Sample Article Directory Oklahoma: citalopram

sye-TAL-oh-pram hye-droe-BROE-mide

Oral route(Tablet;Solution)

Antidepressants increased the risk of suicidal thinking and behavior in children, adolescents, and young adults in short-term studies with major depressive disorder (MDD) and other psychiatric disorders. Short term studies did not show an increase in the risk of suicidality with antidepressants compared to placebo in adults beyond age 24, and there was a reduction in risk with antidepressants compared to placebo in adults aged 65 and older. This risk must be balanced with the clinical need. Monitor patients closely for clinical worsening, suicidality, or unusual changes in behavior. Families and caregivers should be advised of the need for close observation and communication with the prescriber. Not approved for use in pediatric patients .

Commonly used brand name(s)

In the U.S.

Celexa

Available Dosage Forms:

Tablet

Solution

Therapeutic Class: Antidepressant

Pharmacologic Class: Citalopram

Uses For citalopram

Citalopram is used to treat mental depression. It belongs to a group of medicines known as selective serotonin reuptake inhibitors (SSRIs). These medicines are thought to work by increasing the activity of the chemical serotonin in the brain.

citalopram is available only with your doctor's prescription.

Before Using citalopram

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For citalopram, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to citalopram or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of citalopram in the pediatric population. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of citalopram in the elderly. However, elderly patients are more likely to have hyponatremia (low sodium in the blood), which may require caution and an adjustment in the dose for patients receiving citalopram.

Pregnancy

	Pregnancy Category	Explanation
All Trimesters	C	Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

Breast Feeding

Studies in women breastfeeding have demonstrated harmful infant effects. An alternative to this medication should be prescribed or you should stop breastfeeding while using citalopram.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking citalopram, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using citalopram with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

Cisapride

Clorgyline

Dronedarone

Furazolidone

Iproniazid

Isocarboxazid

Levomethadyl

Linezolid

Mesoridazine

Methylene Blue

Metoclopramide

Moclobemide

Nialamide

Pargyline

Phenelzine

Pimozide

Procarbazine

Selegiline

Sparfloxacin

Thioridazine

Toloxatone

Tranylcypromine

Ziprasidone

Using citalopram with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Abciximab

Aceclofenac

Acemetacin

Acenocoumarol

Alclofenac

Alfuzosin

Almotriptan

Amiodarone

Amitriptyline

Amoxapine

Ancrod

Anisindione

Antithrombin III Human

Apazone

Apomorphine

Ardeparin

Arsenic Trioxide

Asenapine

Aspirin

Astemizole

Azithromycin

Benoxaprofen

Bivalirudin

Bromfenac

Bufexamac

Carprofen

Certoparin

Chloramphenicol

Chloroquine

Chlorpromazine

Cilostazol

Cimetidine

Ciprofloxacin

Citalopram

Clarithromycin

Clometacin

Clomipramine

Clonixin

Clopidogrel

Crizotinib

Dalteparin

Danaparoid

Dasatinib

Defibrotide

Dermatan Sulfate

Desirudin

Desvenlafaxine

Dexfenfluramine

Dexketoprofen

Dextroamphetamine

Dextromethorphan

Diclofenac

Dicumarol

Diflunisal

Dipyridamole

Dipyrone

Disopyramide

Dofetilide

Dolasetron

Droperidol

Droxicam

Duloxetine

Eletriptan

Enoxaparin

Eptifibatide

Erythromycin

Escitalopram

Esomeprazole

Etodolac

Etofenamate

Felbamate

Felbinac

Fenbufen

Fenfluramine

Fenoprofen

Fentanyl

Fentiazac

Flecainide

Floctafenine

Fluconazole

Flufenamic Acid

Fluoxetine

Flurbiprofen

Fluvoxamine

Fondaparinux

Frovatriptan

Gatifloxacin

Gemifloxacin

Granisetron

Halofantrine

Haloperidol

Heparin

Ibuprofen

Ibutilide

Iloperidone

Indomethacin

Indoprofen

Isoxicam

Ketoconazole

Ketoprofen

Ketorolac

Lansoprazole

Lapatinib

Levofloxacin

Lopinavir

Lornoxicam

Lumefantrine

Magnesium Salicylate

Meclofenamate

Mefenamic Acid

Mefloquine

Meloxicam

Meperidine

Methadone

Milnacipran

Modafinil

Moxifloxacin

Nabumetone

Nadroparin

Naproxen

Naratriptan

Nepafenac

Niflumic Acid

Nilotinib

Nimesulide

Norfloxacin

Nortriptyline

Octreotide

Ofloxacin

Omeprazole

Ondansetron

Oxaprozin

Oxcarbazepine

Oxyphenbutazone

Paliperidone

Pantoprazole

Parnaparin

Paroxetine

Pazopanib

Pentosan Polysulfate Sodium

Perflutren Lipid Microsphere

Phenindione

Phenprocoumon

Phenylbutazone

Pirazolac

Piroxicam

Pirprofen

Posaconazole

Prasugrel

Probenecid

Procainamide

Prochlorperazine

Promethazine

Propafenone

Propyphenazone

Proquazone

Protriptyline

Quetiapine

Quinidine

Quinine

Rabeprazole

Ranolazine

Rasagiline

Reviparin

Risperidone

Rizatriptan

Salicylic Acid

Salmeterol

Salsalate

Saquinavir

Sertraline

Sibutramine

Sodium Phosphate

Sodium Phosphate, Dibasic

Sodium Phosphate, Monobasic

Solifenacin

Sorafenib

Sotalol

St John's Wort

Sulindac

Sumatriptan

Sunitinib

Suprofen

Tapentadol

Telithromycin

Tenidap

Tenoxicam

Terfenadine

Tetrabenazine

Tiaprofenic Acid

Ticlopidine

Tinzaparin

Tirofiban

Tolmetin

Topiramate

Toremifene

Tramadol

Trazodone

Trifluoperazine

Trimipramine

Vandetanib

Vardenafil

Vemurafenib

Vilazodone

Voriconazole

Warfarin

Zolmitriptan

Zomepirac

Using citalopram with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Bupropion

Clozapine

Desipramine

Ginkgo

Imipramine

Irinotecan

Lithium

Metoprolol

Rifampin

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Proper Use of citalopram

Take citalopram only as directed by your doctor, to benefit your condition as much as possible. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered.

citalopram should come with a Medication Guide. It is very important that you read and understand this information. Be sure to ask your doctor about anything you do not understand.

Citalopram may be taken with or without food. If your doctor tells you to take it at a specific time, follow your doctor's instructions.

If you are using the oral liquid, shake the bottle well before measuring each dose. Use a marked measuring spoon, oral syringe or medicine cup to measure each dose. The teaspoons and tablespoons that are used for serving and eating food do not measure exact amounts.

You may have to take citalopram for 4 weeks before you begin to feel better. Your doctor will check your progress at regular visits during this time. Also, you may need to keep taking citalopram for 6 months or longer to help prevent the return of the depression.

Dosing

The dose of citalopram will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of citalopram. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

For oral dosage forms (solution and tablets):
- For depression:
  - Adults—At first, 20 milligrams (mg) once a day, taken either in the morning or evening. Your doctor may gradually increase your dose if needed. However, the dose usually is not more than 40 mg per day.
  - Older adults—At first, 20 mg once a day, taken either in the morning or evening. Your doctor may gradually increase your dose if needed. However, the dose usually is not more than 40 mg per day.
  - Children—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of citalopram, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions While Using citalopram

It is very important that your doctor check your progress at regular visits, to allow for changes in your dose and to help reduce any side effects. Blood tests may be needed to check for unwanted effects.

Do not take citalopram within 14 days of taking an MAO inhibitor (MAOI) such as isocarboxazid [Marplan®], phenelzine [Nardil®], procarbazine [Matulane®], selegiline [Eldepryl®], or tranylcypromine [Parnate®]). Do not take an MAO inhibitor within 14 days of taking citalopram. If you do, you may have extremely high blood pressure or convulsions (seizures).

For some children, teenagers, and young adults, citalopram can increase thoughts of suicide. Tell your doctor right away if you start to feel more depressed and have thoughts about hurting yourselves. Report any unusual thoughts or behaviors that trouble you especially if they are new or get worse quickly. Make sure the doctor knows if you have trouble sleeping, get upset easily, have a big increase in energy, or start to act reckless. Also tell the doctor if you have sudden or strong feelings, such as feeling nervous, angry, restless, violent, or scared. Let the doctor know if you or anyone in your family has bipolar disorder (manic-depressive) or has tried to commit suicide.

citalopram can cause changes in heart rhythms, such as a condition called QT prolongation. It may change the way your heart beats and cause fainting or serious side effects in some patients. Contact your doctor right away if you have any symptoms of heart rhythm problems, such as fast, pounding, or irregular heartbeats.

Make sure your doctor knows about all the other medicines you are using. Citalopram may cause serious conditions called serotonin syndrome and neuroleptic malignant syndrome (NMS)-like reactions when taken with some medicines. Do not use citalopram with linezolid (Zyvox®), lithium, tryptophan, St. John's wort, or some pain or migraine medicines (e.g., rizatriptan [Maxalt®], sumatriptan [Imitrex®], tramadol [Ultram®], or zolmitriptan [Zomig®]). Check with your doctor first before taking any other medicines, including pimozide (Orap®).

Do not stop taking citalopram without checking with your doctor. Your doctor may want you to gradually reduce the amount you are taking before stopping it completely. This is to decrease the chance of having side effects such as agitation, anxiety, dizziness, a feeling of constant movement of self or surroundings, headache, increased sweating, nausea, trembling or shaking, trouble with sleeping or walking, or unusual tiredness when you stop the medicine.

Citalopram may increase your risk for bleeding problems. Make sure your doctor knows if you are also using other medicines that thin the blood, such as aspirin, pain or arthritis medicines, sometimes called “NSAIDs” (e.g., celecoxib, ibuprofen, naproxen, rofecoxib, valdecoxib, Advil®, Aleve®, Celebrex®, Motrin®, or Vioxx®), or warfarin (Coumadin®).

citalopram may cause hyponatremia (low sodium in the blood). This is more common in elderly patients, those who are taking diuretic medicines for high blood pressure, or those who have decreased amounts of fluid in the body due to severe diarrhea or vomiting. Stop taking citalopram and check with your doctor right away if you have confusion, headache, memory problems, trouble concentrating, weakness, or unsteadiness.

It is important to tell your doctor if you are pregnant or planning to become pregnant while using citalopram.

Citalopram has not been shown to add to the effects of alcohol. However, use of alcohol is not recommended in patients who are taking citalopram.

citalopram may cause some people to become drowsy, to have trouble thinking, or to have problems with movement. Make sure you know how you react to citalopram before you drive, use machines, or do anything else that could be dangerous if you are not alert or well-coordinated.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

citalopram Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common

Decrease in sexual desire or ability

Less common

Agitation

blurred vision

confusion

fever

increase in the frequency of urination or amount of urine produced

lack of emotion

loss of memory

menstrual changes

skin rash or itching

trouble with breathing

Rare

Anxiety

behavior change similar to drunkenness

bleeding gums

breast tenderness or enlargement or unusual secretion of milk (in females)

convulsions (seizures)

diarrhea

difficulty with concentrating

dizziness or fainting

drowsiness

dryness of the mouth

increased hunger

increased thirst

irregular heartbeat

irritability

lack of energy

lethargy

nervousness

nosebleed

overactive reflexes

painful urination

poor coordination

purple or red spots on the skin

rapid weight gain

red or irritated eyes

redness, tenderness, itching, burning, or peeling of the skin

restlessness

shivering

slow or irregular heartbeat (less than 50 beats per minute)

sore throat, fever, and chills

stupor

sweating

swelling of the face, ankles, or hands

talking or acting with excitement you cannot control

trembling, shaking, or twitching

trouble with holding or releasing urine

unusual or sudden body or facial movements or postures

unusual tiredness or weakness

Incidence not known

Abdominal or stomach pain

back or leg pains

black, tarry stools

bleeding gums

bloating

bloody stools

chest pain

confusion as to time, place, or person

constipation

cough

darkened urine

difficult or fast breathing

difficulty swallowing

drooling

fast, slow, or irregular heartbeat

general body swelling

hive-like swelling on the face, eyelids, lips, tongue, or throat

hives

holding false beliefs that cannot be changed by fact

impaired consciousness, ranging from confusion to coma

indigestion

itching, puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue

loss of appetite

loss of bladder control

loss of consciousness

muscle cramps or spasms

muscle tightness

muscle twitching or jerking

nervousness

pale skin

penile erections, frequent or continuing

recurrent fainting

rhythmic movement of the muscles

seeing, hearing, or feeling things that are not there

shortness of breath

swelling of the breasts or unusual milk production

tenderness, pain, swelling, warmth, skin discoloration, and prominent superficial veins over the affected area

tightness in the chest

total body jerking

twitching, twisting, uncontrolled repetitive movements of the tongue, lips, face, arms, or legs

uncontrolled jerking or twisting movements

unusual excitement

vomiting of blood or material that looks like coffee grounds

wheezing

yellowing of the eyes or skin

Get emergency help immediately if any of the following symptoms of overdose occur:

Symptoms of overdose

Bluish colored skin or lips

coma

deep or fast breathing with dizziness

general feeling of discomfort or illness

nausea

problems with memory

sleepiness or unusual drowsiness

vomiting

weakness

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Sleepiness or unusual drowsiness

trouble with sleeping

Less common

Body aches or pain

change in sense of taste

headache (severe and throbbing)

heartburn

increased sweating

increased yawning

loss of appetite

loss of voice

pain in the muscles or joints

sneezing

sore throat

stuffy or runny nose

tingling, burning, or prickly feelings on the skin

tooth grinding

unusual increase or decrease in weight

watering of the mouth

Incidence not known

Bruising

inability to sit still

large, flat, blue or purplish patches in the skin

need to keep moving

restlessness

uncontrolled eye movements

After you stop using citalopram, it may still produce some side effects that need attention. During this period of time, check with your doctor immediately if you notice the following side effects:

Anxiety

dizziness

trembling or shaking

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See also: citalopram side effects (in more detail)

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More citalopram resources

Citalopram Side Effects (in more detail)
Citalopram Use in Pregnancy & Breastfeeding
Drug Images
Citalopram Drug Interactions
Citalopram Support Group
348 Reviews for Citalopram - Add your own review/rating

Citalopram Professional Patient Advice (Wolters Kluwer)

Citalopram MedFacts Consumer Leaflet (Wolters Kluwer)

Celexa Prescribing Information (FDA)

Celexa Monograph (AHFS DI)

Celexa Consumer Overview

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Sample Article Directory Oklahoma

Tuesday, 15 May 2012

citalopram