Taking citalopram and having low levels of magnesium may put you at higher risk of a serious heart rhythm change called QT prolongation, which can cause sudden death.
For people with kidney disease: Talk with your doctor before using citalopram if you have kidney disease. This drug may build up and cause more side effects in people with severe kidney disease. For people with liver disease: Citalopram is processed by the liver. If you have liver disease, the levels of this drug in your body might increase.
You may have more side effects. For people with a history of seizure disorder: Citalopram can increase your risk for seizures. Talk with your doctor before using this drug if you have a history of seizures.
For pregnant women: Citalopram is a category C pregnancy drug. That means two things:. This drug should be used only if the potential benefit justifies the potential risk to the fetus. For women who are breastfeeding: Citalopram passes into breast milk and may cause side effects in a child who is breastfed.
Talk with your doctor if you breastfeed your child. You may need to decide whether to stop breastfeeding or stop taking this medication. For children: Citalopram can cause changes in appetite or weight. Children and adolescents should have height and weight monitored during treatment. This dosage information is for citalopram oral tablet. All possible dosages and drug forms may not be included here. Your dosage, drug form, and how often you take the drug will depend on:.
Stopping citalopram too quickly can cause serious symptoms such as anxiety, irritability, high or low mood, feeling restless, changes in sleep habits, headache, sweating, nausea, dizziness, electric shock-like sensations, shaking, or confusion.
Your doctor may ask you to reduce the dose gradually instead of quickly stopping the medication if these symptoms occur.
However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. Always to speak with your doctor or pharmacist about dosages that are right for you. Citalopram oral tablet is used for long-term treatment. It may even get worse. For this drug to work well, a certain amount needs to be in your body at all times. If you take too much: You could have symptoms of serotonin syndrome.
These include:. What to do if you miss a dose: Take your dose as soon as you remember. But if you remember just a few hours before your next scheduled dose, take only one dose. Never try to catch up by taking two doses at once. This could result in dangerous side effects. How to tell if the drug is working: You will know that citalopram is working if you notice that your depression symptoms are less severe or happen less often.
You may not notice any change in your condition for the first several weeks that you take this drug. Sometimes it can take up to 2 months to start working. Citalopram should be used with caution in patients with severe renal impairment. When treating pregnant women with citalopram during the third trimester, the physician should carefully consider the potential risks and benefits of treatment.
It is generally agreed that acute episodes of depression require several months or longer of sustained pharmacologic therapy.
Systematic evaluation of citalopram in two studies has shown that its antidepressant efficacy is maintained for periods of up to 24 weeks following 6 or 8 weeks of initial treatment 32 weeks total.
Based on these limited data, it is not known whether the dose of citalopram needed to maintain euthymia is identical to the dose needed to induce remission.
Patients should be monitored for these symptoms when discontinuing treatment. Subsequently, the physician may continue decreasing the dose but at a more gradual rate. At least 14 days should elapse between discontinuation of an MAOI intended to treat psychiatric disorders and initiation of therapy with citalopram. Do not start citalopram in a patient who is being treated with linezolid or intravenous methylene blue because there is an increased risk of serotonin syndrome.
In some cases, a patient already receiving citalopram therapy may require urgent treatment with linezolid or intravenous methylene blue.
If acceptable alternatives to linezolid or intravenous methylene blue treatment are not available and the potential benefits of linezolid or intravenous methylene blue treatment are judged to outweigh the risks of serotonin syndrome in a particular patient, citalopram should be stopped promptly, and linezolid or intravenous methylene blue can be administered.
The patient should be monitored for symptoms of serotonin syndrome for 2 weeks or until 24 hours after the last dose of linezolid or intravenous methylene blue, whichever comes first. Tan coloured, round shaped, bic onvex film coated tablets with '10' debossed on one side and plain on the other side. Tan coloured, oval shaped, biconvex film coated tablets with '2 0' debossed '2' on left side and '0' on right side of the break line on one side and '' on the other side.
Tan coloured, oval shaped, biconvex film coated tablets with '4 0' debossed '4' on left side and '0' on right side of the break line on one side and '' on the other side. Additional studies to investigate the mechanism for this pathology have not been performed, and the potential significance of this effect in humans has not been established.
Although appropriate data from that study are not available to directly compare plasma levels of citalopram CT and its metabolites, demethylcitalopram DCT and didemethylcitalopram DDCT , to levels that have been achieved in humans, pharmacokinetic data indicate that the relative dog-to-human exposure was greater for the metabolites than for citalopram.
A subsequent intravenous dosing study demonstrated that in beagle dogs, DDCT caused QT prolongation, a known risk factor for the observed outcome in dogs. This effect occurred in dogs at doses producing peak DDCT plasma levels of to 3, nM 39 to times the mean steady state DDCT plasma level measured at the maximum recommended human daily dose of 60 mg. While DDCT is ordinarily present in humans at lower levels than in dogs, it is unknown whether there are individuals who may achieve higher DDCT levels.
Read the Medication Guide that comes with citalopram tablets before you start taking it and each time you get a refill. There may be new information. This Medication Guide does not take the place of talking to your healthcare provider about your medical condition or treatment.
Talk with your healthcare provider if there is something you do not understand or want to learn more about. What is the most important information I should know about citalopram tablets?
Keep all follow-up visits with your healthcare provider and call between visits if you are worried about symptoms. Call your healthcare provider right away if you have any of the following symptoms, or call if an emergency, especially if they are new, worse, or worry you:. Changes in the electrical activity of your heart QT prolongation and Torsade de Pointes. Serotonin Syndrome. This condition can be life-threatening and may include:. Severe allergic reactions: trouble breathing, swelling of the face, tongue, eyes or mouth.
Abnormal bleeding : Citalopram tablets and other antidepressant medicines may increase your risk of bleeding or bruising, especially if you take the blood thinner warfarin, a non-steroidal anti-inflammatory drug NSAIDs, like ibuprofen or naproxen , or aspirin. Changes in appetite or weight. Low salt sodium levels in the blood. Elderly people may be at greater risk. Do not stop citalopram tablets without first talking to your healthcare provider.
Stopping citalopram tablets too quickly may cause serious symptoms including:. Only some people are at risk for these problems. You may want to undergo an eye examination to see if you are at risk and receive preventative treatment if you are. Citalopram tablets are a prescription medicine used to treat depression. It is important to talk with your healthcare provider about the risks of treating depression and also the risks of not treating it.
You should discuss all treatment choices with your healthcare provider. Citalopram tablets are also used to treat:. People who take citalopram tablets close in time to an MAOI may have serious or even life-threatening side effects. Get medical help right away if you have any of these symptoms :. What should I tell my healthcare provider before taking citalopram tablets? Ask if you are not sure. Tell your healthcare provider about all the medicines that you take, including prescription and non-prescription medicines, vitamins, and herbal supplements.
Citalopram tablets and some medicines may interact with each other, may not work as well, or may cause serious side effects. Your healthcare provider or pharmacist can tell you if it is safe to take citalopram tablets with your other medicines. Do not start or stop any medicine while taking citalopram tablets without talking to your healthcare provider first.
What should I avoid while taking citalopram tablets? Citalopram tablets can cause sleepiness or may affect your ability to make decisions, think clearly, or react quickly. You should not drive, operate heavy machinery, or do other dangerous activities until you know how citalopram tablets affect you.
Do not drink alcohol while using citalopram tablets. See "What is the most important information I should know about citalopram tablets? Tell your healthcare provider if you have any side effect that bothers you or that does not go away. These are not all the possible side effects of citalopram tablets. For more information, ask your healthcare provider or pharmacist.
Keep citalopram tablets and all medicines out of the reach of children. Medicines are sometimes prescribed for purposes other than those listed in a Medication Guide. Do not use citalopram tablets for a condition for which it was not prescribed. Do not give citalopram tablets to other people, even if they have the same condition. It may harm them. This Medication Guide summarizes the most important information about citalopram tablets.
If you would like more information, talk with your healthcare provider. You may ask your healthcare provider or pharmacist for information about citalopram tablets that is written for healthcare professionals. This Medication Guide has been approved by the U. Food and Drug Administration. DailyMed will deliver notification of updates and additions to Drug Label information currently shown on this site through its RSS feed. DailyMed will deliver this notification to your desktop, Web browser, or e-mail depending on the RSS Reader you select to use.
Due to inconsistencies between the drug labels on DailyMed and the pill images provided by RxImage , we no longer display the RxImage pill images associated with drug labels. We anticipate reposting the images once we are able identify and filter out images that do not match the information provided in the drug labels. Drug Label Info. NDC National Drug Code - Each drug product is assigned this unique number which can be found on the drug's outer packaging. Drug Label Information Updated May 22, If you are a consumer or patient please visit this version.
Rx Only. Suicidality and Antidepressant Drugs Antidepressants increased the risk compared to placebo of suicidal thinking and behavior suicidality in children , adolescents , and young adults in short-term studies of major depressive disorder MDD and other psychiatric disorders. Pharmacodynamics The mechanism of action of citalopram hydrobromide as an antidepressant is presumed to be linked to potentiation of serotonergic activity in the central nervous system CNS resulting from its inhibition of CNS neuronal reuptake of serotonin 5-HT.
Absorption and Distribution Following a single oral dose 40 mg tablet of citalopram, peak blood levels occur at about 4 hours. Population Subgroups Age - Citalopram pharmacokinetics in subjects 60 years of age were compared to younger subjects in two normal volunteer studies.
Comparison of Clinical Trial Results Highly variable results have been seen in the clinical development of all antidepressant drugs. Citalopram, is indicated for the treatment of depression. General General Discontinuation of Treatment with Citalopram During marketing of citalopram and other SSRIs and SNRIs serotonin and norepinephrine reuptake inhibitors , there have been spontaneous reports of adverse events occurring upon discontinuation of these drugs, particularly when abrupt, including the following: dysphoric mood, irritability, agitation, dizziness, sensory disturbances e.
Seizures Although anticonvulsant effects of citalopram have been observed in animal studies, citalopram has not been systematically evaluated in patients with a seizure disorder.
Use in Patients with Concomitant Illness Clinical experience with citalopram in patients with certain concomitant systemic illnesses is limited. Information for Patients Physicians are advised to discuss the following issues with patients for whom they prescribe citalopram.
Patients should be advised to notify their physician if they are breastfeeding an infant. Laboratory Tests There are no specific laboratory tests recommended.
Mutagenesis Citalopram was mutagenic in the in vitro bacterial reverse mutation assay Ames test in 2 of 5 bacterial strains Salmonella TA98 and TA in the absence of metabolic activation. Pregnancy-Nonteratogenic Effects Neonates exposed to citalopram and other SSRIs or serotonin and norepinephrine reuptake inhibitors SNRIs , late in the third trimester, have developed complications requiring prolonged hospitalization, respiratory support, and tube feeding.
Labor and Delivery The effect of citalopram on labor and delivery in humans is unknown. Nursing Mothers As has been found to occur with many other drugs, citalopram is excreted in human breast milk. Geriatric Use Of 4, patients in clinical studies of citalopram, 1, were 60 and over, 1, were 65 and over, and were 75 and over.
Treatment Citalopram Placebo males males Abnormal Ejaculation 6. Other Events Observed During the Postmarketing Evaluation of Citalopram It is estimated that over 30 million patients have been treated with citalopram since market introduction. Controlled Substance Class Citalopram is not a controlled substance. Physical and Psychological Dependence Animal studies suggest that the abuse liability of citalopram is low. Human Experience In clinical trials of citalopram, there were reports of citalopram overdose, including overdoses of up to 2, mg, with no associated fatalities.
Management of Overdose Establish and maintain an airway to ensure adequate ventilation and oxygenation. Maintenance Treatment It is generally agreed that acute episodes of depression require several months or longer of sustained pharmacologic therapy. Use of citalopram with Other MAOIs, Such as Linezolid or Methylene Blue Do not start citalopram in a patient who is being treated with linezolid or intravenous methylene blue because there is an increased risk of serotonin syndrome. Citalopram tablets and other antidepressant medicines may cause serious side effects, including: 1.
Suicidal thoughts or actions: Citalopram tablets and other antidepressant medicines may increase suicidal thoughts or actions in some children, teenagers, or young adults within the first few months of treatment or when the dose is changed.
Depression or other serious mental illnesses are the most important causes of suicidal thoughts or actions. Call your healthcare provider right away if you have any of the following symptoms, or call if an emergency, especially if they are new, worse, or worry you: attempts to commit suicide acting on dangerous impulses acting aggressive or violent thoughts about suicide or dying new or worse depression new or worse anxiety or panic attacks feeling agitated, restless, angry or irritable trouble sleeping an increase in activity or talking more than what is normal for you other unusual changes in behavior or mood.
A few people may get sexual side effects, such as problems getting an erection or a lower sex drive. In some cases these can continue even after stopping the medicine. Speak to your doctor if you are worried. Otherwise there do not seem to be any lasting harmful effects from taking citalopram for many months and years. If you have been feeling better for 6 months or more, your doctor may suggest coming off citalopram. Your doctor will probably recommend reducing your dose gradually over several weeks, or longer if you have been taking citalopram for a long time.
This is to help prevent any extra side effects you might get as a reaction to coming off the medicine. Do not stop taking citalopram suddenly or without talking to your doctor first.
But sometimes people respond better to one antidepressant than to another. Citalopram can make you feel less hungry, so you may lose weight when you first start taking it. If you start to have problems with your weight while taking citalopram, talk to your doctor or pharmacist. Some people cannot concentrate properly while they're taking citalopram.
It might be best to stop driving and cycling for the first few days of treatment until you know how this medicine makes you feel. There's some evidence that citalopram can reduce the quality of sperm, but it's not known whether this reduces male fertility.
The effect should reverse once you stop taking the medicine. Speak to your doctor if you're concerned. For women, there's no firm evidence to suggest that taking citalopram will reduce your fertility. But speak to a pharmacist or your doctor if you're trying to get pregnant. They may want to review your treatment. Citalopram will not affect any type of contraception, including the combined pill or emergency contraception.
The good effects of citalopram may, after a while, improve your sex life as your mood lifts and you become interested in life and relationships again. Sexual side effects usually pass after the first couple of weeks. However, very rarely, they can be long lasting and may not get better even after stopping the medicine.
If these happen and are a problem for you, go back to your doctor to see if there's another treatment you can try. You can drink alcohol while taking citalopram, but it may make you feel sleepy. It might be best to stop drinking alcohol until you see how the medicine makes you feel. Antidepressants, including citalopram, are just one of several approaches to treating depression.
Choosing a treatment that's most suitable for you depends on how long you have had depression, your symptoms, whether you have had any previous bouts of depression, whether previous treatment has worked, how likely you are to stick with your treatment, the potential side effects, and your preferences and priorities.
Citalopram and escitalopram are both medicines used to treat depression. Cannabis can also make drowsiness worse with citalopram, especially in people who have just started taking it. Methadone can increase the risk of side effects in people taking citalopram. Talk to your doctor if you think you might use recreational drugs while taking citalopram.
Page last reviewed: 10 December Next review due: 10 December Citalopram - Brand name: Cipramil On this page About citalopram Key facts Who can and cannot take citalopram How and when to take citalopram Side effects How to cope with side effects of citalopram Pregnancy and breastfeeding Cautions with other medicines Common questions about citalopram.
About citalopram Citalopram is a type of antidepressant known as a selective serotonin reuptake inhibitor SSRI. Help us improve our website Can you answer a quick question about your visit today? It usually takes 4 to 6 weeks for citalopram to work. Side effects such as tiredness, dry mouth and sweating are common.
They're usually mild and go away after a couple of weeks. If you and your doctor decide to take you off citalopram, your doctor may recommend reducing your dose gradually to help prevent extra side effects.
The doctor or pharmacist will give you the manufacturer's patient information sheet Medication Guide when you begin treatment with citalopram. Read the information carefully and ask your doctor or pharmacist if you have any questions. No matter your age, before you take an antidepressant, you, your parent, or your caregiver should talk to your doctor about the risks and benefits of treating your condition with an antidepressant or with other treatments.
You should also talk about the risks and benefits of not treating your condition. You should know that having depression or another mental illness greatly increases the risk that you will become suicidal. This risk is higher if you or anyone in your family has or has ever had bipolar disorder mood that changes from depressed to abnormally excited or mania frenzied, abnormally excited mood , or has thought about or attempted suicide.
Talk to your doctor about your condition, symptoms, and personal and family medical history. You and your doctor will decide what type of treatment is right for you. Citalopram is used to treat depression. Citalopram is in a class of antidepressants called selective serotonin reuptake inhibitors SSRIs. It is thought to work by increasing the amount of serotonin, a natural substance in the brain that helps maintain mental balance. Citalopram comes as a tablet and a solution liquid to take by mouth.
It is usually taken once a day, in the morning or in the evening, with or without food. Take citalopram at around the same time every day.
Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take citalopram exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor. Your doctor may start you on a low dose of citalopram and gradually increase your dose, not more often than once a week.
It may take 1 to 4 weeks before you notice the full benefit of citalopram. Continue to take citalopram even if you feel well. If you suddenly stop taking citalopram, you may experience withdrawal symptoms such as mood changes, irritability, agitation, dizziness, numbness, tingling or electric shock-like sensations in the hands or feet, anxiety, confusion, headache, tiredness, nausea, sweating, shaking, and difficulty falling asleep or staying asleep.
Do not stop taking citalopram without talking to your doctor. Your doctor will probably decrease your dose gradually.
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