Provided by You Health for patients

In this medication overview

1. Usage

   How to get the most out of your treatment

2. Warnings

   Important safety information

3. Side Effects

   What to look out for when using your treatment

Usage

1. To get started, follow your provider's dosing instructions
   If you are not already taking citalopram, your provider will likely want you to begin by taking a starting dose for the first 7 days or the first 4 weeks depending on the pill strength prescribed. This may require you to break your pill in half using your hands or an inexpensive pill cutter that can be found at most pharmacies. If your pill splits a bit unevenly, that's okay. Be sure to follow the instructions your provider sent to help your body safely adjust to citalopram.
2. Missed a dose?
   If you miss a dose of citalopram, take it as soon as you remember, unless it is closer to the time of your next dose. Discuss this with your healthcare provider. Do not double your next dose or take more than what is prescribed.
3. Use as prescribed
   Do not abruptly stop taking citalopram or change your dose without talking with your healthcare provider first, even when you feel better. Studies have shown that a taper can reduce possible side-effects caused by stopping the medication abruptly. Abruptly stopping can cause discontinuation symptoms including: vomiting, irritability, dizziness, headaches, sensation of tingling skin, or nightmares. Studies have shown that a taper can reduce possible discontinuation symptoms. Your healthcare provider can provide individualized guidance on tapering your medication. Here are some general guidelines.
   
   If you are taking 40 mg of citalopram, take a ½ tablet (20 mg) for a week, then a ¼ tablet (10 mg) for a week (you may need a pill splitter), then you may stop your medication.
   
   If you are taking 20 mg of citalopram, take a ½ tablet (10 mg) for a week, then you may stop your medication.
   
   If you are taking 10 mg of citalopram, you probably don’t require a taper. If you like, you can take a ½ tablet for a week before stopping.
   
   Your healthcare provider can also provide individualized guidance for tapering your medication.
4. Monitor for improvements
   Sleep, energy, or appetite may show some improvement within the first 1-2 weeks. Improvement in these physical symptoms can be an important early signal that the medication is working. Depressed mood and lack of interest in activities may need up to 6-8 weeks to fully improve.

Warnings

SUICIDALITY AND ANTIDEPRESSANT DRUGS

IMPORTANT SAFETY INFORMATION

Do not take Citalopram if you:

• Are allergic to Citalopram, or any of the ingredients in Citalopram
• Take any medicines called monoamine oxidase inhibitor (MAOI), or if you have stopped taking and MAOI in the last 14 days
• Take St John’s Wort or 5-Hydroxytryptophan (5-HTP)
• Are on methadone
• Are drinking alcohol
• Are using or abusing recreation drugs or prescription medications

Inform your healthcare provider

Citalopram may affect the way other medicines work, and other medicines may affect the way Citalopram works, causing side effects. Especially tell your healthcare provider if you take any of the following:

• Aspirin and nonsteroidal anti-inflammatory drugs (e.g. ibuprofen, naproxen, celecoxib, diclofenac)
• Any other serotonergic medications, migraine medications (triptans), pain medications (tramadol), antibiotic linezolid, amphetamines
• Warfarin or other anticoagulants
• Certain antiarrhythmics: quinidine (Quinidex Extentabs®, Quinaglute®, Quinalan®), procainamide (Procanbid®, Pronestyl®, Pronestyl-SR®), amiodarone (Cordarone®, Pacerone®), sotalol (Betapace®, Sorine®)
• Certain antipsychotics: chlorpromazine (Thorazine®), thioridazine (Mellaril®)
• Certain antibiotics: gatifloxacin (Tequin®), moxifloxacin (Avelox®)
• Methadone

Citalopram may increase the risk of bleeding when taking blood thinners or nonsteroidal anti-inflammatory drugs (NSAIDs). If you are currently taking blood thinners or NSAIDs, we strongly recommend that you inform your primary care provider that you have started taking this mental health medication and be sure to report any signs of abnormal bleeding to your provider, such as bleeding gums, unexplained bruising, or black, tarry stools.

Medication disposal

If no drug take back sites, locations, or programs are available in your area, and there are no specific disposal instructions (such as flushing) in the medication guide or package insert, you can visit FDA- Disposal of Unused Medicines for more information or follow these simple steps to dispose of most medicines in your trash at home:

• Mix medicines (liquid or pills; do not crush tablets or capsules) with an unappealing substance such as dirt, cat litter, or used coffee grounds;
• Place the mixture in a container such as a sealed plastic bag;
• Throw away the container in your trash at home; and
• Delete all personal information on the prescription label of empty medicine bottles or medicine packaging, then trash or recycle the empty bottle or packaging.

Side effects

Citalopram can cause serious side effects and should be reported to your provider immediately. Rarely reported side effects include:

• Increased bleeding (gums)
• Low sodium blood levels (symptoms may include headache, weakness and difficulty remembering or concentrating)
• Teeth grinding
• Seizure
• Angle closure glaucoma (symptoms of angle closure glaucoma may include eye pain, changes in vision, swelling or redness in or around eye)
• At higher doses may cause abnormal electrical activity of the heart
• Serotonin syndrome (symptoms may include shivering, diarrhea, confusion, severe muscle tightness, fever, seizures, and death)

During treatment with this medication, common side effects of this medication may go away as your body adjusts to the medication. The most common side effects of Citalopram are:

• Diarrhea
• Nausea
• Increased sweating
• Nervousness,
• Fatigue or feeling sleepy
• Insomnia

Where to find more side effects information