Concise Prescribing Info
Citalopram HBr
Symptomatic relief of depressive illness.
Dosage/Direction for Use
Adult 20 mg/day single dose, can be increased at intervals of no less than 1 wk to max 40 mg/day. Elderly May be started at 10 mg daily. Max: 20 mg/day single dose. Patient w/ mild to moderate hepatic impairment Initially 10 mg daily single dose, may be increased to max 20 mg/day. CYP2C19 poor metabolisers Initially 10 mg daily for the 1st 2 wk of treatment, may be increased to max 20 mg daily.
May be taken with or without food.
Hypersensitivity. Patients w/ known QT prolongation or w/ congenital long QT syndrome. Combination w/ a MAOI or w/in 14 days of discontinuing treatment w/ a MAOI (including linezolid & methylene blue). Combination w/ pimozide.
Special Precautions
Potential association w/ behavioral & emotional changes, including self-harm. Monitor patients for emergence of suicidal ideation or behaviour. Discontinuation symptoms; gradually taper dose over a period of several wk or mth when discontinuing treatment. Increased risk of bone fractures. Dose-dependent increase in the QT interval. Monitor ECG in patients w/ risk factors for torsades de pointes. Increased risk of bleeding events. Discontinue in case of serotonin syndrome or neuroleptic malignant syndrome-like events. Use w/ caution in combination w/ other serotonergic drugs (eg, triptans, certain TCAs, lithium, tramadol, St. John's Wort). Can cause mydriasis which may trigger an angle-closure attack in patient w/ anatomically narrow ocular angle. Activation of mania/hypomania. Hyponatremia & syndrome of inappropriate antidiuretic hormone secretion (SIADH) especially in elderly female patients. Patients w/ recent history of MI or unstable heart disease; pre-existing slow heart rate; diabetic patients on insulin or other antidiabetics; patients w/ history of seizure disorder. Concurrent use w/ electroconvulsive therapy. Patients w/ hepatic impairment or severe renal impairment. May impair judgment, thinking or motor skills; caution against driving or operating hazardous machinery. May affect sperm quality. Pregnancy & lactation. Risk of neonate complications & persistent pulmonary HTN of the newborn (PPHN) following exposure to SSRIs in late 3rd trimester of pregnancy. Not indicated for use in childn <18 yr. Elderly ≥65 yr.
Adverse Reactions
Nausea; dry mouth, increased sweating; somnolence. Fatigue, fever; tremor, diarrhea, dyspepsia, vomiting, abdominal pain; anorexia, nervousness, anxiety, agitation, libido decreased, yawning; dysmenorrhea in females; ejaculation disorder & impotence in males; upper resp tract infection, rhinitis, pharyngitis, sinusitis; micturition disorder.
Drug Interactions
Use w/ caution when co-administered w/ other centrally acting drugs; CYP2D6 substrates w/ a narrow therapeutic index. Increased Cmax & AUC w/ cimetidine. Potential decrease in clearance w/ potent CYP3A4 inhibitor (eg, ketoconazole, itraconazole, fluconazole, erythromycin) or potent CYP2C19 inhibitor (eg, omeprazole, esomeprazole, fluvoxamine, lansoprazole, ticlopidine). Increased risk of bleeding w/ NSAID, aspirin, warfarin or other anticoagulants. Additive effect on QT interval w/ pimozide, drugs known to prolong the QT/QTc interval or drugs that can disrupt electrolyte levels. Increased risk of serotonin syndrome or neuroleptic malignant syndrome w/ MAOIs & other serotonergic drugs (eg, tryptophan, triptans, serotonin reuptake inhibitors, lithium, St. John's Wort, fentanyl & its analogues, dextromethorphan, tramadol, tapentadol, meperidine, methadone, pentazocine). Avoid concomitant use of alcohol. Do not take together w/ escitalopram.
MIMS Class
ATC Classification
N06AB04 - citalopram ; Belongs to the class of selective serotonin reuptake inhibitors. Used in the management of depression.
pms-Citalopram FC tab 20 mg
3 × 10's
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