Citalopram Hydrobromide

Citalopram is an antidepressant in a group of drugs called selective serotonin reuptake inhibitors (SSRIs).

Citalopram is used to treat depression.

Citalopram may also be used for purposes not listed in this medication guide.

You should not use this medicine if you are allergic to citalopram or escitalopram (Lexapro), or if you also take pimozide.

Do not use citalopram if you have used an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others.

To make sure citalopram is safe for you, tell your doctor if you have:

• a bleeding or blood clotting disorder;
• liver or kidney disease;
• narrow-angle glaucoma;
• seizures or epilepsy;
• heart disease, heart failure, a heart rhythm disorder, slow heartbeats, or recent history of heart attack;
• personal or family history of Long QT syndrome;
• an electrolyte imbalance (such as low levels of potassium or magnesium in your blood);
• bipolar disorder (manic depression); or
• a history of drug abuse or suicidal thoughts.

Some young people have thoughts about suicide when first taking an antidepressant. Your doctor should check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms.

Taking an SSRI antidepressant during pregnancy may cause serious lung problems or other complications in the baby. However, you may have a relapse of depression if you stop taking your antidepressant. Tell your doctor right away if you become pregnant. Do not start or stop taking this medicine during pregnancy without your doctor's advice.

Citalopram can pass into breast milk and may harm a nursing baby. You should not breast-feed while you are using citalopram.

Do not give this medicine to anyone under 18 years old without medical advice. Citalopram is not approved for use in children.

Follow all directions on your prescription label. Your doctor may occasionally change your dose. Do not use this medicine in larger or smaller amounts or for longer than recommended.

Measure liquid medicine with the dosing syringe provided, or with a special dose-measuring spoon or medicine cup. If you do not have a dose-measuring device, ask your pharmacist for one.

It may take up to 4 weeks before your symptoms improve. Keep using the medication as directed and tell your doctor if your symptoms do not improve.

Do not stop using citalopram suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using this medicine.

Store at room temperature away from moisture and heat.

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Ask your doctor before taking a nonsteroidal anti-inflammatory drug (NSAID) for pain, arthritis, fever, or swelling. This includes aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib (Celebrex), diclofenac, indomethacin, meloxicam, and others. Using an NSAID with citalopram may cause you to bruise or bleed easily.

Drinking alcohol can increase certain side effects of citalopram.

Citalopram may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Get emergency medical help if you have signs of an allergic reaction: skin rash or hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

Call your doctor at once if you have:

• a light-headed feeling, like you might pass out;
• blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights;
• headache with chest pain and severe dizziness, fainting, fast or pounding heartbeats;
• severe nervous system reaction--very stiff (rigid) muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, feeling like you might pass out;
• high levels of serotonin in the body--agitation, hallucinations, fever, fast heart rate, overactive reflexes, nausea, vomiting, diarrhea, loss of coordination, fainting; or
• low levels of sodium in the body--headache, confusion, slurred speech, severe weakness, vomiting, feeling unsteady.

Common side effects may include:

• problems with memory or concentration;
• headache, drowsiness;
• dry mouth, increased sweating;
• numbness or tingling;
• increased appetite, nausea, diarrhea, gas;
• fast heartbeats, feeling shaky;
• sleep problems (insomnia), feeling tired;
• cold symptoms such as stuffy nose, sneezing, sore throat;
• changes in weight; or
• difficulty having an orgasm.

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 1-800-FDA-1088.

Taking citalopram with other drugs that make you sleepy or slow your breathing can cause dangerous side effects or death. Ask your doctor before taking a sleeping pill, narcotic pain medicine, prescription cough medicine, a muscle relaxer, or medicine for anxiety, depression, or seizures.

Many drugs can interact with citalopram. Not all possible interactions are listed here. Tell your doctor about all your current medicines and any you start or stop using, especially:

• cimetidine;
• lithium;
• St. John's wort;
• tryptophan (sometimes called L-tryptophan);
• a blood thinner (warfarin, Coumadin, Jantoven);
• any other antidepressant;
• heart medication;
• medicine to treat a psychiatric disorder; or
• "triptan" migraine headache medicine.

This list is not complete and many other drugs can interact with citalopram. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Give a list of all your medicines to any healthcare provider who treats you.

Your pharmacist can provide more information about citalopram.