AdultPediatricGeriatricDosage Forms & Strengths tablet 10mg 20mg 40mg oral solution 10mg/5mL Depression Depression in patients whose diagnosis corresponds most closely to the DSM-III and DSM-III-R category of major depressive disorder Initial dose: 20 mg PO qDay If needed, may increase to 40 mg/day after at least 1 week Doses above 40 mg/day are not recommended, because of risk for QT prolongation without additional benefit for treating depression Dosing Modifications Poor CYP2C19 metabolizers or coadministration with CYP2C19 inhibitors (eg, cimetidine, fluconazole, omeprazole): Do not exceed 20 mg/day Hepatic impairment decreases clearance and therefore increases risk of QT prolongation; do not exceed 20 mg/day MAO inhibitors Not for administration within 14 days of administering a MAO inhibitor Linezolid or Methylene Blue Therapy Not for administration to patients that are receiving linezolid or IV methylene blue; consider other forms of therapy; if therapy required and benefits outweigh risks discontinue citalopram therapy, administer linezolid or methylene blue and monitor for serotonin syndrome for 2 weeks or 24 hr after last dose of linezolid or methylene blue Renal impairment Mild to moderate renal impairment: No dosage adjustment required Severe renal impairment (CrCl <20 mL/min): Not studied; use with caution Alcoholism (Off-label) 20-40 mg PO qDay Binge-eating Disorder (Off-label) 20-60 PO qDay Generalized Anxiety Disorder (Off-label) Initial: 10 mg PO qDay; may titrate to 40 mg/day Panic Disorder (Off-label) 20 mg PO qDay initially; after 1 week, may increase to 40 mg/day if warranted Not to exceed 40 mg/day because of increased risk for QT prolongation Hot Flashes (Off-label) Initial: 10 mg PO qDay; may increase to 20 mg/day after 1 week Obsessive-Compulsive Disorder (Off-label) Initial: 20 mg PO qDay; may titrate to 40-60 mg/day; improvement may be seen 4-6 weeks after initiating therapy Premenstrual Dysphoric Disorder (Off-label) 5 mg PO on the estimated day of ovulation; increase dose by 5 mg each day thereafter to maximum 30 mg; continue thereafter until menstruation begins; decrease dose to 20 mg on the first day of menstruation; the next day, decrease to 10 mg; stop the treatment from day 3 until ovulation beginsDosage Forms & Strengths tablet 10mg 20mg 40mg oral solution 10mg/5mL Depression (Off-label) <12 years 10 mg PO qDay; may increase by 5 mg/day every 2 weeks to 40 mg PO qDay; doses >40 mg not recommended (may increase risk of QT prolongation) ≥12 years 20 mg PO qDay; may increase by 10 mg/day every 2 weeks to 40 mg PO qDay; doses >40 mg not recommended (may increase risk of QT prolongation) Impulsive Aggresive Behavior (Off-label) 10 mg PO qDay; titrate by 10 mg/week, as tolerated to maximum 40 mg/dayDepression >60 years: Do not exceed 20 mg PO qDay Dosing Considerations -The elderly are more prone to SSRI/SNRI-induced hyponatremia and risk for QT prolongationInteraction CheckerEnter a drug name and citalopramNo Results No Interactions Found Interactions FoundContraindicatedSerious - Use AlternativeSignificant - Monitor CloselyMinorAll Interactions Sort By: SeverityName Contraindicated (13)dronedaronedronedarone and citalopram both increase QTc interval. Contraindicated. Concurrent use of dronedarone with other agents that can prolong QT interval is contraindicated. fezolinetantcitalopram will increase the level or effect of fezolinetant by affecting hepatic enzyme CYP1A2 metabolism. Contraindicated. Fezolinetant AUC and peak plasma concentration are increased if coadministered with drugs that are weak, moderate, or strong CYP1A2 inhibitorsfluconazolecitalopram and fluconazole both increase QTc interval. Contraindicated.goserelingoserelin increases toxicity of citalopram by QTc interval. Contraindicated. Increases risk of torsades de pointes.isocarboxazidisocarboxazid 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.leuprolideleuprolide increases toxicity of citalopram by QTc interval. Contraindicated. Increases risk of torsades de pointes.phenelzinephenelzine 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.pimozidecitalopram and pimozide both increase QTc interval. Contraindicated.procarbazineprocarbazine 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.selegilineselegiline 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.selegiline transdermalselegiline transdermal 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.tranylcyprominetranylcypromine 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.ziprasidoneziprasidone and citalopram both increase QTc interval. Contraindicated.Serious - Use Alternative (145)abametapirabametapir will increase the level or effect of citalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. For 2 weeks after abametapir application, avoid taking drugs that are CYP3A4 substrates. If not feasible, avoid use of abametapir.adagrasibadagrasib, citalopram. Either increases effects of the other by QTc interval. Avoid or Use Alternate Drug. Each drug prolongs the QTc interval, which may increased the risk of Torsade de pointes, other serious arryhthmias, and sudden death. If coadministration unavoidable, more frequent monitoring is recommended for such patients.alfentanilalfentanil, citalopram. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.alfuzosinalfuzosin and citalopram both increase QTc interval. Avoid or Use Alternate Drug.almotriptancitalopram, almotriptan. 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.amisulpridecitalopram and amisulpride both increase QTc interval. Avoid or Use Alternate Drug. ECG monitoring is recommended if coadministered.amitriptylinecitalopram and amitriptyline 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 amitriptyline both increase QTc interval. Avoid or Use Alternate Drug.amoxapinecitalopram and amoxapine 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.anagrelidecitalopram and anagrelide both increase QTc interval. Avoid or Use Alternate Drug.apalutamideapalutamide will decrease the level or effect of citalopram by affecting hepatic enzyme CYP2C19 metabolism. Avoid or Use Alternate Drug. Coadministration of apalutamide, a strong CYP2C19 inducer, with drugs that are CYP2C19 substrates can result in lower exposure to these medications. Avoid or substitute another drug for these medications when possible. Evaluate for loss of therapeutic effect if medication must be coadministered.apalutamide will decrease the level or effect of citalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Coadministration of apalutamide, a strong CYP3A4 inducer, with drugs that are CYP3A4 substrates can result in lower exposure to these medications. Avoid or substitute another drug for these medications when possible. Evaluate for loss of therapeutic effect if medication must be coadministered. Adjust dose according to prescribing information if needed.aripiprazolearipiprazole and citalopram both increase QTc interval. Avoid or Use Alternate Drug.artemetherartemether and citalopram both increase QTc interval. Avoid or Use Alternate Drug.buprenorphinecitalopram and buprenorphine both increase QTc interval. Avoid or Use Alternate Drug.buprenorphine buccalbuprenorphine buccal and citalopram both increase QTc interval. Avoid or Use Alternate Drug.buprenorphine subdermal implantbuprenorphine subdermal implant and citalopram both increase QTc interval. Avoid or Use Alternate Drug.buprenorphine transdermalbuprenorphine transdermal and citalopram both increase QTc interval. Avoid or Use Alternate Drug.buprenorphine, long-acting injectionbuprenorphine, long-acting injection and citalopram both increase QTc interval. Avoid or Use Alternate Drug.buspironecitalopram and buspirone both increase serotonin levels. Avoid or Use Alternate Drug. Combination may increase risk of serotonin syndrome or neuroleptic malignant syndrome-like reactions.ceritinibceritinib and citalopram both increase QTc interval. Avoid or Use Alternate Drug.ceritinib will increase the level or effect of citalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.cisapridecitalopram and cisapride both increase QTc interval. Avoid or Use Alternate Drug.clarithromycinclarithromycin, citalopram. Either increases toxicity of the other by QTc interval. Avoid or Use Alternate Drug. To monitor for the prolongation of QT/QTc and/or development of ventricular tachyarrhythmias the labeling recommends monitoring QT interval or ECG.clomipraminecitalopram and clomipramine 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 clomipramine both increase QTc interval. Avoid or Use Alternate Drug.clozapinecitalopram and clozapine both increase QTc interval. Avoid or Use Alternate Drug.cocaine topicalcitalopram and cocaine topical both increase serotonin levels. Avoid or Use Alternate Drug. Combination may increase risk of serotonin syndrome or neuroleptic malignant syndrome-like reactions.crizotinibcitalopram and crizotinib both increase QTc interval. Avoid or Use Alternate Drug.cyclobenzaprinecitalopram and cyclobenzaprine both increase serotonin levels. Avoid or Use Alternate Drug.dacomitinibdacomitinib will increase the level or effect of citalopram by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug. Avoid use with CYP2D6 substrates where minimal increases in concentration of the CYP2D6 substrate may lead to serious or life-threatening toxicities. desfluranedesflurane and citalopram both increase QTc interval. Avoid or Use Alternate Drug.desipraminecitalopram and desipramine 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.desipramine and citalopram both increase QTc interval. Avoid or Use Alternate Drug.desvenlafaxinecitalopram and desvenlafaxine both increase serotonin levels. Avoid or Use Alternate Drug.dextromethorphancitalopram and dextromethorphan both increase serotonin levels. Avoid or Use Alternate Drug. Combination may increase risk of serotonin syndrome or neuroleptic malignant syndrome-like reactions.dolasetrondolasetron, citalopram. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.donepezildonepezil and citalopram both increase QTc interval. Avoid or Use Alternate Drug.doxepincitalopram and doxepin 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.doxepin and citalopram both increase QTc interval. Avoid or Use Alternate Drug.duloxetinecitalopram and duloxetine both increase serotonin levels. Avoid or Use Alternate Drug. Combination may increase risk of serotonin syndrome or neuroleptic malignant syndrome-like reactions.efavirenzefavirenz will decrease the level or effect of citalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.efavirenz and citalopram both increase QTc interval. Avoid or Use Alternate Drug.eletriptancitalopram, eletriptan. 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.eliglustatcitalopram and eliglustat both increase QTc interval. Avoid or Use Alternate Drug.encorafenibencorafenib and citalopram both increase QTc interval. Avoid or Use Alternate Drug. Encorafenib is associated with dose-dependent QTc interval prolongation. Avoid with drugs known to prolong QT interval.entrectinibcitalopram and entrectinib both increase QTc interval. Avoid or Use Alternate Drug.eribulincitalopram and eribulin both increase QTc interval. Avoid or Use Alternate Drug.erythromycin basecitalopram and erythromycin base both increase QTc interval. Avoid or Use Alternate Drug.erythromycin ethylsuccinatecitalopram and erythromycin ethylsuccinate both increase QTc interval. Avoid or Use Alternate Drug.erythromycin lactobionatecitalopram and erythromycin lactobionate both increase QTc interval. Avoid or Use Alternate Drug.erythromycin stearatecitalopram and erythromycin stearate both increase QTc interval. Avoid or Use Alternate Drug.escitalopramcitalopram and escitalopram both increase serotonin levels. Avoid or Use Alternate Drug. 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.fentanylfentanyl, citalopram. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.fentanyl intranasalfentanyl intranasal, citalopram. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.fentanyl transdermalfentanyl transdermal, citalopram. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.fentanyl transmucosalfentanyl transmucosal, citalopram. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.fexinidazolefexinidazole and citalopram both increase QTc interval. Avoid or Use Alternate Drug. Avoid coadministration of fexinidazole with drugs known to block potassium channels or prolong QT interval.fexinidazole will increase the level