Use Alternate Drug. both increase serotonin levels; increased risk of serotonin syndrome.tetrabenazinecitalopram and tetrabenazine both increase QTc interval. Avoid or Use Alternate Drug.thioridazinethioridazine and citalopram both increase QTc interval. Avoid or Use Alternate Drug. Thioridazine should be avoided in combination with drugs that are known to prolong QTc interval.trazodonecitalopram and trazodone both increase QTc interval. Avoid or Use Alternate Drug.trimipraminecitalopram and trimipramine both increase serotonin levels. Avoid or Use Alternate Drug. Citalopram may increase TCA levels. Increased risk of serotonin syndrome or neuroleptic malignant syndrome. Potential risk for QT prolongation. ECG monitoring is recommended.citalopram and trimipramine both increase QTc interval. Avoid or Use Alternate Drug.triptorelintriptorelin increases toxicity of citalopram by QTc interval. Avoid or Use Alternate Drug. Increases risk of torsades de pointes.tucatinibtucatinib will increase the level or effect of citalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid concomitant use of tucatinib with CYP3A substrates, where minimal concentration changes may lead to serious or life-threatening toxicities. If unavoidable, reduce CYP3A substrate dose according to product labeling.umeclidinium bromide/vilanterol inhaledcitalopram increases toxicity of umeclidinium bromide/vilanterol inhaled by QTc interval. Avoid or Use Alternate Drug. Exercise extreme caution when vilanterol coadministered with drugs that prolong QTc interval; adrenergic agonist effects on the cardiovascular system may be potentiated.vandetanibcitalopram, vandetanib. Either increases toxicity of the other by QTc interval. Avoid or Use Alternate Drug. Avoid coadministration with drugs known to prolong QT interval; if a drug known to prolong QT interval must be used, more frequent ECG monitoring is recommended.vemurafenibvemurafenib and citalopram both increase QTc interval. Avoid or Use Alternate Drug. Concomitant use of vemurafenib with drugs that prolong QT interval is not recommended.venlafaxinecitalopram and venlafaxine both increase serotonin levels. Avoid or Use Alternate Drug. Combination may increase risk of serotonin syndrome or neuroleptic malignant syndrome-like reactions.vilanterol/fluticasone furoate inhaledcitalopram increases toxicity of vilanterol/fluticasone furoate inhaled by QTc interval. Avoid or Use Alternate Drug. Exercise extreme caution when vilanterol coadministered with drugs that prolong QTc interval; adrenergic agonist effects on the cardiovascular system may be potentiated.vilazodonecitalopram, vilazodone. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug. Combination may increase risk of serotonin syndrome or neuroleptic malignant syndrome-like reactions.voriconazolecitalopram and voriconazole both increase QTc interval. Avoid or Use Alternate Drug.vorinostatcitalopram and vorinostat both increase QTc interval. Avoid or Use Alternate Drug.vortioxetinecitalopram, vortioxetine. Either increases effects of the other by serotonin levels. Avoid or Use Alternate Drug.voxelotorvoxelotor will increase the level or effect of citalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Voxelotor increases systemic exposure of sensitive CYP3A4 substrates. Avoid coadministration with sensitive CYP3A4 substrates with a narrow therapeutic index. Consider dose reduction of the sensitive CYP3A4 substrate(s) if unable to avoid.ziprasidonecitalopram and ziprasidone both increase QTc interval. Contraindicated.zolmitriptancitalopram, zolmitriptan. Mechanism: unknown. Avoid or Use Alternate Drug. Combination may increase risk of serotonin syndrome. If concomitant treatment with citalopram and a triptan is clinically warranted, careful observation of the patient is advised, particularly during treatment initiation and dose increases.Monitor Closely (285)5-HTPcitalopram and 5-HTP both increase serotonin levels. Use Caution/Monitor. Combination may increase risk of serotonin syndrome or neuroleptic malignant syndrome-like reactions.abciximabcitalopram increases effects of abciximab by pharmacodynamic synergism. Use Caution/Monitor. Combination may increase risk of bleeding.abirateroneabiraterone increases levels of citalopram by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Avoid coadministration of abiraterone with substrates of CYP2D6. If alternative therapy cannot be used, exercise caution and consider a dose reduction of the CYP2D6 substrate.activated charcoalactivated charcoal decreases effects of citalopram by pharmacodynamic antagonism. Use Caution/Monitor. Charcoal can reduce absorption of citalopram, resulting in decreased efficacy.albuterolalbuterol and citalopram both increase QTc interval. Use Caution/Monitor.alfuzosincitalopram and alfuzosin both increase QTc interval. Use Caution/Monitor.amifampridinecitalopram increases toxicity of amifampridine by Other (see comment). Modify Therapy/Monitor Closely. Comment: Amifampridine can cause seizures. Coadministration with drugs that lower seizure threshold may increase this risk.amiodaroneamiodarone and citalopram both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.amobarbitalamobarbital will decrease the level or effect of citalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.amoxapinecitalopram and amoxapine both increase QTc interval. Use Caution/Monitor.anagrelidecitalopram increases effects of anagrelide by pharmacodynamic synergism. Use Caution/Monitor. Combination may increase risk of bleeding.antithrombin IIIcitalopram increases effects of antithrombin III by pharmacodynamic synergism. Use Caution/Monitor. Combination may increase risk of bleeding.apixabancitalopram increases effects of apixaban by anticoagulation. Use Caution/Monitor. SSRIs may inhibit platelet aggregation, thus increase bleeding risk when coadministered with anticoagulants.apomorphineapomorphine and citalopram both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.arformoterolarformoterol and citalopram both increase QTc interval. Use Caution/Monitor.argatrobancitalopram increases effects of argatroban by pharmacodynamic synergism. Use Caution/Monitor. Combination may increase risk of bleeding.arsenic trioxidearsenic trioxide and citalopram both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.artemether/lumefantrineartemether/lumefantrine and citalopram both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.asenapineasenapine and citalopram both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.asenapine transdermalasenapine transdermal and citalopram both increase QTc interval. Use Caution/Monitor.aspirincitalopram, aspirin. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. If possible, avoid concurrent use.aspirin rectalcitalopram, aspirin rectal. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. If possible, avoid concurrent use.aspirin/citric acid/sodium bicarbonatecitalopram, aspirin/citric acid/sodium bicarbonate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. If possible, avoid concurrent use.atazanaviratazanavir increases levels of citalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.atomoxetinecitalopram increases levels of atomoxetine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Although citalopram is a weak inhibitor of 2D6, the potential for an interaction exists.atomoxetine and citalopram both increase QTc interval. Use Caution/Monitor.azithromycinazithromycin and citalopram both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.bedaquilinecitalopram and bedaquiline both increase QTc interval. Modify Therapy/Monitor Closely. ECG should be monitored closelybelzutifanbelzutifan will decrease the level or effect of citalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. If unable to avoid coadministration of belzutifan with sensitive CYP3A4 substrates, consider increasing the sensitive CYP3A4 substrate dose in accordance with its prescribing information. benzhydrocodone/acetaminophenbenzhydrocodone/acetaminophen, citalopram. Either increases effects of the other by serotonin levels. Use Caution/Monitor. Coadministration of drugs that affect the serotonergic neurotransmitter system may result in serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation and dose adjustment.betrixabancitalopram, betrixaban. Either increases levels of the other by anticoagulation. Use Caution/Monitor. SSRIs may inhibit platelet aggregation, thus increase bleeding risk when coadministered with anticoagulants.bivalirudincitalopram increases effects of bivalirudin by pharmacodynamic synergism. Use Caution/Monitor. Combination may increase risk of bleeding.bosentanbosentan will decrease the level or effect of citalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.bumetanidebumetanide, citalopram. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Possible additive hyponatremia.buprenorphine subdermal implantcitalopram, buprenorphine subdermal implant. Either increases toxicity of the other by serotonin levels. Use Caution/Monitor. Concomitant use could result in life-threatening serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation, and during dose adjustment of the serotonergic drug. Discontinue buprenorphine if serotonin syndrome is suspected.buprenorphine, long-acting injectioncitalopram, buprenorphine, long-acting injection. Either increases toxicity of the other by serotonin levels. Use Caution/Monitor. Concomitant use could result in life-threatening serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation, and during dose adjustment of the serotonergic drug. Discontinue buprenorphine if serotonin syndrome is suspected.bupropionbupropion will increase the level or effect of citalopram by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.cannabidiolcannabidiol will increase the level or effect of citalopram by affecting hepatic enzyme CYP2C19 metabolism. Modify Therapy/Monitor Closely. Consider reducing the dose of sensitive CYP2C19 substrates, as clinically appropriate, when coadministered with cannabidiol. carbamazepinecarbamazepine decreases levels of citalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. The possibility that carbamazepine might increase the clearance of citalopram should be considered when both drugs are coadministered.carvedilolcitalopram increases levels of carvedilol by decreasing metabolism. Use Caution/Monitor.celecoxibcitalopram, celecoxib. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. If possible, avoid concurrent use.cenobamatecenobamate will decrease the level or effect of citalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Increase dose of CYP3A4 substrate, as needed, when coadministered with cenobamate.cenobamate will decrease the level or effect of citalopram by affecting hepatic enzyme CYP2C19 metabolism. Modify Therapy/Monitor Closely. Consider a dose reduction of CYP2C19 substrates, as clinically appropriate, when used concomitantly with cenobamate. cenobamate, citalopram. Either increases effects of the other by sedation. Use Caution/Monitor.chloramphenicolchloramphenicol will increase the level or effect of citalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.chloroquinechloroquine increases toxicity of citalopram by QTc interval. Use Caution/Monitor.chlorothiazidechlorothiazide, citalopram. pharmacodynamic synergism. Use Caution/Monitor. Possible additive hyponatremia.chlorpromazinechlorpromazine and citalopram both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.choline magnesium trisalicylatecitalopram, choline magnesium trisalicylate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of GI adverse effects may be increased. If possible, avoid concurrent use.cilostazolcitalopram increases effects of cilostazol by pharmacodynamic synergism. Use Caution/Monitor. Combination may increase risk of bleeding.cimetidinecimetidine increases levels of citalopram by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. Citalopram 20 mg/day is the maximum recommended dose for patients taking CYP2C19 inhibitors because of the risk of QT prolongation.ciprofloxacinciprofloxacin and citalopram both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.clofaziminecitalopram and clofazimine both increase QTc interval. Use Caution/Monitor.clonidineclonidine, citalopram. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration enhances CNS depressant effects.clopidogrelcitalopram increases effects of clopidogrel by pharmacodynamic synergism. Use Caution/Monitor. SSRIs affect platelet activation; coadministration of SSRIs with clopidogrel may increase the risk of bleeding.clozapinecitalopram increases effects of clozapine by pharmacodynamic synergism. Use Caution/Monitor. Increased risk for serotonin syndrome.cobicistatcobicistat will increase the level or effect of citalopram by Other (see comment). Use Caution/Monitor. Carefully titrate dose of the antidepressant to the desired effect, including using the lowest feasible initial or maintenance dose, and monitor its response during coadministration with SSRIs and cobicistat. cobicistat will increase the level or effect of citalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.conivaptanconivaptan increases levels of citalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.crizotinibcrizotinib increases levels of citalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A. ECG monitoring is recommended, along with drugs that may prolong the QT interval.crofelemercrofelemer increases levels of citalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Crofelemer has the potential to inhibit CYP3A4 at concentrations expected in the gut; unlikely to inhibit systemically because minimally absorbed.cyclobenzaprinecyclobenzaprine and citalopram both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.cyproheptadinecyproheptadine decreases effects of citalopram by pharmacodynamic antagonism. Use Caution/Monitor. Cyproheptadine may diminish the serotonergic effect of SSRIs.dabigatrancitalopram increases effects of dabigatran by pharmacodynamic synergism. Use Caution/Monitor. Combination may increase risk of bleeding.dabrafenibdabrafenib will decrease the level or effect of citalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.dalteparincitalopram increases effects of dalteparin by pharmacodynamic synergism. Use Caution/Monitor. Combination may increase risk of bleeding.daridorexantcitalopram and daridorexant both increase sedation. Modify Therapy/Monitor Closely. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment. darunavirdarunavir will increase the level or effect of citalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration with SSRIs, TCAs, or trazodone may require dose titration of antidepressant to desired effect (eg, using the lowest feasible initial or maintenance dose). Monitor for antidepressant response.dasatinibcitalopram and dasatinib both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.defibrotidedefibrotide increases effects of citalopram by Other (see comment). Use Caution/Monitor. Comment: Defibrotide may enhance effects of platelet inhibitors.degarelixdegarelix and citalopram both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.deutetrabenazinecitalopram and deutetrabenazine both increase QTc interval. Use Caution/Monitor. At the maximum recommended dose, deutetrabenazine does not prolong QT interval to a clinically relevant extent. Certain circumstances may increase risk of torsade