Escitalopram (generic Lexapro®) Tablets

About this medicine

ESCITALOPRAM is an antidepressant that belongs to a class of medications called SSRIs (selective serotonin reuptake inhibitors). It is used to treat mood disorders such as anxiety and depression. A side effect of certain SSRIs is delayed ejaculation, so they are also prescribed off-label to help treat premature ejaculation in men. For full prescribing information, view the drug label information.

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Trade names

LEXAPRO® The list of names may not include all products that are available on the market.

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How to take this medicine

• Take escitalopram tablets exactly as prescribed by your healthcare provider
• Take your prescribed dosage once daily at approximately the same time every day
• Take one tablet by mouth daily, with or without food
• Do not take more than 1 tablet per day
• If you take more than your prescribed dosage, accidentally or intentionally, seek medical help right away

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What if I miss a dose?

If you forget to take a dose of this medication, take it as soon as you remember. If you happen to miss it before the day ends, simply resume your regular dosing schedule the next day. Never take more than one dose in 24 hours.

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Who should not take this medicine?

• People who have a sensitivity or allergy to escitalopram, citalopram or any component of the formulation
• People who are currently taking or have recently taken MAOIs
• People who are taking linezolid, methylene blue, or pimozide
• Pregnant or breastfeeding women
• People who have certain medical conditions such as bipolar disorder, acute angle-closure glaucoma, low sodium levels, personal or family history of QT-prolongation, or serotonin syndrome
• Those taking certain medications or supplements that can interact with SSRIs, potentially increasing the risk of adverse effects or reducing the effectiveness of either medication. See below under ‘Inform your healthcare providers’

It's crucial for individuals considering SSRIs to discuss their medical history, current medications, and any concerns with their healthcare provider to determine whether SSRIs are appropriate for them and to ensure safe and effective treatment.

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What should I watch for while using this medicine?

• Inform your provider if your symptoms fail to improve or worsen. Complete the check-ins with your Keeps team and attend your regular check-ups with your primary care provider. Since it may take several weeks to observe the full effects of this medication, it's essential to adhere to your treatment regimen as prescribed by your healthcare team.
• Be aware of any new or escalating thoughts of not wanting to be alive or wanting to harm yourself. Call 988 or 911, go to the nearest emergency room or contact your healthcare team if you experience suicidal thoughts.
• Patients with bipolar tendencies or bipolar disorder who take this medication may experience agitation, or a full blown manic episode. After you start this medication, look out for symptoms of increasing anxiety, agitation, loss of sleep, increasing energy levels, irritable or overly happy mood and significant changes in behavior. Notify your healthcare team immediately if you notice any of these symptoms.
• You may experience drowsiness or dizziness. Refrain from driving, operating machinery, or engaging in activities requiring mental alertness until you understand how this medication affects you. Take care when changing positions, especially if you are over age 65, to reduce the risk of dizziness or fainting. If the medication makes you drowsy, take it at bedtime. If it interferes with your sleep, take it in the morning. Consumption of alcohol may interfere with the effects of this medication; therefore, it is best to avoid alcoholic beverages.
• Signs of bleeding such as bruising, blood in your stool, bleeding gums, nosebleeds, or tiny brown/purple/red round spots on your skin

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Side effects

Escitalopram can cause serious side effects. Seek immediate medical attention if you notice any of the following:

• Increased risk of bleeding- symptoms include bruising, blood in your stool, bleeding gums, nosebleeds, or tiny brown/purple/red round spots on your skin
• Serotonin syndrome- symptoms include irritability, confusion, fast or irregular heartbeat, muscle stiffness, twitching muscles, sweating, high fever, seizure, chills, vomiting, diarrhea
• Heart rhythm changes- symptoms might include fast or irregular heartbeat, dizziness, feeling faint or lightheaded, chest pain, trouble breathing
• Suicidal thoughts, thoughts of self-harm, depression, or mood changes
• Allergic reactions- symptoms include rashes, breathing difficulty, itching, hives, swelling of the face, lips, tongue, or throat
• Sudden eye pain or visual changes
• Low sodium levels- symptoms include muscle weakness, fatigue, dizziness, headache, confusion

Contact your doctor if you have additional questions about side effects. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

More common side effects include:

• nausea
• diarrhea
• constipation
• heartburn
• stomach pain or upset
• drowsiness
• headaches
• sleep changes
• dizziness
• fatigue
• dry mouth
• decreased appetite
• weight loss or gain
• flu-like symptoms
• although the desired effect of this medication is to delay ejaculation, it can cause unwanted sexual problems in a minority of patients which include changes in sex drive, erectile dysfunction, or other changes in ejaculation.

Tell your healthcare provider if you have any side effect that bothers you or does not go away. Many common side effects are temporary and improve within a few weeks. However, it is a good idea to let your healthcare provider know about them.

These are not all the possible side effects of escitalopram. For more information, ask your healthcare provider or pharmacist.

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Storage

Store the medicine in a closed container at room temperature (68-77 degrees Fahrenheit), away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your pharmacist about how you should dispose of any medicine you do not use.

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Other important information

Medicine may not work

The recommended treatments do not work for every single person and results vary. There is a risk the medication will not improve your PE symptoms. If after more than 6 weeks your symptoms have not improved, please reach out to your healthcare provider.

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Inform your healthcare providers

Before you take this medication, let your healthcare provider know if you have:

• any medical conditions
• any mental health conditions
• a personal or family history of bipolar disorder
• glaucoma
• heart disease
• family or personal history of QT prolongation
• kidney or liver disease
• seizure disorder
• suicidal thoughts or thoughts of self-harm by you or an immediate family member
• ever had low sodium levels (hyponatremia) from any cause
• previously had serotonin syndrome
• had an allergic reaction to escitalopram or citalopram

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Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Especially tell your healthcare provider if you take any of the following:

• Any and all medications that are taken for your mental health such as SNRIs, SSRIs, MAO inhibitors, TCAs, Buspirone, Lithium,
• Triptan medications that are taken for migraine headaches such as sumatriptan, naratriptan, rizatriptan, zolmitriptan, eletriptan
• Medications for fungal infections such as fluconazole, itraconazole, ketoconazole
• Cisapride
• Dronedarone
• Linezolid
• Pimozide
• Thioridazine
• Carbamazepine
• Anticoagulant medications such as warfarin, enoxaparin, dalteparin
• Antiplatelet medications such as aspirin, clopidogrel, ticagrelor, prasugrel, cilostazol, dipyridamole
• NSAIDs such as ibuprofen, naproxen, diclofenac, meloxicam
• Cimetidine
• Dofetilide
• Fentanyl
• Furazolidone
• Isoniazid
• Supplements like St. John's wort, kava kava, valerian
• Tramadol
• Tryptophan
• Ziprasidone
• Recreational drugs such as cannabis, alcohol, cigarettes, heroin, cocaine, amphetamines, ecstasy, MDMA, amyl nitrites (poppers, rush), Molly

This list does not include all possible medication interactions.

Telemedicine does not replace your primary care physician. It is important to keep your primary care physician and pharmacist informed of all medications you are taking, including those in your Keeps treatment plan, as they can interact with other medicines you may be taking.