Drug Index

Citalopram

 
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Mechanism :

Citalopram is an orally administered selective serotonin reuptake inhibitor (SSRI) with a chemical structure unrelated to that of other SSRIs or of tricyclic, tetracyclic, or other available antidepressant agents.


Indication :

• Depression

• Obsessive compulsive disorder

• Anxiety


Contraindications :

Concomitant use in patients taking monoamine oxidase inhibitors (MAOIs) and pimozide is contraindicated. And in patients with a hypersensitivity to citalopram.


Dosing :

<12 years: 10 mg/day PO; every 2 weeks, may be increased by 5 mg/day to 40 mg PO/day.

≥12 years: 20 mg/day PO; every 2 weeks, may be increased by 10 mg/day to 40 mg PO/day.


Adverse Effect :

Dry mouth, nausea, headache, light headedness, restlessness, anxiety, somnolence, seizures, rash, urticaria, fever, neuroleptic malignant syndrome, social disinhibition, euphoria, mania, diminished libido, anorgasmia.


Interaction :

NSAIDs, Aspirin, Warfarin: Concurrent use of an NSAID or aspirin potentiated the risk of upper gastrointestinal bleeding.
Cimetidine: Resulted in an increase in citalopram levels.
Sumatriptan: Weakness, hyperreflexia, and incoordination following the use of a SSRI and sumatriptan.
Carbamazepine: The possibility that carbamazepine might increase the clearance of citalopram should be considered if the two drugs are coadministered.
Metoprolol: Two-fold increase in the plasma levels of the beta-adrenergic blocker metoprolol.



Renal Dose :

Dose in Renal Impairment GFR (mL/min)
20-50Dose as in normal renal function
10-20Dose as in normal renal function
<10Dose as in normal renal function.Use with caution

Dose in Patients undergoing Renal Replacement Therapies
CAPDUnlikely to be dialysed. Dose as in GFR<10 mL/min
HDNot dialysed. Dose as in GFR<10 mL/min
HDF/High fluxNot dialysed. Dose as in GFR<10 mL/min
CAV/VVHDUnlikely to be dialysed. Dose as in GFR=10–20 mL/min

Hepatic Dose :

Do not exceed 20 mg PO OD in hepatic impairment, due to the risk of QT prolongation. Monitor QTc and adjust the dose.
05/30/2020 06:04:59 Citalopram
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