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Citalopram

US Brand Name: CeleXA

Description

Citalopram is used to treat depression, including major depressive disorder (MDD). It is an antidepressant that belongs to a group of medicines known as selective serotonin reuptake inhibitors (SSRIs). These medicines are thought to work by increasing the activity of a chemical called serotonin in the brain.

This medicine is available only with your doctor's prescription.

This product is available in the following dosage forms:

Tablet

Solution

Capsule

How is citalopram supplied (dosage forms)?

Citalopram is available in the following dosage forms that are taken by mouth.

30 mg oral capsules

10 mg/5mL oral solution

10 mg, 20 mg, 40 mg oral tablets

How should I store citalopram?

Oral Capsules and Tablets. Citalopram oral capsules or oral tablets should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). They can be exposed to temperatures between 59 F to 86 F (15 C to 30 C), for shorter periods of time, such as when transporting them. Store in a cool, dry place.

Oral Liquid. Citalopram oral solution should be stored at room temperature, between 68 F to 77 F (20 C to 25 C).

Before Using

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 this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine 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

Citalopram capsules is not recommended for use in the elderly because an adjustment in the dose is not possible with the available dose strength of this medicine.

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.

Breastfeeding

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

Drug Interactions

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 this medicine, 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 this medicine 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.

Bepridil

Bromopride

Cisapride

Dronedarone

Fluconazole

Isocarboxazid

Levoketoconazole

Linezolid

Mesoridazine

Methylene Blue

Metoclopramide

Ozanimod

Phenelzine

Pimozide

Piperaquine

Posaconazole

Procarbazine

Rasagiline

Safinamide

Selegiline

Sparfloxacin

Terfenadine

Thioridazine

Tranylcypromine

Ziprasidone

Using this medicine 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

Adagrasib

Alfentanil

Alfuzosin

Almotriptan

Amineptine

Amiodarone

Amisulpride

Amitriptyline

Amitriptylinoxide

Amoxapine

Amphetamine

Amtolmetin Guacil

Anagrelide

Anileridine

Apixaban

Apomorphine

Ardeparin

Argatroban

Aripiprazole

Aripiprazole Lauroxil

Armodafinil

Arsenic Trioxide

Artemether

Asenapine

Aspirin

Astemizole

Atazanavir

Azathioprine

Azithromycin

Bedaquiline

Bemiparin

Benzhydrocodone

Benzphetamine

Betrixaban

Bivalirudin

Bromfenac

Using this medicine 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.

Ginkgo Irinotecan Mavacamten Rifampin

Other Interactions

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.

Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

Bipolar disorder (mood disorder with mania and depression), or risk of or

Bleeding problems or

Glaucoma, angle-closure or

Hyponatremia (low sodium in the blood) or

Mania, history of or

Seizures, history of or

Sexual problems—Use with caution. May make these conditions worse.

Bradycardia (slow heart rate) or

Heart attack, recent or

Heart failure or

Heart rhythm problems (eg, congenital long QT syndrome) or

Hypokalemia (low potassium in the blood) or

Hypomagnesemia (low magnesium in the blood)—Use with caution. May cause side effects to become worse.

Kidney disease, severe or

Liver disease—Use with caution. The effects may be increased because of slower removal of the medicine from the body.

Proper Use

Take this medicine 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.

This medicine should come with a Medication Guide. Read and follow these instructions carefully. Ask your doctor or pharmacist if you have any questions.

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 average household teaspoon may not hold the right amount of liquid.

You may have to take citalopram for a month or longer before you begin to feel better.

Dosing

Usual Adult Dose for Depression:

Initial dose: 20 mg orally once a day

Maintenance dose: 20 to 40 mg orally once a day

Maximum dose: 40 mg orally per day

Comments:

-The initial dose may be increased if necessary to 40 mg once a day after at least 1 week of therapy.

-Doses of 60 mg/day did not demonstrate an advantage in efficacy over 40 mg/day doses.

-Acute episodes of depression may require several months or more of sustained pharmacologic therapy

Use: Treatment of depression

Usual Geriatric Dose for Depression:

Over 60 years of age:

Recommended dose: 20 mg orally once a day

Comments:

-Doses of 60 mg/day did not demonstrate an advantage in efficacy over 40 mg/day doses.

-Acute episodes of depression may require several months or more of sustained pharmacologic therapy.

Use: Treatment of depression

Missed Dose

If you miss a dose of this medicine, 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

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 with a monoamine oxidase (MAO) inhibitor (eg, isocarboxazid [Marplan®], linezolid (Zyvox®), methylene blue injection, phenelzine [Nardil®], selegiline [Eldepryl®], tranylcypromine [Parnate®]). Do not start taking citalopram during the 14 days after you stop a MAO inhibitor. Wait 14 days after stopping citalopram before you start taking a MAO inhibitor. If you take them together or do not the proper amount of time, you may develop confusion, agitation, restlessness, stomach or intestinal symptoms, a sudden high body temperature, an extremely high blood pressure, or severe seizures.

Do not take pimozide (Orap®) while you are taking this medicine. Using these medicines together can cause very serious heart problems.

Citalopram may cause a serious condition called serotonin syndrome if taken together with some medicines. Do not use citalopram with buspirone (Buspar®), fentanyl (Abstral®, Duragesic®), lithium (Eskalith®, Lithobid®), methylene blue injection, tryptophan, St John's wort, amphetamines, or some pain or migraine medicines (eg, meperidine, methadone, rizatriptan, sumatriptan, tramadol, Demerol®, Frova®, Imitrex®, Maxalt®, Methadose®, Relpax®, Ultram®, Zomig®). Check with your doctor first before taking any other medicines with citalopram.

Citalopram may cause some teenagers and young adults to be agitated, irritable, or display other abnormal behaviors. It may also cause some people to have suicidal thoughts and tendencies or to become more depressed. Some people may have trouble sleeping, get upset easily, have a big increase in energy, or start to act reckless. If you or your caregiver notice any of these unwanted effects, tell your doctor right away. Let the doctor know if you or anyone in your family has bipolar disorder (manic-depressive) or has tried to commit suicide.

Contact your doctor right away if you have any changes to your heart rhythm. You might feel dizzy or faint, or you might have a fast, pounding, or irregular heartbeat. Make sure your doctor knows if you or anyone in your family has ever had a heart rhythm problem including QT prolongation or slow heartbeat.

Do not suddenly stop taking this medicine without checking first with your doctor. Your doctor may want you to gradually reduce the amount you are using before stopping it completely. This will decrease the chance of having withdrawal symptoms including agitation, breathing problems, chest pain, confusion, diarrhea, dizziness or lightheadedness, fast heartbeat, headache, increased sweating, muscle pain, nausea, restlessness, runny nose, trouble in sleeping, trembling or shaking, unusual tiredness or weakness, vision changes, or vomiting.

This medicine may increase your risk for bleeding problems. Make sure your doctor knows if you are also taking other medicines that thin the blood, including aspirin, NSAIDs (eg, diclofenac, ibuprofen, naproxen, Advil®, Aleve®, Celebrex®, Voltaren®), or warfarin (Coumadin®, Jantoven®).

This medicine 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. Check with your doctor right away if you have confusion, headache, memory problems, trouble concentrating, weakness, or feel unsteady when standing.

The use of alcohol is not recommended in patients who are taking this medicine.

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

Your doctor may want to monitor your child's weight and height, because this medicine may cause decreased appetite and weight loss in children.

Check with your doctor right away if you have decreased interest in sexual intercourse, delayed or inability to have an orgasm, inability to have or keep an erection, or loss in sexual ability, desire, drive, or performance. These could be symptoms of sexual dysfunction.

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 (eg, St. John's wort) or vitamin supplements.

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Control Help line at 800-222-1222.

Side Effects

Get emergency medical help if you have signs of an allergic reaction to citalopram: hives, difficult breathing, swelling of your face, lips, tongue, or throat.

Tell your doctor right away if you have new or sudden changes in mood or behavior, including new or worse depression or anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, more active or talkative, or have thoughts about suicide or hurting yourself.

Citalopram may cause serious side effects. Call your doctor at once if you have:

a light-headed feeling, like you might pass out;

blurred vision, eye pain or redness, seeing halos around lights;

fast or pounding heartbeats, pain or fluttering in your chest, shortness of breath, and sudden dizziness (like you might pass out);

a seizure;

unusual bleeding - nosebleeds, bleeding gums, abnormal vaginal bleeding, any bleeding that will not stop;

manic episodes - racing thoughts, increased energy, decreased need for sleep, risk-taking behavior, being agitated or talkative;

severe nervous system reaction - very stiff (rigid) muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors; or

low blood sodium - headache, confusion, problems with thinking or memory, weakness, feeling unsteady.

Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.

Citalopram can affect growth in children. Tell your doctor if your child is not growing at a normal rate while using this medicine.

Common citalopram side effects may include:

sexual problems;

dizziness, drowsiness;

dry mouth, thirst, increased sweating or urination;

loss of appetite, nausea, diarrhea, constipation;

feeling anxious, agitated, or shaky;

feeling weak or tired, sleep problems (insomnia), yawning;

increased muscle movement;

nosebleed, heavy menstrual bleeding; or

cold symptoms such as stuffy nose, sneezing, sore throat.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 800-FDA-1088.

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Most recent revision June 12, 2025 08:58:15 PM