Interactions

Drug-Drug

• May cause serious, potentially fatal reactions when used with MAO inhibitors; allow at least 14 days between citalopram and MAO inhibitors

• Concurrent use with pimozide may result in prolongation of the QTc interval and is contraindicated

• Use cautiously with other centrally acting drugs (including alcohol, antihistamines, opioid analgesics, and sedative/hypnotics; concurrent use with alcohol is not recommended)

• Cimetidine blood levels of citalopram

• Serotonergic effects may be by lithium (concurrent use should be carefully monitored)

• Ketoconazole, itraconazole, erythromycin, and omeprazole may blood levels

• Carbamazepine may blood levels

• May blood levels of metoprolol

• Concurrent use with tricyclic antidepressants should be undertaken with caution because of altered pharmacokinetics

• Concurrent use with 5-HT1 agonists used for migraine headaches may risk of adverse reactions (weakness, hyperreflexia, incoordination)

• Use cautiously with tricyclic antidepressants due to unpredictable effects on serotonin and norepinephrine reuptake

• Risk of bleeding may be with aspirin, NSAIDs, warfarin, thrombolytics, and other agents affecting coagulation and platelet function

Drug-Natural Products
risk of serotonergic side effects including serotonin syndrome with St. John's wort and SAMe

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