Citalopram (By mouth)

Brand Name(s)

Celexa

When This Medicine Should Not Be Used

How to Use This Medicine

Liquid, Tablet

• Your doctor will tell you how much of this medicine to use and how often. Your dose may need to be changed several times in order to find out what works best for you. Do not use more medicine or use it more often than your doctor tells you to.
• You may need to take this medicine for several weeks before you feel better. Keep taking the medicine as your doctor ordered.
• You may take this medicine with or without food.If your doctor tells you to take it at a specific time, follow your doctor's instructions.
• Measure the oral liquid medicine with a marked measuring spoon, oral syringe, or medicine cup.Shake the bottle well before using. High doses of this medicine may cause heart problems.
• This medicine should come with a Medication Guide. Read and follow these instructions carefully. Ask your doctor or pharmacist if you have any questions. Ask your pharmacist for the Medication Guide if you do not have one.

If a dose is missed:

• If you miss a dose or forget to use your medicine, use it as soon as you can. If it is almost time for your next dose, wait until then to use the medicine and skip the missed dose. Do not use extra medicine to make up for a missed dose.

Possible Side Effects While Using This Medicine

Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Aggression, anxiety, anger, or hostility
• Blistering, peeling, or red skin rash
• Change in how much or how often you urinate
• Chest pain or shortness of breath
• Fainting, dizziness, lightheadedness
• Fast, pounding, or uneven heartbeat
• Fever, chills, cough, runny or stuffy nose, sore throat, and body aches
• Headache, trouble concentrating, memory problems, weakness, or unsteadiness
• Increased thirst
• Lightheadedness or fainting
• Muscle stiffness, twitching, shaking, or uncontrolled muscle movements
• Numbness or weakness in your arm or leg, or on one side of your body
• Painful, prolonged erection of the penis
• Rapid weight gain
• Severe confusion, sweating, nausea, vomiting, or diarrhea
• Swelling of your hands, ankles, or feet
• Unusual behavior, or thoughts of hurting yourself or others
• Unusual bleeding or bruising
• Unusual tiredness or weakness

If you notice these less serious side effects, talk with your doctor:

• Dry mouth, change in appetite, weight changes, or mild nausea
• Mild skin rash
• Numbness or tingling in your hands or feet
• Problems with sex
• Sleepiness or unusual drowsiness
• Trouble sleeping
• Weight loss

Introduction

Citalopram Hydrobromide (sye-TAL-oh-pram hye-droe-BROE-mide)

Treats depression. This medicine is an antidepressant called selective serotonin reuptake inhibitor (SSRI).

How to Store and Dispose of This Medicine

• Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.
• Ask your pharmacist, doctor, or health caregiver about the best way to dispose of any outdated medicine or medicine no longer needed.
• Keep all medicine away from children and never share your medicine with anyone.

Drugs and Foods to Avoid

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Do not take tryptophan while you are using this medicine, unless your doctor says it is okay.
• Make sure your doctor knows if you are using St. John's wort, carbamazepine (Tegretol®), cimetidine (Tagamet®), ketoconazole (Nizoral®), linezolid (Zyvox®), lithium (Eskalith®, Lithobid®), metoprolol (Lopressor®), medicine to treat migraine headaches (such as rizatriptan, sumatriptan, tramadol, zolmitriptan, Imitrex®, Maxalt®, Ultram®, or Zomig®), or a blood thinner (such as warfarin, Coumadin®). Your doctor will need to know if you are using a diuretic or water pill (such as hydrochlorothiazide [HCTZ], furosemide, or Lasix®).
• Tell your doctor if you are also using arsenic trioxide (Trisenox®), cisapride (Propulsid®), dofetilide (Tikosyn®), medicine for heart rhythm problems (such as amiodarone, disopyramide, procainamide, quinidine, sotalol, Betapace®, Cardioquin®, Cordarone®, Norpace®, or Procanbid®), medicine for depression (such as amitriptyline, fluoxetine, fluvoxamine, imipramine, nortriptyline, Elavil®, Pamelor®, Prozac®, Sarafem®, or Vivactil®), certain antibiotics (such as chloramphenicol, erythromycin, gatifloxacin, levofloxacin, moxifloxacin, sparfloxacin, Avelox®, Levaquin®, or Zagam®), or medicine to treat mental illness (such as chlorpromazine, haloperidol, mesoridazine, prochlorperazine, quetiapine, thioridazine, ziprasidone, Compazine®, Geodon®, Haldol®, Mellaril®, Serentil®, or Seroquel®)
• Make sure your doctor knows if you are also using aspirin, NSAID pain or arthritis medicines (such as celecoxib, ibuprofen, indomethacin, naproxen, rofecoxib, valdecoxib, Advil®, Aleve®, Celebrex®, Motrin®, or Vioxx®), stomach medicines (such as lansoprazole, omeprazole, pantoprazole, rabeprazole, Prevacid®, or Prilosec®). dronedarone (Multaq®), felbamate (Felbatol®), levomethadyl (Orlaam®), methadone (Dolophine®), modafinil (Provigil®), oxcarbazepine (Trileptal®), pentamidine (Nebupent®), probenecid (Benemid®), ticlopidine (Ticlid®), or topiramate (Topamax®).
• Do not drink alcohol while you are using this medicine.
• Tell your doctor if you are using any medicines that make you sleepy. These include sleeping pills, cold and allergy medicine, narcotic pain relievers, and sedatives.

Warnings While Using This Medicine

• Make sure your doctor knows if you are pregnant or breastfeeding, or if you have kidney disease, liver disease, bleeding problems, congestive heart failure, heart rhythm problems (such as congenital long QT syndrome, QT prolongation, slow heartbeat), recent heart attack, mineral imbalance (such as low magnesium, potassium, or sodium in the blood), or a history of mania, seizures, or drug abuse.
• For some children, teenagers, and young adults, this medicine can increase thoughts of suicide. Tell your doctor right away if you start to feel more depressed and have thoughts about hurting yourself. Report any unusual thoughts or behaviors that trouble you especially if they are new or get worse quickly. Make sure the doctor knows if you have trouble sleeping, get upset easily, have a big increase in energy, or start to act reckless. Also tell the doctor if you have sudden or strong feelings, such as feeling nervous, angry, restless, violent, or scared. Let the doctor know if you or anyone in your family has bipolar disorder (manic-depressive) or has tried to commit suicide.
• Contact your doctor right away if you have any changes to your heart rhythm. You might feel dizzy or faint, or you might have a fast, pounding, or uneven heartbeat. Make sure your doctor knows if you or anyone in your family has ever had a heart rhythm problem such as QT prolongation.
• This medicine may cause serious conditions such as serotonin syndrome and neuroleptic malignant syndrome (NMS)-like reactions when taken with certain medicines. Check with your doctor first before taking any other medicines.
• Do not stop using this medicine suddenly without asking your doctor. You may need to slowly decrease your dose before stopping it completely.
• This medicine may cause hyponatremia (low sodium in the blood). This is more common in elderly patients, those who are taking diuretic medicines for high blood pressure, or those who have decreased amounts of fluid in the body due to severe diarrhea or vomiting. Check with your doctor right away if you have confusion, headache, memory problems, trouble concentrating, weakness, or unsteadiness.
• This medicine may make you dizzy or drowsy. Avoid driving, using machines, or doing anything else that could be dangerous if you are not alert.
• Your doctor will need to check your progress at regular visits while you are using this medicine. Be sure to keep all appointments.Blood tests may be needed to check for unwanted effects.

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088