Jovia Dosage/Direction for Use

Escitalopram should be administered as single oral daily dose, in the morning or evening, with or without food. (See Table.)

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Special Population: Geriatric: A longer t_¹/2 and decreased clearance have been shown in the elderly. Initial dosage is 5 mg once per day. Depending on individual response and tolerance, the dose may be increased to 10 mg per day.
Hepatic impairment: Dosages should be restricted to the lower end of the dose range in patients with mild to moderate hepatic insufficiency. Accordingly, an initial dose of 5 mg per day is recommended. Subsequently, the dose may be increased based on the patient's response and clinical judgment. A daily dose of 10 mg is the recommended maximum dose for most patients with hepatic impairment.
Renal impairment: Dosage adjustment is not necessary in patients with mild to moderate renal impairment. No information is available on the treatment of patients with severely reduced renal function.
Poor Metabolizers of CYP2C19: For patients who are known to be poor metabolizers with respect to CYP2C19, an initial dose of 5 mg per day during the first two weeks of treatment is recommended. Depending on individual patient response, the dose may be increased to 10 mg.
Discontinuation of treatment: Symptoms associated with discontinuation of escitalopram and other SSRIs and serotonin norepinephrine reuptake inhibitors (SNRIs) have been reported. Patients should be monitored for these symptoms when discontinuing treatment. A gradual dose reduction rather than abrupt cessation is recommended whenever possible. If intolerable symptoms occur after a decrease in the dose or upon discontinuation of treatment, then resuming the previously prescribed dose may be considered. Subsequently, the physician may continue decreasing the dose but at a more gradual rate.
Switching a patient to or from a monoamine oxidase inhibitor (MAOI) intended to treat psychiatric disorders: At least 14 days should elapse between discontinuation of a MAOI intended to treat psychiatric disorders and initiation of therapy with escitalopram. Conversely, at least 14 days should be allowed after stopping escitalopram before starting a MAOI intended to treat psychiatric disorders.
Use of escitalopram with other MAOIs such as linezolid or methylene blue: Do not start escitalopram in a patient who is being treated with linezolid or intravenous (IV) methylene blue because there is an increased risk of serotonin syndrome. In a patient who required more urgent treatment of a psychiatric condition, other interventions, including hospitalization, should be considered.
In some cases, a patient already receiving escitalopram therapy may require urgent treatment with linezolid or IV methylene blue. If acceptable alternatives to linezolid or IV methylene blue treatment are not available and the potential benefits of linezolid or IV methylene blue treatment are judged to outweigh the risks of serotonin syndrome in particular patient, escitalopram should be stopped promptly, and linezolid or IV methylene blue can be administered. The patient should be monitored for symptoms of serotonin syndrome for two weeks or until 24 hours after the last dose of linezolid or IV methylene blue, whichever comes first, Therapy escitalopram may be resumed 24 hours after the last dose of linezolid or IV methylene blue.
The risk of administering methylene blue by non-IV routes (such as oral tablets or by local injection) or in IV doses much lower than 1 mg/kg with escitalopram is unclear. The clinician should, nevertheless, be aware of the possibility of emergent symptoms of serotonin syndrome with such use.
Or, as prescribed by a physician.