Citalopram Capsules

What is this medication?

CITALOPRAM (sye TAL oh pram) treats depression. It increases the amount of serotonin in the brain, a substance that helps regulate mood. It belongs to a group of medications called SSRIs.

This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

What should I tell my care team before I take this medication?

They need to know if you have any of these conditions:

• Bipolar disorder or a family history of bipolar disorder
• Bleeding disorders
• Glaucoma
• Heart disease
• History of irregular heartbeat
• Kidney disease
• Liver disease
• Low levels of magnesium or potassium in the blood
• Receiving electroconvulsive therapy
• Seizures
• Suicidal thoughts, plans, or attempt by you or a family member
• Take medications that treat or prevent blood clots
• Thyroid disease
• An unusual or allergic reaction to citalopram, other medications, foods, dyes, or preservatives
• Pregnant or trying to become pregnant
• Breast-feeding

How should I use this medication?

Take this medication by mouth with water. Take it as directed on the prescription label at the same time every day. Do not cut, crush, or chew this medication. Swallow the capsules whole. You can take it with or without food. Keep taking it unless your care team tells you to stop. Stopping this medication too quickly may cause serious side effects or your condition may worsen.

A special MedGuide will be given to you by the pharmacist with each prescription and refill. Be sure to read this information carefully each time.

Talk to your care team about the use of this medication in children. Special care may be needed.

People over 60 years of age may have a stronger reaction and need a smaller dose.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

NOTE: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.

What may interact with this medication?

Do not take this medication with any of the following:

• Certain medications for fungal infections, such as fluconazole, itraconazole, ketoconazole, posaconazole, voriconazole
• Cisapride
• Dronedarone
• Escitalopram
• Linezolid
• MAOIs, such as Marplan, Nardil, and Parnate
• Methylene blue
• Pimozide
• Thioridazine

This medication may also interact with the following:

• Alcohol
• Amphetamines
• Aspirin and aspirin-like medications
• Carbamazepine
• Certain medications for infections, such as chloroquine, clarithromycin, erythromycin, furazolidone, isoniazid, pentamidine
• Certain medications for mental health conditions
• Certain medications for migraine headaches, such as almotriptan, eletriptan, frovatriptan, naratriptan, rizatriptan, sumatriptan, zolmitriptan
• Certain medications for sleep
• Certain medications that treat or prevent blood clots, such as dalteparin, enoxaparin, warfarin
• Cimetidine
• Diuretics
• Dofetilide
• Fentanyl
• Lithium
• Methadone
• Metoprolol
• NSAIDs, medications for pain and inflammation, such as ibuprofen or naproxen
• Omeprazole
• Other medications that cause heart rhythm changes
• Procarbazine
• Rasagiline
• Supplements, such as St. John's wort, kava kava, valerian
• Tramadol
• Tryptophan
• Ziprasidone

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medication?

Tell your care team if your symptoms do not get better or if they get worse. Visit your care team for regular checks on your progress. Because it may take several weeks to see the full effects of this medication, it is important to continue your treatment as prescribed.

Watch for new or worsening thoughts of suicide or depression. This includes sudden changes in mood, behavior, or thoughts. These changes can happen at any time but are more common in the beginning of treatment or after a change in dose. Call your care team right away if you experience these thoughts or worsening depression.

This medication may cause mood and behavior changes, such as anxiety, nervousness, irritability, hostility, restlessness, excitability, hyperactivity, or trouble sleeping. These changes can happen at any time but are more common in the beginning of treatment or after a change in dose. Call your care team right away if you notice any of these symptoms.

This medication may affect your coordination, reaction time, or judgment. Do not drive or operate machinery until you know how this medication affects you. Sit up or stand slowly to reduce the risk of dizzy or fainting spells. Drinking alcohol with this medication can increase the risk of these side effects.

Your mouth may get dry. Chewing sugarless gum or sucking hard candy, and drinking plenty of water may help. Contact your care team if the problem does not go away or is severe.

What side effects may I notice from receiving this medication?

Side effects that you should report to your care team as soon as possible:

• Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
• Bleeding—bloody or black, tar-like stools, vomiting blood or brown material that looks like coffee grounds, red or dark brown urine, small red or purple spots on skin, unusual bruising or bleeding
• Heart rhythm changes—fast or irregular heartbeat, dizziness, feeling faint or lightheaded, chest pain, trouble breathing
• Irritability, confusion, fast or irregular heartbeat, muscle stiffness, twitching muscles, sweating, high fever, seizure, chills, vomiting, diarrhea, which may be signs of serotonin syndrome
• Low sodium level—muscle weakness, fatigue, dizziness, headache, confusion
• Sudden eye pain or change in vision such as blurry vision, seeing halos around lights, vision loss
• Thoughts of suicide or self-harm, worsening mood, feelings of depression

Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):

• Change in sex drive or performance
• Diarrhea
• Dry mouth
• Excessive sweating
• Nausea
• Tremors or shaking
• Upset stomach

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Where should I keep my medication?

Keep out of the reach of children and pets.

Store at room temperature between 20 and 25 degrees C (68 and 77 degrees F). Get rid of any unused medication after the expiration date.

To get rid of medications that are no longer needed or have expired:

• Take the medication to a medication take-back program. Check with your pharmacy or law enforcement to find a location.
• If you cannot return the medication, check the label or package insert to see if the medication should be thrown out in the garbage or flushed down the toilet. If you are not sure, ask your care team. If it is safe to put it in the trash, empty the medication out of the container. Mix the medication with cat litter, dirt, coffee grounds, or other unwanted substance. Seal the mixture in a bag or container. Put it in the trash.

NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.