Citalopram

Generic for Celexa®

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Celexa/Citalopram

What the medicinal ingredient is:

Citalopram hydrobromide

What the medication is used for:

CITALOPRAM has been prescribed to you by your doctor to relieve your symptoms of depression. Treatment with these types of medications is most safe and effective when you and your doctor have good communication about how you are feeling.

What it does:

CITALOPRAM belongs to a group of medicines known as antidepressants, more specifically to the family of medicines called SSRIs (Selective Serotonin Reuptake Inhibitors).

CITALOPRAM is thought to work by increasing the levels of a chemical in the brain called serotonin (5-hydroxytryptamine).

What dosage forms it comes in:

Tablets: 10 mg, 20 mg and 40 mg

When it should not be used:

  • Do not use CITALOPRAM at the same time as pimozide.
  • Do not use CITALOPRAM if you are currently or have recently taken monoamine oxidase antidepressants (e.g. selegiline, moclobemide).
  • Do not take CITALOPRAM if you are allergic to it, or to any of the components of its formulation (for list of ingredients see below).
  • Stop taking CITALOPRAM and contact your doctor immediately if you experience an allergic reaction or any severe side effect.
  • Do not use CITALOPRAM if you have been diagnosed with a congenital long QT syndrome

 

Before you use CITALOPRAM tell your doctor or pharmacist:

  • All your medical conditions, including heart problems, history of seizures, manic-depressive illness, liver or kidney disease or diabetes.
  • You have a bleeding disorder or have been told that you have low platelets.
  • If you have QT/QTc prolongation or a family history of QT/QTc prolongation.
  • If you have a personal history of fainting spells.
  • If you have a family history of sudden cardiac death at <50 years.
  • If you have electrolyte disturbances (e.g., low blood potassium, magnesium, or calcium levels) or conditions that could lead to electrolyte disturbances (e.g., vomiting, diarrhea, dehydration).
  • If you have an eating disorder or are following a strict diet.
  • If you had a recent bone fracture or were told you have osteoporosis or risk factors for osteoporosis.
  • If you are pregnant or thinking about becoming pregnant, or if you are breast feeding.
  • Any medications (prescription or non-prescription) which you are taking or have taken within the last 14 days, especially monoamine oxidase inhibitors, pimozide, any other antidepressants, triptans used to treat migraines, lithium, tramadol or drugs containing tryptophan.
  • Your habits of alcohol and /or street drug consumption.
  • Any natural or herbal products you are taking (e.g. St. John’s Wort).
  • If you drive a vehicle or perform hazardous tasks during your work.

 

INTERACTIONS WITH THIS MEDICATION:

Do not use CITALOPRAM if you are taking or have recently taken:

  • Monoamine oxidase inhibitor (e.g., phenelzine, tranylcypromine, moclobemide or selegiline)
  • Pimozide
  • Linezolid (an antibiotic)
  • Methylene blue (intravenous)

 

The following list includes some, but not all, of the drugs that may increase the risk of side-effects while receiving CITALOPRAM. You should check with your doctor or pharmacist before taking any other medication (prescription, non-prescription or natural/herbal) with CITALOPRAM.

  • drugs to treat heart rhythm disturbances (antiarrhythmics)
  • antipsychotics
  • opioid painkillers
  • drugs to treat infections
  • drugs to treat nausea and vomiting
  • cancer drugs
  • asthma drugs
  • diuretics (water pills)
  • Carbamezepine
  • Other SSRIs e.g., escitalopram or any other antidepressant (e.g., imipramine, desipramine)
  • Lithium
  • Tryptophan
  • Cimetidine
  • Triptans (e.g., sumatriptan, zolmitriptan, naratriptan)
  • Fluconazole, Ketoconazole, Itraconazole
  • Erythromycin
  • Warfarin
  • Omeprazole
  • Any herbal product such as St. John’s Wort
  • Certain medicines which may affect blood clotting and increase bleeding, such as oral anticoagulants (e.g.warfarin, dabigatran), acetylsalicylic acid (e.g. Aspirin) and other non-steroidal anti-inflammatory drugs (ibuprofen)·
  • Certain medicines used to treat pain, such as fentanyl (used in anaesthesia or to treat chronic pain), tramadol, tapentadol, meperidine, methadone, pentazocine.
  • Certain medicines used to treat cough, such as dextromethorphan.

Avoid drinking alcohol while taking CITALOPRAM

PROPER USE OF THIS MEDICATION:

Usual dose:

  • It is important that you take CITALOPRAM exactly as your doctor has instructed.
    • Usually your doctor will prescribe 20 mg per day, which you will take once daily preferably at the same time each day. If you are elderly, your doctor may prescribe a lower dose. This dose may be increased. Never change the dose of CITALOPRAM you are taking, or that someone in your care is taking unless your doctor tells you to. Dosage directions should be followed carefully. Never exceed the prescribed dose.
  • Swallow the tablets whole with a drink of water. Do not chew them. CITALOPRAM can be taken with or without food.
  • You should continue to take CITALOPRAM even if you do not feel better, as it may take several weeks for your medication to work. Improvement may be gradual.
  • Continue to take CITALOPRAM for as long as your doctor recommends it. Do not stop taking your tablets abruptly even if you begin to feel better, unless you are told to do so by your doctor. Your doctor may tell you to continue to take CITALOPRAM for several months. Continue to follow your doctor’s instructions.

SIDE EFFECTS AND WHAT TO DO ABOUT THEM:

  • CITALOPRAM may cause unwanted effects (side-effects). These may include:
    • Fatigue
    • dry mouth
    • increased sweating
    • tremor (shakiness)
    • nausea
    • diarrhea
    • somnolence (sleepiness)
    • ejaculation disorder
    • upper respiratory tract infection.
  • Contact your doctor before stopping or reducing your dosage of citalopram. Symptoms such as dizziness, abnormal dreams, electric shock sensations, agitation, anxiety, emotional indifference, difficulty concentrating, headache, migraine, tremor (shakiness), nausea, vomiting, sweating or other symptoms may occur after stopping or reducing the dosage of citalopram. Such symptoms may also occur if a dose is missed. These symptoms usually disappear without needing treatment. Tell your doctor immediately if you have these or any other symptoms. Your doctor may adjust the dosage of citalopram to reduce the symptoms.
  • Side-effects are often mild and may disappear after a few days. If they are troublesome or persistent, or if you develop any other unusual side-effects while taking CITALOPRAM, please consult your doctor.
  • Usually CITALOPRAM does not affect your ability to carry out normal daily activities. However, you should not drive a car or operate machinery until you are reasonably certain that CITALOPRAM does not affect you adversely.
  • If you experience any symptoms of a possible heart rhythm disturbance, such as dizziness, palpitations, fainting or seizures, you should seek immediate medical attention.