increases levels of nadolol by decreasing metabolism. Minor/Significance Unknown.nafcillinMonitor Closely (1)nafcillin will decrease the level or effect of escitalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.naproxenMonitor Closely (1)escitalopram, naproxen. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.naratriptanMonitor Closely (1)naratriptan and escitalopram both increase serotonin levels. Modify Therapy/Monitor Closely.Minor (1)escitalopram, naratriptan. Mechanism: unknown. Minor/Significance Unknown. Risk of weakness, dyspnea, chest pain.nebivololMinor (1)escitalopram increases levels of nebivolol by decreasing metabolism. Minor/Significance Unknown.nefazodoneSerious - Use Alternative (2)escitalopram and nefazodone both increase serotonin levels. Avoid or Use Alternate Drug. nefazodone will increase the level or effect of escitalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.nelfinavirMonitor Closely (1)nelfinavir increases levels of escitalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Potential for increased toxicity. Increased risk of serotonin syndrome.netupitant/palonosetronSerious - Use Alternative (1)netupitant/palonosetron, escitalopram. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.nilotinibSerious - Use Alternative (1)escitalopram increases toxicity of nilotinib by QTc interval. Avoid or Use Alternate Drug.nortriptylineMonitor Closely (1)escitalopram increases toxicity of nortriptyline by QTc interval. Use Caution/Monitor.Serious - Use Alternative (1)escitalopram and nortriptyline both increase serotonin levels. Avoid or Use Alternate Drug.octreotideMonitor Closely (1)escitalopram increases toxicity of octreotide by QTc interval. Use Caution/Monitor.ofloxacinMonitor Closely (1)escitalopram increases toxicity of ofloxacin by QTc interval. Use Caution/Monitor.olanzapineMonitor Closely (1)escitalopram increases toxicity of olanzapine by QTc interval. Use Caution/Monitor. Limited data, including some case reports, suggest that olanzapine may be associated with a significant prolongation of the QTc interval in rare instances.oliceridineMonitor Closely (1)escitalopram, oliceridine. Either increases toxicity of the other by serotonin levels. Modify Therapy/Monitor Closely.olodaterol inhaledMonitor Closely (1)escitalopram 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)escitalopram 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 escitalopram by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.ondansetronSerious - Use Alternative (2)escitalopram 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, escitalopram. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.osilodrostatMonitor Closely (2)osilodrostat and escitalopram both increase QTc interval. Use Caution/Monitor. escitalopram and osilodrostat both increase QTc interval. Use Caution/Monitor. Dose dependent QT prolongation - avoid drugs known to prolong the QT intervalosimertinibMonitor Closely (1)osimertinib and escitalopram both increase QTc interval. Use Caution/Monitor. Conduct periodic monitoring with ECGs and electrolytes in patients taking drugs known to prolong the QTc interval.Serious - Use Alternative (1)escitalopram increases toxicity of osimertinib by QTc interval. Avoid or Use Alternate Drug.oxaliplatinMonitor Closely (1)oxaliplatin will increase the level or effect of escitalopram 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)oxaliplatin and escitalopram both increase QTc interval. Avoid or Use Alternate Drug.oxaprozinMonitor Closely (1)escitalopram, oxaprozin. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.oxcarbazepineMonitor Closely (1)oxcarbazepine will increase the level or effect of escitalopram by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.oxycodoneMonitor Closely (1)oxycodone increases effects of escitalopram 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 escitalopram 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 escitalopram 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.paliperidoneSerious - Use Alternative (1)escitalopram increases toxicity of paliperidone by QTc interval. Avoid or Use Alternate Drug.palonosetronSerious - Use Alternative (1)palonosetron, escitalopram. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.panax ginsengMinor (1)panax ginseng increases effects of escitalopram by pharmacodynamic synergism. Minor/Significance Unknown.panobinostatSerious - Use Alternative (1)escitalopram 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.parecoxibMonitor Closely (1)escitalopram, parecoxib. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.Minor (1)parecoxib will increase the level or effect of escitalopram by affecting hepatic enzyme CYP2C19 metabolism. Minor/Significance Unknown.paroxetineSerious - Use Alternative (1)escitalopram and paroxetine both increase serotonin levels. Avoid or Use Alternate Drug.pasireotideMonitor Closely (1)escitalopram and pasireotide both increase QTc interval. Modify Therapy/Monitor Closely.pazopanibSerious - Use Alternative (1)escitalopram increases toxicity of pazopanib by QTc interval. Avoid or Use Alternate Drug.penbutololMinor (1)escitalopram increases levels of penbutolol by decreasing metabolism. Minor/Significance Unknown.pentamidineSerious - Use Alternative (1)escitalopram increases toxicity of pentamidine by QTc interval. Avoid or Use Alternate Drug.pentazocineMonitor Closely (1)escitalopram and pentazocine both increase serotonin levels. Modify Therapy/Monitor Closely.pentobarbitalMonitor Closely (1)pentobarbital will decrease the level or effect of escitalopram by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.perphenazineMonitor Closely (1)escitalopram increases toxicity of perphenazine by QTc interval. Use Caution/Monitor.phenelzineContraindicated (1)phenelzine and escitalopram both increase serotonin levels. Contraindicated.phenobarbitalMonitor Closely (2)phenobarbital will decrease the level or effect of escitalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. phenobarbital will decrease the level or effect of escitalopram by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.phentermineSerious - Use Alternative (1)escitalopram, 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 escitalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.pimavanserinSerious - Use Alternative (1)escitalopram increases toxicity of pimavanserin by QTc interval. Avoid or Use Alternate Drug.pimozideContraindicated (1)escitalopram and pimozide both increase QTc interval. Contraindicated.pindololMinor (1)escitalopram increases levels of pindolol by decreasing metabolism. Minor/Significance Unknown.piroxicamMonitor Closely (1)escitalopram, piroxicam. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.pitolisantSerious - Use Alternative (1)escitalopram and pitolisant both increase QTc interval. Avoid or Use Alternate Drug.pleurisy rootMinor (1)pleurisy root decreases effects of escitalopram by unspecified interaction mechanism. Minor/Significance Unknown. Theoretical interaction.posaconazoleMonitor Closely (2)posaconazole will increase the level or effect of escitalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. escitalopram increases toxicity of posaconazole by QTc interval. Use Caution/Monitor.pregabalinMonitor Closely (1)pregabalin, escitalopram. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.primaquineMonitor Closely (1)primaquine and escitalopram both increase QTc interval. Use Caution/Monitor.primidoneMonitor Closely (2)primidone will decrease the level or effect of escitalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. primidone will decrease the level or effect of escitalopram by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.procainamideSerious - Use Alternative (1)escitalopram increases toxicity of procainamide by QTc interval. Avoid or Use Alternate Drug.procarbazineContraindicated (1)procarbazine and escitalopram both increase serotonin levels. Contraindicated. Combination is contraindicated within 2 weeks of MAOI use.propafenoneMonitor Closely (1)escitalopram increases toxicity of propafenone by QTc interval. Use Caution/Monitor.propranololMinor (1)escitalopram increases levels of propranolol by decreasing metabolism. Minor/Significance Unknown.protriptylineMonitor Closely (1)escitalopram increases toxicity of protriptyline by QTc interval. Use Caution/Monitor.Serious - Use Alternative (1)escitalopram and protriptyline both increase serotonin levels. Avoid or Use Alternate Drug.quetiapineMonitor Closely (1)quetiapine, escitalopram. Either increases toxicity of the other by QTc interval. Use Caution/Monitor. Avoid use with drugs that prolong QT and in patients with risk factors for prolonged QT interval. Postmarketing cases show QT prolongation with overdose in patients with concomitant illness or with drugs known to cause electrolyte imbalance or prolong QT.Serious - Use Alternative (1)escitalopram increases toxicity of quetiapine by QTc interval. Avoid or Use Alternate Drug.quinidineSerious - Use Alternative (1)escitalopram increases toxicity of quinidine by QTc interval. Avoid or Use Alternate Drug.quinineMonitor Closely (1)escitalopram and quinine both increase QTc interval. Use Caution/Monitor.ranolazineMonitor Closely (1)escitalopram increases toxicity of ranolazine by QTc interval. Use Caution/Monitor.rasagilineSerious - Use Alternative (1)rasagiline and escitalopram both increase serotonin levels. Avoid or Use Alternate Drug. Severe CNS toxicity associated with hyperpyrexia has been reported with the combined treatment of an antidepressant and rasagiline. Avoid combination within 14 days of MAOI use.remifentanilSerious - Use Alternative (1)remifentanil, escitalopram. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.remimazolamMonitor Closely (1)remimazolam, escitalopram. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely. Coadministration may result in profound sedation, respiratory depression, coma, and/or death. Continuously monitor vital signs during sedation and recovery period if coadministered. Carefully titrate remimazolam dose if administered with opioid analgesics and/or sedative/hypnotics.ribociclibMonitor Closely (1)ribociclib will increase the level or effect of escitalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.Serious - Use Alternative (2)ribociclib increases toxicity of escitalopram by QTc interval. Avoid or Use Alternate Drug. escitalopram increases toxicity of ribociclib by QTc interval. Avoid or Use Alternate Drug.rifabutinMonitor Closely (1)rifabutin will decrease the level or effect of escitalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.rifampinMonitor Closely (2)rifampin will decrease the level or effect of escitalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. rifampin will decrease the level or effect of escitalopram by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.rifapentineMonitor Closely (1)rifapentine will decrease the level or effect of escitalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.rilpivirineMonitor Closely (2)escitalopram increases toxicity of rilpivirine by QTc interval. Use Caution/Monitor. rilpivirine increases toxicity of escitalopram by QTc interval. Use Caution/Monitor. Rilpivirine should be used with caution when co-administered with a drug with a known risk of Torsades de Pointes.risperidoneMonitor Closely (1)escitalopram increases toxicity of risperidone by QTc interval. Use Caution/Monitor.ritonavirMonitor Closely (1)ritonavir increases levels of escitalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Potential for increased toxicity. Increased risk of serotonin syndrome.rivaroxabanMonitor Closely (1)escitalopram increases effects of rivaroxaban by pharmacodynamic synergism. Use Caution/Monitor. Combination may increase risk of bleeding.rizatriptanMonitor Closely (1)rizatriptan and escitalopram both increase serotonin levels. Modify Therapy/Monitor Closely.Minor (1)escitalopram, rizatriptan. Mechanism: unknown. Minor/Significance Unknown. Risk of weakness, dyspnea, chest pain.romidepsinMonitor Closely (1)escitalopram increases toxicity of romidepsin by QTc interval. Use Caution/Monitor.ropeginterferon alfa 2bSerious - Use Alternative (1)ropeginterferon alfa 2b, escitalopram. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.safinamideMonitor Closely (1)escitalopram, safinamide. Either increases toxicity of the other by serotonin levels. Use Caution/Monitor. Monitor patients for symptoms of serotonin syndrome if SSRIs are coadministered with safinamide.salicylates (non-asa)Monitor Closely (1)escitalopram, salicylates (non-asa). Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.salsalateMonitor Closely (1)escitalopram, salsalate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.SAMeMonitor Closely (1)escitalopram and SAMe both increase serotonin levels. Modify Therapy/Monitor Closely.saquinavirSerious - Use Alternative (2)saquinavir will increase the level or effect of escitalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. escitalopram increases toxicity of saquinavir by QTc interval. Avoid or Use Alternate Drug.secobarbitalMonitor Closely (2)secobarbital will decrease the level or effect of escitalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. secobarbital will decrease the level or effect of escitalopram by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.selegilineContraindicated (1)selegiline and escitalopram both increase serotonin levels. Contraindicated. At least 14 days should elapse between discontinuation of selegiline and initiation of treatment with a serotonergic drug.selegiline transdermalSerious - Use Alternative (1)selegiline transdermal and escitalopram both increase serotonin levels. Avoid or Use Alternate Drug.selinexorSerious - Use Alternative (1)selinexor, escitalopram. unspecified interaction mechanism. Avoid or Use Alternate Drug. Patients treated with selinexor may experience neurological toxicities. Avoid taking selinexor