drugs that may prolong the QT interval.lurasidoneMonitor Closely (1)lurasidone, citalopram. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: Potential for increased CNS depressant effects when used concurrently; monitor for increased adverse effects and toxicity.macimorelinSerious - Use Alternative (1)macimorelin and citalopram both increase QTc interval. Avoid or Use Alternate Drug. Macimorelin causes an increase of ~11 msec in the corrected QT interval. Avoid coadministration with drugs that prolong QT interval, which could increase risk for developing torsade de pointes-type ventricular tachycardia. Allow sufficient washout time of drugs that are known to prolong the QT interval before administering macimorelin.maprotilineMonitor Closely (1)citalopram and maprotiline both increase serotonin levels. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.Serious - Use Alternative (1)citalopram and maprotiline both increase QTc interval. Avoid or Use Alternate Drug.mavacamtenMonitor Closely (1)citalopram will increase the level or effect of mavacamten by affecting hepatic enzyme CYP2C19 metabolism. Modify Therapy/Monitor Closely. Inititiation of weak CYP2C19 inhibitors may require decreased mavacamten dose. meclofenamateMonitor Closely (1)citalopram, meclofenamate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. If possible, avoid concurrent use.mefenamic acidMonitor Closely (1)citalopram, mefenamic acid. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. If possible, avoid concurrent use.mefloquineSerious - Use Alternative (1)mefloquine and citalopram both increase QTc interval. Avoid or Use Alternate Drug. ECG monitoring is recommended, along with drugs that may prolong the QT interval.meloxicamMonitor Closely (1)citalopram, meloxicam. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. If possible, avoid concurrent use.meperidineMonitor Closely (1)citalopram and meperidine both increase serotonin levels. Use Caution/Monitor. Combination may increase risk of serotonin syndrome or neuroleptic malignant syndrome-like reactions.Serious - Use Alternative (1)meperidine, citalopram. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.metforminMonitor Closely (1)citalopram increases effects of metformin by pharmacodynamic synergism. Use Caution/Monitor.methadoneMonitor Closely (1)methadone and citalopram both increase QTc interval. Use Caution/Monitor. Combination may increase risk of serotonin syndrome or neuroleptic malignant syndrome like reactions. ECG monitoring is recommended, along with drugs that may prolong the QT interval.methamphetamineMonitor Closely (1)methamphetamine, citalopram. Either increases effects of the other by unknown mechanism. Use Caution/Monitor. Risk of serotonin syndrome.methyclothiazideMonitor Closely (1)methyclothiazide, citalopram. pharmacodynamic synergism. Use Caution/Monitor. Possible additive hyponatremia.methylene blueSerious - Use Alternative (1)methylene blue and citalopram both increase serotonin levels. Avoid or Use Alternate Drug. Methylene blue may increase serotonin as a result of MAO-A inhibition. If methylene blue must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last methylene blue dose or after 2 weeks of monitoring, whichever comes first.methylphenidate transdermalMonitor Closely (1)methylphenidate transdermal will increase the level or effect of citalopram by decreasing metabolism. Modify Therapy/Monitor Closely. Consider decreasing the dose of these drugs when given coadministered with methylphenidate. Monitor for drug toxiticities when initiating or discontinuing methylphenidate. metoclopramideSerious - Use Alternative (1)metoclopramide and citalopram both increase serotonin levels. Avoid or Use Alternate Drug. Additive effects; increased risk for serotonin syndrome, neuroleptic malignant syndrome, dystonia, or other extrapyramidal reactionsmetoclopramide intranasalSerious - Use Alternative (1)citalopram, metoclopramide intranasal. Either increases effects of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Avoid use of metoclopramide intranasal or interacting drug, depending on importance of drug to patient.metolazoneMonitor Closely (1)metolazone, citalopram. pharmacodynamic synergism. Use Caution/Monitor. Possible additive hyponatremia.metoprololMonitor Closely (1)citalopram increases levels of metoprolol by decreasing metabolism. Use Caution/Monitor. Increased metoprolol plasma levels have been associated with decreased cardioselectivity.midazolam intranasalMonitor Closely (1)midazolam intranasal, citalopram. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Concomitant use of barbiturates, alcohol, or other CNS depressants may increase the risk of hypoventilation, airway obstruction, desaturation, or apnea and may contribute to profound and/or prolonged drug effect.midostaurinSerious - Use Alternative (1)citalopram and midostaurin both increase QTc interval. Avoid or Use Alternate Drug.mifepristoneMonitor Closely (2)mifepristone, citalopram. QTc interval. Modify Therapy/Monitor Closely. Use alternatives if available. mifepristone will increase the level or effect of citalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. If concurrent therapy considered essential, ECG monitoring recommendedmilnacipranSerious - Use Alternative (1)citalopram and milnacipran both increase serotonin levels. Avoid or Use Alternate Drug. Combination may increase risk of serotonin syndrome or neuroleptic malignant syndrome-like reactions.mirabegronMonitor Closely (1)mirabegron will increase the level or effect of citalopram by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.mirtazapineMonitor Closely (1)citalopram and mirtazapine both increase serotonin levels. Use Caution/Monitor. Combination may increase risk of serotonin syndrome or neuroleptic malignant syndrome-like reactions.Serious - Use Alternative (1)citalopram and mirtazapine both increase QTc interval. Avoid or Use Alternate Drug.mitotaneMonitor Closely (1)mitotane decreases levels of citalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Mitotane is a strong inducer of cytochrome P-4503A4; monitor when coadministered with CYP3A4 substrates for possible dosage adjustments.mobocertinibSerious - Use Alternative (1)mobocertinib and citalopram both increase QTc interval. Avoid or Use Alternate Drug. If coadministration unavoidable, reduce mobocertinib dose and monitor QTc interval more frequently.modafinilMonitor Closely (1)modafinil will increase the level or effect 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.morphineMonitor Closely (1)citalopram and morphine both increase serotonin levels. Use Caution/Monitor. Combination may increase risk of serotonin syndrome or neuroleptic malignant syndrome-like reactions.Serious - Use Alternative (1)morphine, citalopram. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.moxifloxacinMonitor Closely (1)moxifloxacin and citalopram both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.nabumetoneMonitor Closely (1)citalopram, nabumetone. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. If possible, avoid concurrent use.nafcillinMonitor Closely (1)nafcillin will decrease the level or effect of citalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.naproxenMonitor Closely (1)citalopram, naproxen. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. If possible, avoid concurrent use.naratriptanSerious - Use Alternative (1)citalopram, naratriptan. 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.nefazodoneMonitor Closely (1)nefazodone increases levels of citalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Combination may increase risk of serotonin syndrome or neuroleptic malignant syndrome-like reactions.Serious - Use Alternative (1)citalopram and nefazodone both increase serotonin levels. Avoid or Use Alternate Drug.nelfinavirMonitor Closely (1)nelfinavir increases levels of citalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Potential for increased toxicity. .netupitant/palonosetronSerious - Use Alternative (1)netupitant/palonosetron, citalopram. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.nevirapineMonitor Closely (1)nevirapine will decrease the level or effect of citalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.nicardipineMonitor Closely (1)nicardipine increases levels of citalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.nilotinibMonitor Closely (1)nilotinib and citalopram both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.nortriptylineSerious - Use Alternative (2)citalopram and nortriptyline 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 nortriptyline both increase QTc interval. Avoid or Use Alternate Drug.octreotideMonitor Closely (1)octreotide and citalopram both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.ofloxacinMonitor Closely (1)ofloxacin and citalopram both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.olanzapineSerious - Use Alternative (1)citalopram and olanzapine both increase QTc interval. Avoid or Use Alternate Drug. Limited data, including some case reports, suggest that olanzapine may be associated with a significant prolongation of the QTc interval in rare instancesoliceridineMonitor Closely (1)citalopram, oliceridine. Either increases toxicity of the other by serotonin levels. Modify Therapy/Monitor Closely.olodaterol inhaledMonitor Closely (1)citalopram and olodaterol inhaled both increase QTc interval. Use Caution/Monitor. Drugs that prolong the QTc interval and may potentiate the effects of beta2 agonists on the cardiovascular system; increased risk of ventricular arrhythmiasolopatadine intranasalSerious - Use Alternative (1)citalopram and olopatadine intranasal both increase sedation. Avoid or Use Alternate Drug. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment. omeprazoleMonitor Closely (1)omeprazole will increase the level or effect 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.ondansetronSerious - Use Alternative (2)citalopram and ondansetron both increase QTc interval. Avoid or Use Alternate Drug. Avoid with congenital long QT syndrome; ECG monitoring recommended with concomitant medications that prolong QT interval, electrolyte abnormalities, CHF, or bradyarrhythmias. ondansetron, citalopram. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.osilodrostatMonitor Closely (1)osilodrostat and citalopram both increase QTc interval. Use Caution/Monitor.osimertinibMonitor Closely (1)osimertinib and citalopram both increase QTc interval. Use Caution/Monitor. Conduct periodic monitoring with ECGs and electrolytes in patients taking drugs known to prolong the QTc interval.oxaliplatinMonitor Closely (1)oxaliplatin will increase the level or effect of citalopram by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.Serious - Use Alternative (1)citalopram and oxaliplatin both increase QTc interval. Avoid or Use Alternate Drug.oxaprozinMonitor Closely (1)citalopram, oxaprozin. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. If possible, avoid concurrent use.oxycodoneMonitor Closely (1)oxycodone increases effects of citalopram by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Opioids may enhance the serotonergic effects of SSRIs and increase risk for serotonergic syndrome.ozanimodMonitor Closely (1)ozanimod and citalopram both increase QTc interval. Modify Therapy/Monitor Closely. The potential additive effects on heart rate, treatment with ozanimod should generally not be initiated in patients who are concurrently treated with QT prolonging drugs with known arrhythmogenic properties.Serious - Use Alternative (1)ozanimod increases toxicity of citalopram by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Avoid or Use Alternate Drug. Because the active metabolite of ozanimod inhibits MAO-B in vitro, there is a potential for serious adverse reactions, including hypertensive crisis. Therefore, coadministration of ozanimod with drugs that can increase norepinephrine or serotonin is not recommended. Monitor for hypertension with concomitant use.paliperidoneMonitor Closely (1)paliperidone and citalopram both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.palonosetronSerious - Use Alternative (1)palonosetron, citalopram. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.panobinostatSerious - Use Alternative (1)citalopram and panobinostat both increase QTc interval. Avoid or Use Alternate Drug. Panobinostat is known to significantly prolong QT interval. Panobinostat prescribing information states use with drugs known to prolong QTc is not recommended.paroxetineSerious - Use Alternative (1)citalopram and paroxetine both increase serotonin levels. Avoid or Use Alternate Drug. Combination may increase risk of serotonin syndrome or neuroleptic malignant syndrome-like reactions.pasireotideMonitor Closely (1)citalopram and pasireotide both increase QTc interval. Modify Therapy/Monitor Closely.pazopanibMonitor Closely (1)pazopanib and citalopram both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.pentamidineMonitor Closely (1)pentamidine and citalopram both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.pentazocineMonitor Closely (1)citalopram and pentazocine both increase serotonin levels. Modify Therapy/Monitor Closely.perphenazineMonitor Closely (1)citalopram and perphenazine both increase QTc interval. Use Caution/Monitor.phenelzineContraindicated (1)phenelzine and citalopram both increase serotonin levels. Contraindicated. At least 2 weeks should elapse between discontinuation of MAOI therapy and the start of citalopram therapy, and at least 2 weeks between discontinuation of citalopram therapy and commencement of MAOI therapy.phenobarbitalMonitor Closely (1)phenobarbital will decrease the level or effect of citalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.phentermineSerious - Use Alternative (1)citalopram, phentermine. Either increases toxicity of the other by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of serotonin syndrome.phenytoinMonitor Closely (1)phenytoin will decrease the level or effect of citalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.pimavanserinSerious - Use Alternative (1)citalopram and pimavanserin both increase QTc interval. Avoid or Use Alternate Drug. Coadministration may increase the risk of QT prolongation and cardiac arrhythmia.pimozideContraindicated (1)citalopram and pimozide both increase