Ingredient Name: ESCITALOPRAM (ess-sye-TAL-oh-pram)

Drug Manufacturer: FOREST PHARMACEUTICAL

Common Uses: This medicine is a selective serotonin reuptake inhibitor or SSRI used to treat depression and generalized anxiety disorder (GAD). It may also be used to treat other conditions as determined by your doctor.

Before Using This Medicine: WARNING: ANTIDEPRESSANT MEDICINES MAY INCREASE THE RISK OF SUICIDAL THOUGHTS AND BEHAVIORS IN CHILDREN AND ADOLESCENTS WHO HAVE SEVERE DEPRESSION OR CERTAIN OTHER MENTAL OR MOOD DISORDERS. Children and adolescents who take this medicine should be monitored daily for any worsening of their condition, thoughts of hurting themselves, or any other sudden or unusual changes in mood or behavior, especially during the first few months after starting this medicine and after any change in the dose of this medicine. If any of these serious side effects occur, contact the doctor immediately. Some medicines or medical conditions may interact with this medicine. INFORM YOUR DOCTOR OR PHARMACIST of all prescription and over-the-counter medicine that you are taking. DO NOT TAKE THIS MEDICINE if you are taking or have taken a monoamine oxidase inhibitor (MAOI) (such as furazolidone, isocarboxazid, linezolid, moclobemide, phenelzine, procarbazine, selegiline, or tranylcypromine) within 2 weeks before or after treatment with this medicine. DO NOT TAKE THIS MEDICINE if you are taking citalopram, or weight loss medicines such as sibutramine or phentermine. ADDITIONAL MONITORING OF YOUR DOSE OR CONDITION may be needed if you are taking another SSRI antidepressant such as fluoxetine or sertraline, nonsteroidal anti-inflammatory medicines such as aspirin or ibuprofen, "blood thinners" such as warfarin, selegiline, tramadol, "triptan" migraine medicines such as sumatriptan, tricyclic antidepressants such as desipramine, lithium, metoprolol, any herbal/natural products (such as St. John's wort). DO NOT START OR STOP any medicine without doctor or pharmacist approval. Inform your doctor of any other medical conditions including any mental or mood disorders (such as bipolar disorder), liver or kidney problems, seizures, heart problems, other mental/mood disorders such as bipolar disorder, mineral/electrolyte problems such as low sodium levels in the blood or SIADH, allergies, pregnancy, or breast-feeding. Contact your doctor or pharmacist if you have any questions or concerns about using this medicine.

How to Use This Medicine: Follow the directions for using this medicine provided by your doctor. This medicine may be taken on an empty stomach or with food. STORE THIS MEDICINE at room temperature 77 degrees F (25 degrees C) in a tightly-closed container away from heat and light. Brief storage between 59 and 86 degrees F (15 and 30 degrees C) is permitted. CONTINUE TO TAKE THIS MEDICINE even if you feel well. Do not miss any doses. Taking this medicine at the same time each day will help you to remember. IF YOU MISS A DOSE OF THIS MEDICINE, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Cautions: DO NOT TAKE THIS MEDICINE if you have had an allergic reaction to it or are allergic to any ingredient in this product. SEVERAL WEEKS MAY PASS before this medicine reaches its full effect. Do not stop taking this medicine without checking with your doctor. Some conditions may become worse if the medicine is suddenly stopped. Your dose may need to be slowly lowered to avoid side effects when the medicine is stopped. KEEP ALL DOCTOR AND LABORATORY APPOINTMENTS while you are taking this medicine. ADDITIONAL MONITORING OF YOUR CONDITION is recommended at the start of treatment with this medicine and whenever a change to your dose is made. If you experience anxiety, agitation, panic attacks, difficulty sleeping, irritability, hostility, impulsive feelings, severe restlessness, or worsening of depression contact your doctor as soon as possible. These may be signs that your condition is worsening or that your treatment with this medicine should be evaluated. If you are a parent or caregiver of a patient that is taking this medicine, it is important for you to watch for these symptoms. Contact the doctor as soon as possible if any of these symptoms occur. Contact your doctor for more information. THIS MEDICINE MAY CAUSE drowsiness or dizziness. DO NOT DRIVE, OPERATE MACHINERY, OR DO ANYTHING ELSE THAT COULD BE DANGEROUS until you know how you react to this medicine. Using this medicine alone, with other medicines, or with alcohol may lessen your ability to drive or to perform other potentially dangerous tasks. THIS MEDICINE WILL ADD TO THE EFFECTS of alcohol and other depressants. Ask your pharmacist if you have questions about which medicines are depressants. Use of alcohol while taking this medicine is not recommended. Talk with your doctor about the use of alcohol with this medicine. BEFORE YOU BEGIN TAKING ANY NEW MEDICINE, either prescription or over-the-counter, check with your doctor or pharmacist. This includes any medicines that contain drowsiness-causing ingredients. Ask your pharmacist about the safe use of these products. CAUTION IS ADVISED WHEN USING THIS MEDICINE IN THE ELDERLY because they may be more sensitive to the effects of this medicine. CAUTION IS ADVISED WHEN USING THIS MEDICINE IN CHILDREN OR ADOLESCENT PATIENTS because they may be more sensitive to the effects of the medicine. F0R WOMEN: IF YOU PLAN ON BECOMING PREGNANT, discuss with your doctor the benefits and risks of using this medicine during pregnancy, especially during the third trimester. THIS MEDICINE IS EXCRETED IN BREAST MILK. DO NOT BREAST-FEED while taking this medicine.

Possible Side Effects: SIDE EFFECTS that may occur while taking this medicine include nausea, vomiting, diarrhea, constipation, upset stomach, loss of appetite, dizziness, drowsiness, trouble sleeping, back pain, or dry mouth. If they continue or are bothersome, check with your doctor. CHECK WITH YOUR DOCTOR AS SOON AS POSSIBLE if you experience increased sweating, unusual fatigue, or changes in sexual ability/interest. CONTACT YOUR DOCTOR IMMEDIATELY if you experience stomach pain, black or tarry stools, vomit that looks like coffee grounds, unusual bleeding or bruising, vision changes, unusually fast or slow heartbeat, uncontrolled movements (tremors), chest pain, muscle cramps, seizures, painful or prolonged erection, change in amount of your urine, severe nervousness or anxiety, agitation, panic attacks, difficulty sleeping, feelings of irritability or hostility, impulsive behavior or other unusual changes in behavior, severe restlessness, worsening feelings of depression, thoughts of hurting yourself, or any other mental or mood changes. AN ALLERGIC REACTION to this medicine is unlikely, but seek immediate medical attention if it occurs. Symptoms of an allergic reaction include rash, itching, swelling, severe dizziness, or trouble breathing. If you notice other effects not listed above, contact your doctor, nurse, or pharmacist.

Overdose: If overdose is suspected, contact your local poison control center or emergency room immediately. Symptoms of overdose may include irregular heartbeat, fainting, severe dizziness or lightheadedness, and seizures.

Additional Information: DO NOT SHARE THIS MEDICINE with others for whom it was not prescribed. DO NOT USE THIS MEDICINE for other health conditions. KEEP THIS MEDICINE out of the reach of children. IF USING THIS MEDICINE FOR AN EXTENDED PERIOD OF TIME, obtain refills before your supply runs out.