as this medication may affect mental functions. In cases of overdose, symptoms such as dizziness, tremors, nausea, and heart abnormalities may arise, necessitating immediate emergency treatment. Special care is needed for children and the elderly, with the elderly advised to start at a reduced dose for safety. Interactions with other medications are possible while taking this medication, so it is important to inform healthcare providers of all medications being used.

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, nervousness, panic attack, confusion, aggression, depersonalization, hallucination, mania, suicidal thoughts, suicidal behavior, insomnia, drowsiness, dizziness, perceptual disturbances, tremors, taste disorders, sleep disorders, syncope, serotonin syndrome, movement disorders, motor disorders, seizures, psychomotor agitation, akathisia, mydriasis, visual impairment, tinnitus, tachycardia, bradycardia, ECG QT 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 disorders, 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, palpitations, hypertension, paralysis, extrapyramidal disorders, migraine, chest pain, frequent urination, sedation, tremors, abdominal discomfort, anxiety, visual hallucinations, retroactive anxiety, epileptic seizures, mania, hyponatremia, bleeding, serotonin syndrome, withdrawal symptoms, dizziness, sleep disorders, anxiety, tremors, confusion, sweating, diarrhea, emotional instability, irritability, visual impairment, QT interval prolongation, sexual dysfunction, nausea, vomiting, hypotension, arrhythmia, hypokalemia, hyponatremia

This medication should be stored in a tightly sealed container to protect it from air and moisture. The storage temperature should be maintained between 1 degree and 30 degrees Celsius. Proper storage will help maintain the effectiveness of the medication for a long time.

Appearance

White oval film-coated tablet

Package unit

30 tablets/bottle, 100 tablets/bottle