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Loxalate

contains the active ingredient escitalopram oxalate


Consumer Medicine Information

What is in this leaflet

This leaflet answers some common questions about Loxalate.

It does not contain all the available information. It does not take the place of talking to your doctor or pharmacist.

All medicines have benefits and risks. Your doctor has weighed the risks of you taking Loxalate against the benefits expected for you.

If you have any concerns about taking this medicine, talk to your doctor or pharmacist.

Keep this leaflet with your medicine. You may need to read it again.

What Loxalate is used for

Loxalate is used to treat depression.

Loxalate belongs to a group of medicines called selective serotonin reuptake inhibitors (SSRIs). Depression is longer lasting and/or more severe than the "low moods" everyone has from time to time due to the stress of everyday life. It is thought to be caused by a chemical imbalance in parts of the brain. This imbalance affects your whole body and can cause emotional and physical symptoms such as feeling low in spirit, loss of interest in activities, being unable to enjoy life, poor appetite or overeating, disturbed sleep, often waking up early, loss of sex drive, lack of energy and feeling guilty over nothing.

Loxalate corrects this chemical imbalance and may help relieve the symptoms of depression.

Ask your doctor if you have any questions about why Loxalate has been prescribed for you. Your doctor may have prescribed Loxalate for another reason.

Loxalate is available only with a doctor's prescription.

Before you take Loxalate

When you must not take it

Do not take Loxalate if you are allergic to medicines containing citalopram or any of the ingredients listed at the end of this leaflet. If you have an allergic reaction you may get a skin rash, have difficulty in breathing, get symptoms of hayfever or feel faint.

Do not take Loxalate if you are currently taking another medicine for depression known as a monoamine oxidase inhibitor (MAOI) or have taken one within the last 14 days. Taking Loxalate with a MAOI may cause a serious reaction with a sudden increase in body temperature, extremely high blood pressure and convulsions (fits).

MAOIs are medicines used to treat depression and Parkinson's disease.

Some examples of MAOIs include moclobemide (e.g. Aurorix), phenelzine (Nardil), tranylcypromine (Parnate), selegiline (e.g. Eldepryl).

Do not take Loxalate if you are taking pimozide, a medicine used to treat mental disorders.

Do not take Loxalate after the expiry date printed on the pack or if the packaging is torn or shows signs of tampering. If it has expired or is damaged, return it to your pharmacist for disposal.

Before you start to take it

Tell your doctor if you are allergic to any other medicines, foods, dyes or preservatives.

Tell your doctor if you are pregnant or plan to become pregnant. Your doctor will provide information to you regarding the use of Loxalate, during pregnancy. You should not stop taking your tablets until you have spoken to your doctor. Your doctor will discuss the possible risks and benefits of taking Loxalate during pregnancy.

The general condition of your newborn baby might be affected by medicines like Loxalate.

Tell your doctor if you are breastfeeding or wish to breastfeed. Loxalate passes into breast milk. However, it is not known whether this may affect your baby. Your doctor will discuss the risks and benefits of taking Loxalate when breastfeeding.

Tell your doctor if you have or have had any of the following medical conditions:

  • heart problems
  • diabetes
  • epilepsy
  • liver problems
  • kidney problems
  • bipolar disorder (manic depression)
  • bleeding disorders.

If you have not told your doctor about any of the above, tell them before you start taking Loxalate.

Taking other medicines

Tell your doctor if you are taking any other medicines, including any that you buy without a prescription from a pharmacy, supermarket or health food shop.

Some medicines and Loxalate may interfere with each other. These include:

  • bupropion, a medicine helping to treat nicotine dependence
  • medicines used to treat reflux and ulcers, such as cimetidine, omeprazole, esomeprazole and lansoprazole
  • medicines known to prolong bleeding, e.g. aspirin or other non-steroidal anti-inflammatory drugs (NSAIDs)
  • ticlopidine and warfarin, medicines used to prevent blood clots
  • mefloquine, an anti-malaria medicine
  • sumatriptan, used to treat migraines
  • tramadol, used to relieve pain
  • some heart medications, e.g. flecainide, propafenone, metoprolol
  • tryptophan, an amino-acid
  • lithium, used to treat mood swings and some types of depression
  • medicines used to treat certain mental and emotional conditions, also called antipsychotics; e.g. risperidone, thioridazine and haloperidol
  • tricyclic antidepressants, e.g. imipramine, desipramine
  • St John's Wort (Hypericum perforatum), a herbal remedy
  • other medicines for depression, anxiety, obsessive-compulsive disorder or pre-menstrual dysphoric disorder.

These medicines may be affected by Loxalate or may affect how well it works. You may need different amounts of your medicines, or you may need to take different medicines.

Some combinations of medicines may increase the risk of serious side effects and are potentially life threatening.

Your doctor and pharmacist have more information on medicines to be careful with or avoid while taking this medicine.

Use in children

Do not give Loxalate to children. Loxalate should not be given to children under 18 years of age as there is no specific information about such use. Always ask your doctor before giving medicines to children.

Use in elderly

Loxalate can be given to elderly patients with a reduced dose. The effects of Loxalate in elderly patients are similar to that in other patients.

How to take Loxalate

Follow all directions given to you by your doctor and pharmacist carefully. They may differ from the information contained in this leaflet.

If you do not understand the instructions on the pack or bottle, ask your doctor or pharmacist for help.

How much to take

Your doctor will tell you how much Loxalate to take.

The usual dose is 10 mg per day. This may be increased by your doctor to 20 mg per day.

The recommended maximum dose in elderly patients is 10 mg per day.

It is recommended that patients with liver disease receive an initial dose of 5 mg daily for the first two weeks. This dose may be increased to 10 mg daily.

How to take it

Swallow the tablets with a full glass of water.

Do not chew the tablets.

Loxalate 10 mg and 20 mg tablets can be divided in half if advised by your doctor or pharmacist.

When to take it

Take Loxalate at about the same time each day.

Taking it at the same time each day will have the best effect. It will also help you to remember when to take it.

Loxalate can be taken with or without food, either in the morning or evening.

How long to take it for

Continue taking your medicine for as long as your doctor tells you.

The length of treatment with Loxalate will depend on how quickly your symptoms improve.

Most medicines of this type take time to work, so do not be discouraged if you do not feel better right away. The treatment of depression may take at least six months.

If you forget to take it

If it is almost time for your next dose, skip the dose you missed and take your next dose when you are meant to.

Otherwise, take the missed dose as soon as you remember, and then go back to taking your tablets as you would normally.

Do not take a double dose to make up for the dose you missed.

If you are not sure what to do, ask your doctor or pharmacist.

If you take too much (overdose)

Immediately telephone your doctor or the Poisons Information Centre (telephone 13 11 26) for advice, or go to Accident and Emergency at the nearest hospital, if you think you or anyone else may have taken too much Loxalate. Do this even if there are no signs of discomfort or poisoning. You may need urgent medical attention.

Symptoms of an overdose may include dizziness, low blood pressure, nausea (feeling sick), vomiting, agitation, tremor (shaking) and rarely convulsions and coma.

While you are taking Loxalate

Things you must do

If you are about to be started on any new medicine, remind your doctor or pharmacist that you are taking Loxalate.

Tell any other doctors, dentists and pharmacists who treat you that you are taking Loxalate.

Tell your doctor immediately if you have any suicidal thoughts or other mental/mood changes.

A worsening of depressive symptoms including thoughts of suicide or self-harm may occur during initial treatment (generally the first one to two months) or when the doctor changes your dose. These symptoms should be controlled when the full effect of Loxalate takes place. Children, adolescents or young adults under 25 years of age are more likely to experience these effects during the first few months of treatment.

Patients and caregivers should be alert and monitor for these effects.

If you or someone you know is showing any of the following warning signs of suicide while taking Loxalate, contact your doctor or a mental health professional right away or go to the nearest hospital for treatment:

  • worsening of symptoms
  • thoughts or talk of death or suicide
  • thoughts or talk of self-harm or harm to others
  • any recent attempts of self-harm
  • increase in aggressive behaviour, irritability, or any other unusual changes in behaviour or mood.

If you become pregnant while taking Loxalate, tell your doctor immediately.

Keep all your doctor's appointments so that your progress can be checked.

Things you must not do

Do not stop taking Loxalate, or change the dose, without checking with your doctor.

Do not let yourself run out of Loxalate over weekends or holidays. If you stop Loxalate suddenly or reduce the dose too quickly, you may get unwanted side effects such as dizziness, nausea (feeling sick) and headache.

Your doctor will tell you how to gradually reduce the amount of Loxalate you are taking before stopping completely.

Do not take Loxalate to treat any other complaints unless your doctor tells you to.

Do not give Loxalate to anyone else, even if they have the same condition as you.

Things to be careful of

Be careful driving or operating machinery until you know how Loxalate affects you. Loxalate may cause dizziness, visual disturbances or drowsiness in some people. If you experience any of these, do not drive, operate machinery or do anything else that could be dangerous.

Avoid alcohol while you are taking this medicine. It is not advisable to drink alcohol while you are being treated for depression.

Side effects

Tell your doctor or pharmacist as soon as possible if you do not feel well while you are taking Loxalate. Loxalate helps most people with depression, but it may have unwanted side effects in a few people.

All medicines have side effects. Sometimes they are serious, most of the time they are not. You may need medical treatment if you get some of the side effects.

Do not be alarmed by this list of possible side effects. You may not experience any of them.

Ask your doctor or pharmacist to answer any questions you may have.

Tell your doctor if you notice any of the following and they worry you:

  • sinusitis (clogged or running nose)
  • decreased appetite
  • dry mouth
  • nausea (feeling sick)
  • diarrhoea
  • constipation
  • difficulties falling asleep
  • fatigue
  • sleepiness or drowsiness, yawning
  • increased sweating
  • sexual disturbances (delayed ejaculation, problems with erection, decreased sexual drive and women may experience difficulties getting orgasm)

Tell your doctor as soon as possible if you notice any of the following:

  • dizziness
  • dizziness when you stand up due to low blood pressure#
  • decreased levels of sodium in the blood (the symptoms are feeling sick and unwell with weak muscles or confused)#
  • abnormal liver function test (increased amounts of liver enzymes in the blood)#
  • confusion, panic attacks#, anxiety, nervousness, agitation
  • difficulties urinating#
  • unusual secretion of breast milk#
  • increased tendency to develop bruises#
  • rash, itching, patches of circumscribed swellings.

The above list includes serious side effects that may require medical attention.

If any of the following happen, tell your doctor immediately or go to Accident and Emergency at your nearest hospital.

  • signs of an allergic reaction such as skin rash, itching or hives; swelling of the face, lips or tongue which may cause difficulty in swallowing or breathing; wheezing or shortness of breath
  • high fever, agitation, confusion, trembling and abrupt contractions of muscles may be signs of a rare condition called serotonin syndrome#
  • mania#
  • hallucinations
  • seizures, tremors, movement disorders (involuntary movements of the muscles)#

The above list includes very serious side effects. You may need urgent medical attention or hospitalisation.

#The side effects marked with a hash (#) are rare side effects that are known to occur with medicines that work in a similar way to Loxalate.

Tell your doctor or pharmacist if you notice anything that is making you feel unwell. Other side effects not listed above may also occur in some people.

There is no evidence that Loxalate is addictive; however, if you suddenly stop taking Loxalate, you may get side effects. Tell your doctor if you get any side effects after stopping Loxalate.

After taking Loxalate

Storage

Keep Loxalate where children cannot reach it. A locked cupboard at least one-and-a-half metres above the ground is a good place to store medicines.

Keep your tablets in the pack or bottle until it is time to take them. If you take the tablets out of the pack or bottle they may not keep well.

Keep your tablets protected from moisture in a cool dry place, where the temperature stays below 25 degrees C.

Do not store Loxalate or any other medicine in the bathroom or near a sink. Do not leave Loxalate in the car or on window stills. Heat and dampness can destroy some medicines.

Disposal

If your doctor tells you to stop taking this medicine or the expiry date has passed, ask your pharmacist what to do with any medicine that is left over.

Product description

What it looks like

Loxalate is available in 2 strengths:

Loxalate Tablets 10 mg:
9.5 mm x 5.5 mm oblong normal convex white film-coated tablet debossed "EC10" on one side and "G" on the other, supplied in packs of 28 tablets.

Loxalate Tablets 20 mg:
12.5mm x 7 mm oblong normal convex white film-coated tablet debossed "EC20" on one side and "G" on the other, supplied in packs of 28 tablets.

Ingredients

The active ingredient in Loxalate is escitalopram oxalate.

Loxalate tablets contain 10 mg or 20 mg of escitalopram (as escitalopram oxalate).

The tablets also contain the following inactive ingredients:

  • microcrystalline cellulose
  • silica-colloidal anhydrous
  • talc-purified
  • croscarmellose sodium
  • magnesium stearate
  • Opadry White OY-LS-28908 (ARTG No. 2596)

The coating on each tablet contains lactose.

The tablets are gluten free.

Manufacturer

Loxalate is made in Australia by:
Alphapharm Pty Limited
(ABN 93 002 359 739)
Chase Building 2
Wentworth Park Road
Glebe NSW 2037
Phone: (02) 9298 3999
www.alphapharm.com.au
Medical Information
Phone: 1800 028 365

Australian registration numbers:

  • Loxalate 10 mg
    AUST R 119964 (blister pack)
  • Loxalate 20 mg
    AUST R 119966 (blister pack)

This leaflet was prepared on 16 June 2009.

Published by MIMS September 2009

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