Terry White Chemists Escitalopram

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Terry White Chemists Escitalopram
Contains the active ingredient, escitalopram (as escitalopram oxalate)

Consumer Medicine Information

For a copy of a large print leaflet,     What this medicine is                     Escitalopram corrects this chemical
Ph: 1800 195 055                                                                   imbalance and may help relieve the
                                         used for
                                                                                   symptoms of depression.
                                         The name of your medicine is Terry        There is no evidence that
                                         White Chemists Escitalopram. It           escitalopram is addictive. However,
What is in this leaflet                  contains the active ingredient,           if you suddenly stop taking it, you
                                         escitalopram (as escitalopram             may get side effects.
Read this leaflet carefully before       oxalate).
taking your medicine.                                                              Tell your doctor if you get any side
                                         It is used to treat:                      effects after stopping escitalopram.
This leaflet answers some common
                                         •   depression
questions about escitalopram.
                                         •   social anxiety disorder               Use in children
It does not contain all the available    •   general anxiety disorder
information. It does not take the                                                  Do not give this medicine to a child
                                         •   obsessive-compulsive disorder.        or adolescent.
place of talking to your doctor or
pharmacist.                              Ask your doctor if you have any           There is no experience with its use in
                                         questions about why this medicine         children and adolescents under 18
The information in this leaflet was      has been prescribed for you. Your         years of age.
last updated on the date listed on the   doctor may have prescribed this
last page. More recent information on
                                         medicine for another reason.
this medicine may be available.
                                         This medicine is available only with
Ask your doctor or pharmacist:           a doctor's prescription.                  Before you take this
• if there is anything you do not                                                  medicine
  understand in this leaflet,            How it works
• if you are worried about taking
  your medicine, or                      Escitalopram belongs to a group of        When you must not take it
                                         medicines called Selective Serotonin
• to obtain the most up-to-date                                                    Do not take this medicine if:
                                         Reuptake Inhibitors (SSRIs).
  information.
                                         Escitalopram and other SSRIs are
You can also download the most up        thought to help by increasing the
to date leaflet from                     amount of serotonin in your brain.
www.apotex.com.au.
                                         Depression is longer lasting or more
All medicines have risks and             severe than the "low moods"
benefits. Your doctor has weighed        everyone has from time to time due
the risks of you using this medicine     to the stress of everyday life. It is
against the benefits they expect it      thought to be caused by a chemical
will have for you.                       imbalance in parts of the brain. This
Pharmaceutical companies cannot          imbalance affects your whole body
give you medical advice or an            and can cause emotional and physical
individual diagnosis.                    symptoms such as feeling low in
                                         spirit, loss of interest in activities,
Keep this leaflet with your
                                         being unable to enjoy life, poor
medicine.
                                         appetite or overeating, disturbed
You may want to read it again.
                                         sleep, often waking up early, loss of
                                         sex drive, lack of energy and feeling
                                         guilty over nothing.

Terry White Chemists Escitalopram                                         Published by MIMS January 2015             1
• You are taking the following          • You have had an allergic               2. You have or have had any
  other medicines:                        reaction to escitalopram,                 medical conditions, especially
  - pimozide, used to treat disorders     citalopram or any of the                  the following:
  which affect the way you think,         ingredients listed at the end of          - mania, hypomania, bipolar
  feel or act                             this leaflet.                             disorder or any other conditions
  - monoamine oxidase inhibitors          Symptoms of an allergic reaction          which affect the way you think,
  (MAOIs), used to treat depression       may include cough, shortness of           feel or act
  (phenelzine, tranylcypromine,           breath, wheezing or difficulty            - epilepsy or convulsions, fits or
  moclobemide), Parkinson's               breathing; swelling of the face,          seizures (you should avoid taking
  Disease (selegiline) or infections      lips, tongue, throat or other parts       escitalopram if your epilepsy is
  (linezolid).                            of the body; rash, itching or hives       not properly controlled; if it is
  Do not take escitalopram until 14       on the skin; fainting or hayfever-        properly controlled your doctor
  days after stopping most MAOIs.         like symptoms.                            will wish to watch you carefully
  The exception is the MAOI,              If you think you are having an            if you take escitalopram)
  moclobemide, where you may              allergic reaction do not take             - heart problems
  take escitalopram one whole day         any more of the medicine and              - liver problems
  after finishing taking                  contact your doctor                       - kidney problems
  moclobemide. Similarly, do not          immediately or go to the                  - problems with blood clotting or
  take any MAOI until at least 14         Accident and Emergency                    abnormal bleeding, i.e. a
  days after stopping taking              department at the nearest                 tendency to bleed or bruise easily
  escitalopram.                           hospital.                                 - thoughts or actions relating to
  Taking escitalopram with MAOIs                                                    self-harm or suicide
  may cause a serious reaction with     Before you start to take it                 - diabetes
  signs such as a sudden increase in                                                - a decreased level of sodium in
  body temperature, very high           Before you start taking this                your blood
  blood pressure, rigid muscles,        medicine, tell your doctor if:              - restlessness and/or a need to
  nausea/vomiting and/or fits           1. You have allergies to:                   move often (akathisia)
  (convulsions). Your doctor will          - any other medicines                 3. You are currently pregnant or
  know when it is safe to start            - any other substances such as           you plan to become pregnant.
  escitalopram after the MAOI has          foods, preservatives, lactose or         There have been reports that
  been stopped.                            dyes.                                    babies exposed to certain
• The expiry date (EXP) printed on                                                  antidepressants during the third
  the pack has passed.                                                              trimester of pregnancy may
• The packaging is torn, shows                                                      develop complications after birth.
  signs of tampering or it does not                                                 Do not take this medicine whilst
  look quite right.                                                                 pregnant until you and your
                                                                                    doctor have discussed the risks
                                                                                    and benefits involved.
                                                                                 4. You are currently breast-
                                                                                    feeding or you plan to breast-
                                                                                    feed.
                                                                                    It is not recommended that you
                                                                                    breast-feed while taking this
                                                                                    medicine because escitalopram
                                                                                    passes into breast milk and may
                                                                                    affect your baby.
                                                                                    Do not take this medicine whilst
                                                                                    breast-feeding until you and your
                                                                                    doctor have discussed the risks
                                                                                    and benefits involved.
                                                                                 5. You are receiving
                                                                                    electroconvulsive therapy
                                                                                    (ECT).
                                                                                 6. You are planning to have, or
                                                                                    have very recently had, surgery
                                                                                    or an anaesthetic.

Terry White Chemists Escitalopram                                        Published by MIMS January 2015           2
7. You are currently receiving or        • antipsychotics, medicines used to       How much to take
   are planning to receive dental          treat psychoses, schizophrenia
   treatment.                              and other conditions which affect       Your doctor will tell you how much
                                           the way you think, feel or act          of this medicine you should take.
8. You are taking or are planning to
                                           (e.g. risperidone, thioridazine and     This will depend on your condition
   take any other medicines.
                                           haloperidol)                            and whether you are taking any other
   This includes vitamins and
                                                                                   medicines.
   supplements that are available        • any other medicines affecting the
   from your pharmacy, supermarket         chemicals in the brain                  The standard dose for this medicine
   or health food shop.                  • prochlorperazine, used to prevent       is 10 mg per day. Your doctor may
                                           or treat severe nausea and              increase your dose to 20 mg per day
Some combinations of medicines
may increase the risk of serious           vomiting                                depending on how you respond to
                                                                                   this medicine.
side effects and are potentially life-   • bupropion, a medicine helping to
threatening.                               treat nicotine dependence               Elderly people may need smaller
Therefore some medicines MUST            • mefloquine, an anti-malaria             doses. The maximum dose for elderly
NOT be taken with escitalopram.            medicine                                people is 10 mg per day.
These include:                           • some heart or blood pressure            Patients with liver disease or with a
• monoamine oxidase inhibitors,            medications, e.g. dipyridamole,         lack of certain liver enzymes may
  such as moclobemide, phenelzine,         flecainide, propafenone,                receive a lower initial dose of 5 mg
  tranylcypromine, selegiline and          metoprolol                              daily for the first two weeks. Your
  linezolid                              • medicines known to prolong              doctor may increase the dose to 10
• pimozide                                 bleeding e.g. aspirin or other non-     mg daily.
(see also "When you must not take          steroidal anti-inflammatory drugs       Do not stop taking your medicine or
it").                                      (NSAIDs) and anti-coagulants            change your dosage without first
                                           (such as warfarin and ticlopidine),     checking with your doctor.
Some other medicines may interact          which are used to prevent blood
with escitalopram.                         clots
                                                                                   How to take it
These include:                           • medicines used to treat reflux and
• tryptophan, contained in some            ulcers, such as cimetidine,             Swallow the tablets whole with a
  multivitamin and herbal                  omeprazole, esomeprazole and            full glass of water.
  preparations                             lansoprazole
                                                                                   Do not chew them.
• sumatriptan, used to treat             • imipramine and desipramine
  migraines                                types of antidepressants.
                                                                                   When to take it
• tramadol, a strong pain killer         If you are taking any of these you
• sumatriptan and similar                may need a different dose or you          Take escitalopram as a single dose,
                                         may need to take different medicines.     either in the morning or in the
  medicines used to treat migraines
                                                                                   evening.
  and cluster headaches                  Other medicines not listed above
• St John's Wort (Hypericum              may also interact with escitalopram.      Take this medicine at the same
  perforatum), a herbal remedy                                                     time each day.
                                                                                   Taking it at the same time each day
• other medicines used to treat
                                                                                   will have the best effect and will also
  depression, including SSRIs,
                                                                                   help you remember when to take it.
  imipramine, clomipramine,              How to take this
  nortriptyline and desipramine          medicine                                  It does not matter if you take it
• lithium, used to treat mood                                                      before, with or after food.
  swings and some types of               Follow carefully all directions
  depression                             given to you by your doctor.              How long to take it for
• any other medicines used to treat      Their instructions may be different to
                                                                                   Continue taking your medicine for
  anxiety, obsessive-compulsive          the information in this leaflet.          as long as your doctor tells you,
  disorder or pre-menstrual
                                                                                   even if it takes some time before
  dysphoric disorder                                                               you feel any improvement in your
                                                                                   condition.
                                                                                   Make sure you have enough to last
                                                                                   over weekends and holidays.

Terry White Chemists Escitalopram                                          Published by MIMS January 2015              3
As with other medicines for the            Do not stop taking this medicine        Do this even if there are no signs of
treatment of these conditions, it may      suddenly.                               discomfort or poisoning. You may
take a few weeks before you feel any       If you suddenly stop taking your        need urgent medical attention.
improvement.                               medicine, you may experience mild,      If you take too much escitalopram,
                                           but usually temporary, symptoms         you may get symptoms of
Individuals will vary greatly in their
                                           such as dizziness, pins and needles,    drowsiness, sleepiness, dizziness,
response to escitalopram.
                                           electric shock sensations, sleeping     high or low blood pressure, nausea
Your doctor will check your progress       problems (vivid dreams, nightmares,     (feeling sick), vomiting, agitation or
at regular intervals.                      inability to sleep), feeling anxious,   tremor (shaking), fast or slow heart
The length of treatment may vary for       restless or agitated, headaches,        beat or change in heart rhythm,
each individual, but is usually at least   feeling sick (nausea), vomiting,        dilated pupils or, rarely, temporary
6 months.                                  sweating, tremor (shaking), feeling     paralysis or weakness of muscles,
                                           confused, feeling emotional or          convulsions or coma.
In some cases, your doctor may             irritable, diarrhoea, visual
decide that longer treatment is            disturbances, or fast or irregular      A condition called serotonin
necessary.                                 heartbeats.                             syndrome may occur, with high
                                                                                   fever, agitation, confusion, trembling
Occasionally the symptoms of               When you have completed your
depression or other psychiatric                                                    and abrupt contraction of muscles.
                                           course of treatment, the dose of
conditions may include thoughts of         escitalopram is gradually reduced
harming yourself or committing             over a couple of weeks rather than
suicide. It is possible that these         stopped abruptly.
symptoms may continue or increase                                                  While you are taking
until the full anti-depressant effect of   Your doctor will tell you how to        this medicine
your medicine becomes apparent.            reduce the dosage so that you help
                                           avoid getting side effects.
You or anyone close to you or                                                      Things you must do
caring for you should watch for
these symptoms and tell your               If you forget to take it
                                                                                   People taking escitalopram may be
doctor immediately or go to the                                                    more likely to think about killing
                                           If you missed a dose and remember
nearest hospital if you have any                                                   themselves or actually trying to do
                                           in less than 12 hours, take it
distressing thoughts or experiences                                                so, especially when escitalopram is
                                           straight away, and then go back to
during this initial period or at any       taking it as you would normally.        first started or the dose is changed.
other time.                                                                        Tell your doctor immediately if
                                           Otherwise, if you are more than 12      you have thoughts about killing
Also contact your doctor if you
                                           hours late, skip the dose you           yourself or if you are close to or
experience any worsening of your           missed and take the next dose           care for someone using
depression or other symptoms at any        when you are meant to.                  escitalopram who talks about or
time during your treatment.                                                        shows signs of killing him or
                                           Do not take a double dose to make
                                                                                   herself.
                                           up for missed doses.
Stopping Treatment                         This may increase the chance of you     All mentions of suicide or violence
Do not stop taking this medicine           experiencing side effects.              must be taken seriously.
even if you begin to feel better.          If you have trouble remembering         Occasionally, the symptoms of
Your doctor may decide that you            to take your medicine, ask your         depression may include thoughts of
should continue to take it for some        pharmacist for some hints to help       suicide or self-harm. It is possible
time, even when you have overcome          you remember.                           that these symptoms continue or get
your problem. For best effect, this                                                worse until the full antidepressant
medicine must be taken regularly.          If you take too much                    effect of the medicine becomes
                                           (overdose)                              apparent. This is more likely to occur
The underlying illness may persist
                                                                                   if you are a young adult, i.e. 18 to 24
for a long time and if you stop your       If you think that you or anyone         years of age, and you have not used
treatment too soon, your symptoms          else may have taken too much of         antidepressant medicines before.
may return.                                this medicine, immediately
                                           telephone your doctor or the
                                           Poisons Information Centre (Tel:
                                           13 11 26 in Australia) for advice.
                                           Alternatively go to the Accident
                                           and Emergency Department at
                                           your nearest hospital.

Terry White Chemists Escitalopram                                          Published by MIMS January 2015             4
If you or someone you know or            Tell your doctor immediately if          Tell your doctor if, for any reason,
care for demonstrates any of the         you become pregnant. If you are a        you have not taken your medicine
following warning signs of suicide-      woman of child-bearing age, you          exactly as prescribed.
related behaviour while taking           should avoid becoming pregnant           Otherwise your doctor may think that
escitalopram, contact a doctor           while taking escitalopram.               it was not effective and change your
immediately, or even to go to the        Make sure your midwife and/or            treatment unnecessarily.
nearest hospital for treatment:          doctor know you are taking
                                                                                  Tell your doctor if you feel this
• thoughts or talk of death or           escitalopram. When taken during
                                                                                  medicine is not helping your
  suicide                                pregnancy, particularly in the last 3
                                                                                  condition.
• thoughts or talk of self-harm or       months of pregnancy, medicines like
                                                                                  If you are being treated for
  harm to others                         escitalopram may increase the risk of
                                                                                  depression, be sure to discuss with
                                         a serious condition in babies, called
• any recent attempts of self-harm                                                your doctor any problems you may
                                         persistent pulmonary hypertension of
• increase in aggressive behaviour,                                               have and how you feel, especially
                                         the newborn (PPHN), making the
  irritability or agitation                                                       any feelings of severe sadness,
                                         baby breathe faster and appear
• worsening of depression.                                                        thoughts of suicide, bursts of unusual
                                         bluish. These symptoms usually
                                                                                  energy, anger or aggression, or if you
Follow your doctor's instructions.       begin during the first 24 hours after
                                                                                  become particularly agitated or
Do not stop taking this medicine or      the baby is born. If this happens to
                                                                                  restless.
change the dose without consulting       your baby you should contact your
your doctor, even if you experience      midwife and/or doctor immediately.       Tell your doctor immediately if
increased anxiety at the beginning                                                you have any suicidal thoughts or
of treatment.                            Low Sodium                               other mental/mood changes.
At the beginning of treatment, some      Some people (especially older people
                                         or those taking diuretics/water          Make sure you have enough tablets
patients may experience increased
                                         tablets) may experience a lack of        to last over weekends and holidays.
anxiety, which will disappear during
continued treatment.                     sodium in the blood when taking this
                                         medicine. Tell your doctor if you get    Things you must not do
Tell your doctor immediately if          a headache or start to feel sick,
you experience symptoms such as          restless, irritated, confused or         Do not:
restlessness or difficulty sitting or                                             • Give this medicine to anyone
                                         fatigued or if you vomit or have fits,
standing still.
                                         muscle weakness or spasms.                 else, even if their symptoms seem
These symptoms can also occur
                                                                                    similar to yours.
during the first weeks of treatment.     Tell your doctor that you are
                                         taking this medicine if:                 • Take your medicine to treat any
Contact your doctor as soon as                                                      other condition unless your
possible if you suddenly experience      • you are about to be started on any
                                                                                    doctor or pharmacist tells you to.
an episode of mania.                       new medicine
                                                                                  • Stop taking your medicine, or
Some people with bipolar disorder        • you are breast-feeding or are
                                                                                    change the dosage, without first
(manic depression) may enter into a        planning to breast-feed
                                                                                    checking with your doctor.
manic phase. Symptoms of mania           • you are about to have any blood
include lots of rapidly changing           tests                                  Do not let yourself run out of
thoughts or ideas, exaggerated gaiety,                                            medicine over the weekend or on
                                         • you are going to have surgery or       holidays.
being much more physically active          an anaesthetic or are going into       Suddenly stopping escitalopram may
and much more restless.                    hospital.                              cause unwanted discontinuation
Sometimes you may not know that          Your doctor may occasionally do          symptoms, such as dizziness,
you are manic, so it may be helpful      tests to make sure the medicine is       headache and nausea. Your doctor
to have a friend or relative watch       working and to prevent side effects.     will tell you when and how
over you for any possible signs of                                                escitalopram should be discontinued.
                                         Go to your doctor regularly for a
change in your behaviour.                                                         You doctor will gradually reduce the
                                         check-up.
Visit your doctor regularly so they                                               amount you are using, usually over a
can check on your progress.              Tell any other doctors, dentists and     period of one to two weeks, before
                                         pharmacists who are treating you         stopping completely.
                                         that you take this medicine.

Terry White Chemists Escitalopram                                         Published by MIMS January 2015            5
Things to be careful of                 • feeling or being sick, reflux,        • flu-like symptoms, runny or
                                          diarrhoea or loose bowel motions,       blocked nose, sneezing, facial
Be careful when driving or                constipation, indigestion, stomach      pressure or pain, coughing or sore
operating machinery until you             pain or discomfort, wind,               throat
know how this medicine affects
                                          burping, hiccups, problems            Tell your doctor as soon as possible
you.
                                          swallowing, sore mouth, tongue        if you notice any of the following.
This medicine may cause nausea,
                                          or throat, haemorrhoids (piles)
fatigue, drowsiness, sight problems                                             These may be serious side effects.
or dizziness in some people,            • dry mouth, feeling thirsty
                                                                                You may need medical attention.
especially early in the treatment. If     increased saliva, taste disturbance
                                                                                • becoming nervous, confused,
you have any of these symptoms, do      • fatigue, sleepiness or drowsiness,
                                          yawning, sleeping difficulties,         forgetful, unable to concentrate,
not drive, operate machinery, or do
                                                                                  agitated, confused, panicky or
anything else that could be               strange or terrifying dreams
                                                                                  anxious
dangerous.                              • teeth grinding or clenching
                                                                                • feeling restless or unable to sit
Avoid alcohol while you are taking      • increased or decreased appetite,
                                                                                  still
this medicine.                            weight loss
                                                                                • stomach pain with nausea and
It is best not to drink alcohol while   • excessive and/or abnormal
                                                                                  vomiting of blood, or blood in the
you are being treated for depression.     movements
                                                                                  bowel movements
                                        • increased muscle tension, muscle
You should be aware that people                                                 • aggression, worsening of
over 50 years of age who take             twitching
                                                                                  depression
antidepressants have an increased       • sexual problems, painful erection,
                                                                                • general swelling or swollen
risk of having a bone fracture.           prostate problems
                                                                                  hands, ankles, feet or face or eye
                                        • symptoms of hyperglycaemia              area due to fluid build-up
                                          (high blood sugar): feeling
                                                                                • problems speaking
                                          hungry, thirsty and/or frequent or
                                                                                • feelings of not being part of your
Possible side effects                     excessive urination;
                                                                                  body, or in a daze
                                        • problems with eyes or eyesight
                                                                                • feeling sick or unwell with weak
Tell your doctor as soon as possible    • dizziness when you stand up
                                                                                  muscles or feeling confused
if you do not feel well while you are     suddenly, due to low blood
                                                                                  (these symptoms may be signs of
taking escitalopram or if you have        pressure
                                                                                  a rare condition as a result of low
any questions or concerns.              • unable to tolerate alcohol              levels of sodium in the blood,
Do not be alarmed by the following      • menstrual irregularities, period        which may be caused by
lists of side effects. You may not        pain, breast pain, unusual vaginal      antidepressants and occurs
experience any of them. All               bleeding                                especially in elderly women)
medicines can have side effects.        • loss of bladder control unusual         increased tendency to bleed,
Sometimes they are serious, but most      hair loss or thinning                   develop bruises or broken bones
of the time, they are not.              • tingling or numbness of the hands     • passing more or less urine than
Tell your doctor if you notice any        or feet                                 normal, or problems when
of the following:                       • breast enlargement or unusual           urinating, or bladder infection
• feeling tired and weak (fatigued),      secretion of breast milk in men or    • abnormal liver function tests
  hot flushes, fever, feeling unwell,     women                                   (increased amount of liver
  shaking or tremors, migraine,         • mild rash, or itching or prickling      enzymes)
  headache, or giddiness                  of the skin                           • flushing, varicose veins
• muscle, back, bone, nerve or joint    • acne, eczema, dermatitis, dry         • infection in any part of your body
  pain, stiffness, weakness or            skin, psoriasis or other skin         • dizziness
  cramps, decrease or loss of touch       problem                               • agitation, anxiety, feeling tense
  or other senses                       • pain of any type                        and restless, tired, drowsy, lack of
• increased or decreased sensitivity    • ringing or other persistent noise       energy, irritable, problems
  to outside stimuli                      in the ears, problems hearing or        sleeping, headache, nausea and
                                          earache                                 tingling or numbness of the hands
                                        • increased or decreased sweating         and feet after stopping
                                        • bruises                                 escitalopram.
                                        • osteoporosis
                                        • tooth or jaw problems

Terry White Chemists Escitalopram                                       Published by MIMS January 2015               6
If you experience any of the             • jaundice (yellowing of the skin        Keep your medicine in a cool dry
following, stop taking your                and/or eyes), with or without          place where the temperature will
medicine and contact your doctor           other signs of hepatitis or liver      stay below 30°C.
immediately or go to the Accident          problems (loss of appetite,
and Emergency department at                                                       Do not store your medicine, or any
                                           tiredness, feeling or being sick,      other medicine, in the bathroom,
your nearest hospital.
                                           dark urine, stomach pain or            or near a sink.
These are very serious side effects.       swelling, confusion,
                                                                                  Do not leave it on a window-sill or
You may need urgent medical                unconsciousness)
                                                                                  in the car. Heat and dampness can
attention or hospitalisation.            • feeling paranoid, panicky, or          destroy some medicines.
• seizures, tremors, movement              "high" or having mood swings or
  disorders (involuntary                   feeling more depressed or in a         Keep this medicine where children
                                           trance                                 cannot reach it.
  movements of the muscles or
                                                                                  A locked cupboard at least one-and-
  being unco-ordinated)                  • thoughts of suicide or attempting
                                                                                  a-half metres above the ground is a
• coma (unconsciousness)                   suicide or self-harm
                                                                                  good place to store medicines.
• a collection of symptoms               • sudden, severe breathing
  including weight gain (despite           problems
                                                                                  Disposal
  loss of appetite), feeling and         • sudden weakness or numbness of
  being sick, muscle weakness and          the face, arms or legs, especially     If your doctor tells you to stop
  irritability                             on one side, slurred speech            taking this medicine, or it has
• severe rash, with blisters and/ or     Other side effects not listed above      passed its expiry date, your
  excessive peeling of skin and also                                              pharmacist can dispose of the
                                         may also occur in some people.
  possibly severe blisters and                                                    remaining medicine safely.
  bleeding in the lips, eyes, mouth,
                                         Allergic reactions
  nose and genitals
• a sudden increase in body              If you think you are having an
  temperature, very high blood           allergic reaction to escitalopram,       Product description
  pressure, rigid muscles,               do not take any more of this
  nausea/vomiting and/or fits            medicine and tell your doctor
  (convulsions). These symptoms          immediately or go to the Accident        What Terry White Chemists
                                         and Emergency department at              Escitalopram looks like
  may be signs of a rare condition
                                         your nearest hospital.
  called Serotonin Syndrome.
• Neuroleptic Malignant Syndrome         Symptoms of an allergic reaction         New formulation
  (a serious reaction to some            may include some or all of the
                                         following:                               Terry White Chemists Escitalopram
  medicines with a sudden increase
                                                                                  tablets are available in the following
  in body temperature, extremely         • cough, shortness of breath,
                                                                                  strengths:
  high blood pressure and severe           wheezing or difficulty breathing
  convulsions)                           • swelling of the face, lips, tongue,    • 10 mg tablets: white to off-white,
• fast, slow or irregular heartbeat,       throat or other parts of the body        oval, biconvex, film-coated
                                                                                    tablets with "C4" embossed on
  high blood pressure                    • rash, itching or hives on the skin
                                                                                    one side and a notch break-line
• palpitations, fainting or chest pain   • fainting
                                                                                    on the other side.
  or tightness                           • hayfever-like symptoms
                                                                                  • 20 mg tablets: white to off-white,
• abnormal bleeding
                                                                                    oval, biconvex, film-coated
• kidney pain, difficulty in passing
                                                                                    tablets with "C3" embossed on
  urine, dark coloured urine or
                                                                                    one side and a notch break-line
  blood in the urine                     Storage and disposal                       on the other side.
• a collection of symptoms
                                                                                  Blister packs of 28 tablets.
  including fever, sore throat,
  swollen glands, mouth ulcers,          Storage                                  * Not all strengths may be available.
  unusual bleeding or bruising
                                         Keep your medicine in its original
  under the skin                         packaging until it is time to take it.   Old Formulation
• mania (mood of excitement, over-       If you take your medicine out of its
                                                                                  APO-Escitalopram tablets come in
  activity and uninhibited               original packaging, it may not keep
                                                                                  the following strengths:
  behaviour or aggression),              well.
  hallucinations (hearing, seeing or
  feeling things that are not there)

Terry White Chemists Escitalopram                                         Published by MIMS January 2015             7
• 5 mg tablets: white, round,             •   croscarmellose sodium
  biconvex, film-coated tablets,          •   butylated hydroxyanisole
  engraved "APO" on one side,             •   hypromellose
  "ESC" over "5" on the other side.
                                          •   hydroxypropylcellulose
• 10 mg tablets: white, round,
                                          •   macrogol 8000
  biconvex, film-coated tablets,
  engraved "APO" on one side,             •   titanium dioxide.
  "ESC" over score "10" on the            This medicine is gluten-free, sucrose-
  other side.                             free, tartrazine-free and free of other
• 15 mg tablets: white, round,            azo dyes.
  biconvex, film-coated tablets,
  engraved "APO" on one side,             Australian Registration
  "ESC" over score "15" on the            Numbers
  other side.
• 20 mg tablets: white, round,            New formulation
  biconvex, film-coated tablets,
  engraved "APO" on one side,             • Terry White Chemists
  "ESC" over score "20" on the              Escitalopram 10 mg tablets
  other side.                               (blister pack):
                                            AUST R 213725.
Blister packs of 28 tablets.
                                          • Terry White Chemists
                                            Escitalopram 20 mg tablets
Ingredients
                                            (blister pack):
                                            AUST R 213726.
New formulation                           • Terry White Chemists
                                            Escitalopram 5 mg tablets
Each tablet contains, 10 mg, or 20
                                            Blister pack: AUST R 146029.
mg of escitalopram (as oxalate) as
the active ingredient.                    • Terry White Chemists
                                            Escitalopram 10 mg tablets
It also contains the following inactive     Blister pack: AUST R 146031.
ingredients:
                                          • Terry White Chemists
•   microcrystalline cellulose              Escitalopram 15 mg tablets
•   colloidal anhydrous silica              Blister pack: AUST R 146036.
•   hypromellose                          • Terry White Chemists
•   magnesium stearate                      Escitalopram 20 mg tablets
•   croscarmellose sodium                   Blister pack: AUST R 146038.
•   purified talc
•   macrogol 400
                                          Sponsor
•   titanium dioxide.                     Apotex Pty Ltd
This medicine is gluten-free, lactose     16 Giffnock Avenue
free, sucrose-free, tartrazine-free and   Macquarie Park NSW 2113
free of other azo dyes.                   This leaflet was last updated in:
                                          August 2014.
Old formulation
Each tablet contains 5 mg, 10 mg, 15
mg or 20 mg of escitalopram (as
escitalopram oxalate) as the active
ingredient.
It also contains the following inactive
ingredients:
• microcrystalline cellulose
• lactose
• magnesium stearate

Terry White Chemists Escitalopram                                             Published by MIMS January 2015   8
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