What is the most important information I should know about Lexapro?

• You may have an increased risk of suicidal thoughts or behavior at the start of treatment with an antidepressant medication, especially if you are under 18 years old. Talk with your doctor about this risk. While you are taking Lexapro you will need to be monitored for worsening symptoms of depression and/ or suicidal thoughts during the first weeks of treatment, or whenever your dose is changed. In addition to you watching for changes in your own symptoms, your family or other caregivers should be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.
• Contact your doctor promptly if you have any of the following side effects, especially if they are new symptoms or if they get worse: mood changes, anxiety, panic attacks, trouble sleeping, irritability, agitation, aggressiveness, severe restlessness, mania (mental and/ or physical hyperactivity), thoughts of suicide or hurting yourself.
• Do not take Lexapro together with a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate). You must wait at least 14 days after stopping an MAOI before you can take Lexapro.

What is Lexapro?

• Lexapro is an antidepressant in a group of drugs called selective serotonin reuptake inhibitors (SSRIs). Lexapro affects chemicals in the brain that may become unbalanced and cause depression or anxiety.
• Lexapro is used to treat anxiety and major depressive disorder.
• Lexapro may also be used for purposes other than those listed in this medication guide.

What should I discuss with my healthcare provider before taking Lexapro?

• You may have an increased risk of suicidal thoughts or behavior at the start of treatment with an antidepressant medication, especially if you are under 18 years old. Talk with your doctor about this risk. While you are taking Lexapro you will need to be monitored for worsening symptoms of depression and/ or suicidal thoughts during the first weeks of treatment, or whenever your dose is changed. In addition to you watching for changes in your own symptoms, your family or other caregivers should be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.
• Do not use Lexapro if you are using an MAO inhibitor such as isocarboxazid (Marplan), tranylcypromine (Parnate), phenelzine (Nardil), or selegiline (Eldepryl, Emsam). Serious and sometimes fatal reactions can occur when these medicines are taken with Lexapro. You must wait at least 14 days after stopping an MAO inhibitor before you can take Lexapro.
• Before taking Lexapro, tell your doctor if you have:
  • liver or kidney disease;
  • seizures or epilepsy;
  • bipolar disorder (manic depression); or
  • a history of drug abuse or suicidal thoughts.
• If you have any of these conditions, you may not be able to use Lexapro, or you may need a dosage adjustment or special tests during treatment.
• FDA pregnancy category C. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.
• Lexapro can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How should I take Lexapro?

• Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Your doctor may occasionally change your dose to make sure you get the best results from the medication.
• Take each dose with a full glass of water.
• Try to take the medicine at the same time each day.
• To be sure you get the correct dose of liquid Lexapro, measure the liquid with a marked measuring spoon or medicine cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.
• It may take 4 weeks or more for you to start feeling better. Do not stop using Lexapro without first talking to your doctor. You may have unpleasant side effects if you stop taking this medication suddenly.
• Store Lexapro at room temperature away from moisture and heat.

What happens if I miss a dose?

• Take the missed dose as soon as you remember. However, if it is almost time for the next regularly scheduled dose, skip the missed dose and take the next one as directed. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

• Seek emergency medical attention if you think you have taken too much of this medication. Symptoms of an Lexapro overdose may include nausea, vomiting, tremor, sweating, rapid heartbeat, confusion, dizziness, seizures, and coma.

What should I avoid while taking Lexapro?

• Do not take Lexapro together with citalopram (Celexa), isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate).
• Avoid drinking alcohol, which can increase some of the side effects of Lexapro.
• Avoid using other medicines that make you sleepy (such as cold medicine, other pain medication, muscle relaxants). They can add to sleepiness caused by Lexapro.
• Lexapro can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

What are the possible side effects of Lexapro?

• Get emergency medical help if you have any of these signs of an allergic reaction: skin rash or hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
• Contact your doctor promptly if you have any of the following side effects, especially if they are new symptoms or if they get worse: mood changes, anxiety, panic attacks, trouble sleeping, irritability, agitation, aggressiveness, severe restlessness, mania (mental and/ or physical hyperactivity), thoughts of suicide or hurting yourself.
• Call your doctor at once if you have any of these serious side effects:
  • seizure (convulsions);
  • tremors, shivering, muscle stiffness or twitching;
  • problems with balance or coordination; or
  • agitation, confusion, sweating, fast heartbeat.
• Other less serious side effects are more likely to occur, such as:
  • feeling nervous, restless, or unable to sit still;
  • headache, trouble concentrating;
  • drowsiness, dizziness;
  • sleep problems (insomnia);
  • nausea, diarrhea, heartburn;
  • weight changes;
  • decreased sex drive, impotence, or difficulty having an orgasm; or
  • dry mouth, ringing in your ears.
• Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect Lexapro?

• Talk to your doctor before taking any medicine for pain, arthritis, fever, or swelling. This includes aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), diclofenac (Voltaren), indomethacin, piroxicam (Feldene), nabumetone (Relafen), etodolac (Lodine), and others. Taking any of these drugs with Lexapro may cause you to bruise or bleed easily.
• Before taking Lexapro, tell your doctor if you are using any of the following medicines:
  • carbamazepine (Tegretol);
  • cimetidine (Tagamet);
  • lithium (Lithobid, Eskalith);
  • a blood thinner such as warfarin (Coumadin);
  • any other antidepressants such as amitriptyline (Elavil), citalopram (Celexa), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), imipramine (Tofranil), nortriptyline (Pamelor), paroxetine (Paxil), or sertraline (Zoloft); or
  • almotriptan (Axert), frovatriptan (Frova), sumatriptan (Imitrex), naratriptan (Amerge), rizatriptan (Maxalt), or zolmitriptan (Zomig).
• If you are using any of these drugs, you may not be able to use Lexapro, or you may need dosage adjustments or special tests during treatment.
• There may be other drugs not listed that can affect Lexapro. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.