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Read the medication guide and, if available, the patient information leaflet provides by your pharmacist before you start taking Citalopram and each time you get a refill.

If you have any questions, ask your doctor or pharmacist .

Take this medication with or without food as direct by your doctor, usually once daily in the morning or evening.

The dosage is based on your medical condition, response to treatment, age, laboratory tests, and other medications you may be taking.

Be sure to tell your doctor and pharmacist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

If you’re using the liquid form of this medication, carefully measure the dose using a special measuring cup/spoon.

Do not use a household spoon, as you may not get the correct dose.

To reduce your risk of side effects, your doctor may advise you to start this medication at a low dose and gradually increase your dosage.

Follow your doctor’s instructions carefully.

Do not increase your dosage or use this medication more often or for longer than prescribe.

Your condition will not improve any faster, and your risk of side effects will increase.

Take this medication regularly to get the most benefit from it. To help you remember, take it at the same time each day.

Continue taking this medication even if you feel well.

Do not stop taking this medication without consulting your doctor.

Some conditions may worsen when this medication is suddenly stop.

You may also experience mood swings, headaches, fatigue, sleep changes, and fleeting feelings like electric shock.

To prevent these symptoms while you are stopping treatment with this medication, your doctor may gradually reduce your dose.

Consult your doctor or pharmacist for more information. Report any new or worsening symptoms immediately.

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Nausea, dry mouth, loss of appetite, fatigue, drowsiness, sweating, blurred vision, and yawning may occur.

Tell your doctor or pharmacist immediately if any of these effects persist or worsen.

Remember that Citalopram has been prescribe because your doctor has determine that the benefits outweigh the risks of side effects.

Many people who use Citalopram do not experience serious side effects.

Tell your doctor straight away if you experience any serious side effects including shaking (tremors), decrease interest in sex, changes in sexual performance and easy bleeding/bruising.

Seek immediate medical attention if you have any serious side effects, including fainting, fast/irregular heartbeat, black stools, vomit that looks

like coffee grounds, seizures, eye pain/swelling/redness, dilated pupils, vision changes (such as seeing rainbows around lights at night).

Citalopram can increase serotonin levels and rarely cause a serious condition called serotonin syndrome/toxicity. This risk increases if you are also taking other medications that increase serotonin levels, so tell your doctor or pharmacist about all your medications. Seek immediate medical attention if you experience symptoms such as: rapid heartbeat, hallucinations, loss of coordination, severe dizziness, severe nausea/vomiting/diarrhea, muscle twitching, unexplained fever, or unusual agitation/restlessness.

Rarely, men may experience a painful or prolonged erection lasting four hours or longer. If this happens, stop taking this medication and seek immediate medical attention, otherwise, permanent problems may occur.

A serious allergic reaction to this medication is rare. However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, or difficulty breathing.

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Before taking citalopram, tell your doctor or pharmacist if you are allergic to it or escitalopram, or if you have any other allergies. This product may contain inactive ingredients that can cause allergic reactions or other problems. Talk to your pharmacist for more information.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: personal or family history of bipolar/manic-depressive disorder, personal or family history of suicide attempts, liver disease, seizures, low sodium levels in the blood, bleeding problems, personal or family history of glaucoma (angle closure type).

Citalopram can cause a condition that affects the heart rhythm (QT prolongation). QT prolongation can rarely cause a serious (rarely fatal) fast/irregular heartbeat and other symptoms (such as severe dizziness and fainting) that require immediate medical attention.

The risk of QT prolongation may be increased if you have certain medical conditions or are taking other medicines that can cause QT prolongation. Before taking citalopram, tell your doctor or pharmacist about all the medicines you are taking and if you have any of the following conditions: specific heart problems (heart failure, slow heart rate, recent heart attack, QT prolongation in an ECG), family history of certain heart problems (QT prolongation in an ECG, sudden cardiac death).

Low blood potassium or magnesium levels can also increase your risk of QT prolongation. This risk may increase if you take certain medications (such as diuretics/water pills) or if you experience heavy sweating, diarrhea, or vomiting. Talk to your doctor about using citalopram safely.

Citalopram may make you drowsy or blur your vision. Alcohol or marijuana (cannabis) can make you more tired. Do not drive, operate machinery, or do anything that requires alertness or clear vision until you can do so safely. Avoid alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

Older adults may be more sensitive to the side effects of this medication, especially bleeding, loss of coordination, and QT prolongation (see above). They may also be more likely to develop a type of salt imbalance (hyponatremia), especially if they also take “water pills” (diuretics). Loss of coordination can increase the risk of falls.

Children may be more sensitive to the side effects of this medication, especially loss of appetite and weight loss. Monitor the weight and height of children taking this medication.

During pregnancy, this medication should be used only when needed. It may harm an unborn baby. In rare cases, babies born to mothers who used this medication during the last three months of pregnancy may experience withdrawal symptoms such as feeding/breathing difficulties, seizures, muscle stiffness, or constant crying. Tell your doctor right away if you notice any of these symptoms in your newborn.

Because untreated mental/mood problems (such as depression, obsessive-compulsive disorder, and panic disorder) can be serious, do not stop taking this medication unless directed by your doctor. If you are planning to become pregnant, become pregnant, or think you may be pregnant, discuss the benefits and risks of taking this medication during pregnancy with your doctor right away.

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Interactions

Drug interactions can change how your medications work or increase your risk of serious side effects. This document does not contain all possible drug interactions. Keep a list of all your products (including prescription and over-the-counter medications and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medications without your doctor’s approval.

Some products that may interact with this medicine include other medicines that can cause bleeding/bruising (including antiplatelet agents such as clopidogrel, NSAIDs such as ibuprofen/naproxen, “blood thinners” such as dabigatran/warfarin).

Aspirin can increase the risk of bleeding when used with this medication. For example, if your doctor has prescribed low-dose aspirin for heart attack or stroke prevention (usually 81-162 milligrams per day), you should continue taking it unless your doctor tells you otherwise. Ask your doctor or pharmacist for more information.

Using MAOIs with this medication may cause a serious (possibly fatal) drug interaction. Avoid taking MAOIs (isocarboxazid, linezolid, metaxalone, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, safinamide, selegiline, tranylcypromine) while taking this medication. Most MAOIs should also not be taken for two weeks before and after treatment with this medication. Ask your doctor when you should start or stop taking this medication.

The risk of serotonin syndrome/toxicity increases if you also use other medications that increase serotonin levels. Examples include street drugs such as MDMA/ecstasy, St. John’s wort, certain antidepressants (including other SSRIs such as fluoxetine/paroxetine, SNRIs such as duloxetine/venlafaxine), and tryptophan, among others. The risk of serotonin syndrome/toxicity may be increased when you start or increase the dose of these medications.

Tell your doctor or pharmacist if you are taking other products that cause drowsiness, including alcohol, marijuana (cannabis), antihistamines (such as cetirizine, diphenhydramine), drugs for sleep or anxiety (such as alprazolam, diazepam, zolpidem), muscle relaxants, and opioid pain relievers (such as codeine).

Check the labels on all your medications (such as allergy or cough and cold products) because they may contain ingredients that cause drowsiness. Ask your pharmacist how to use these products safely.

Many drugs in addition to citalopram can affect the heart rhythm (QT prolongation), including amiodarone, pimozide, procainamide, quinidine and sotalol.

Citalopram is very similar to escitalopram. Do not use medications containing escitalopram while taking citalopram.

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