Product Name: Citalopram
Common Brand Names: Celexa; Cipram
Pharmaceutical Category: Antidepressants / Anti Anxiety
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There is an additional general information about this medication active ingredient citalopram:
Citalopram is an antidepressant. The mechanism of action is associated with selective blockade of the inverse of neuronal serotonin in the synapses of neurons of the CNS. Citalopram lacks or has a very weak ability to bind to histamine, m-choline- and adrenoreceptors.
After oral administration Cmax of citalopram in plasma is achieved within 2-4 hours. The oral bioavailability is about 80%. Changes in plasma concentrations of citalopram are linear. Css in the plasma is established within 1-2 weeks of therapy.
Binding to plasma proteins is less than 80%.
In blood plasma citalopram is present mainly in unchanged form. This drug is metabolized by demethylation, deamination and oxidation.
T1/2 is 1.5 days.
Citalopram is excreted by the kidneys and the bowel.
Why is Citalopram prescribed?
Depression of various etiologies, panic disorder, obsessive-compulsive disorder.
Dosage and administration
Citalopram is taken oral 1 time / day.
For adults depending on the evidence the initial dose of Citalopram is 10-20 mg / day, if necessary, it may be increased up to 60 mg / day. For patients older than 65 years the dose is 20 mg / day, if necessary, it may be increase to 40 mg / day.
Citalopram side effects
Digestive system: frequently - dry mouth, nausea.
CNS: frequently - drowsiness, tremor, and in rare cases - seizures (when used in high doses).
Cardiovascular system: possible slight decrease in heart rate.
Other: often - increased sweating.
Adverse reactions are usually transient and weakly expressed. They occur mainly during the first 2 weeks of treatment and usually decrease significantly with the improvement of the patient with depression.
Hypersensitivity to citalopram; simultaneous taking MAO inhibitors.
Using during pregnancy and breastfeeding
Safety of citalopram during pregnancy and lactation has not been established. Use of the drug is justified only in cases where the potential benefits of therapy to the mother justifies the potential risk to the fetus and child.
In experimental studies there was revealed no teratogenic effects and any effect of citalopram on reproduction and prenatal development of the fetus.
In patients with liver failure citalopram should be used in minimal doses.
At weak and moderate renal insufficiency it does not require correction of dosing regimen of Citalopram, the information on the application in severe renal failure is absent.
During the treatment period with citalopram it is possibly a slight decrease in heart rate that has no clinical significance, however, patients with initially reduced heart rate citalopram may cause a more pronounced bradycardia.
The efficacy and safety of citalopram in children has not been established.
Citalopram should not be used concurrently with MAO inhibitors.
Patients should be prescribed with care for citalopram in highest dose and high doses of cimetidine.
It should be borne in mind that patients with depression are often a decrease in ability to concentrate which can be exacerbated by the use of psychotropic drugs.
Citalopram drug interactions
Simultaneous administration of Citalopram with:
MAO inhibitors may develop a hypertensive crisis (serotonin syndrome);
cimetidine may moderate increase in Css of citalopram in plasma
The inhibitory effect on CYP2D6 isoenzyme is expressed very poorly, so the interaction with drugs that affect the metabolism of this enzyme is minimal. But we can not exclude the decrease in the concentration of citalopram in plasma by increasing its metabolism by carbamazepine induction of liver enzymes in their simultaneous application.
The effects of sumatriptan and other serotonergic medications can be amplified by Citalopram in their simultaneous application.
Citalopram in case of emergency / overdose
Symptoms: dizziness, sweating, nausea, vomiting, tremor, somnolence, sinus tachycardia. In more rare cases - amnesia, confusion, coma, convulsions, hyperventilation, cyanosis, rhabdomyolysis, ECG changes.
Treatment: gastric lavage and use of activated carbon. Maintaining an airway to ensure adequate ventilation and oxygenation. It is recommended careful observation and monitoring of vital functions. Due to the large volume of distribution of citalopram is unlikely efficiency such measures as forced diuresis, dialysis, hemoperfusion and exchange transfusion. There is no specific antidote.