Drug Interaction:
Selective serotonin reuptake inhibitors include-
Fluoxetine, Fluvoxamine, Paroxetine, Sertraline, Citalopram, Escitalopram
Refer- Fluoxetine
Reports of enhanced serotonergic effects when other SSRI's have been given with lithium and tryptophan and therfore the concomittant use of citalopram with these drugs should be undertaken with caution.
Cimetidine causes a moderate increase in the average steady state levels of citalopram.
Experience with citalopram has not revealed any clinically relevant interactions with neuroleptics
However, as with other SSRIs the possibility of a pharmacodynamic interaction cannot be excluded.
Indication:
Depressive illness
Approved by (DCI) Drug Controller GENERAL - India For Marketing
(Ref- IDMA Publication)
Name of Drug Indication Date of Approval
Citalopram HBr Anti-depressant 0-3-10-2001
Patent Expiry Date of drugs (Ref - IDMA Publication)
Chemical Category Manufacturer/ US Patent
Ingredient- Marketer Expiration Date
Citalopram CNS Forest Laboratories 17-01-2004
Selective serotonin reuptake inhibitors include- Fluoxetine, Fluvoxamine, Paroxetine, Sertraline, Citalopram, Escitalopram
Refer- Fluoxetine
Adverse Reaction:
Increased sweating, headache, tremor, dizziness, abnormal accomodation, somnolence,
insomnia, agitation, nervousness, nausea, dry mouth, constipation, diarrhoea, palpitation,
asthenia, rash, pruritus, migraine amnesia, anxiety, increased appetite, anorexia, suicide attempt.
Contra-Indications:
Hypersensitivity
Special precautions:
Should not be given to patients receiving monoamine oxidase inhibitors, or for 14 days after their discontinuation.
Until further evidence is available it is advised not to use citalopram simultaneously with 5-HT agonists eg., sumatriptan.
Should be discontinued if the patient enters a manic phase.
Due to limited human data, it should only be used in pregnancy if considered necessary and under the close supervision of a physician
Citalopram appears in breast milk in very low concentrations.
Dosages/ Overdosage Etc:
Date of Approval 2001
Indication-
Depression
Dosage-
Adults -20mg should be administered as a single oral dose.
Dose may be increased to a maximum of 60mg daily.
Patient Information:
Refer- Fluoxetine
Pharmacology/ Pharmacokinetics:
Pharmacology:
Citalopram is a potent inhibitor of the serotin 5-hydroxytryptamine (5-HT) uptake. Tolerance to the inhibition of 5-HT uptake is not induced by long term treatment with citalopram.
Pharmacokinetics:
Absorption is almost complete and independent of food intake. The oral bioavailability is about 80%. Steady state plasma levels are reached in 1-2 weeks. it is metabolised into active metabolites which are also SSRIs, although weaker than the parent compound.
The elimination half-life is about 1and 1/2 days.
Citalopram is excreted mainly via the liver (85%) and the remainder (15%) via the kidneys. 12-23% of the daily dose is excreted in urine as unchanged citalopram.
Interaction with Food:
Absorption is almost complete and independent of food intake.
Pregnancy and lactation:
Should only be used in pregnancy if considered necessary and under the close supervision of a physician
Citalopram appears in breast milk in very low concentrations.
Manufacturer Details