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Citalopram 10mg, 20mg 40mg Tablets
Citalopram 10mg, 20mg and 40mg film-coated Tablets
Important things you need to know about citalopram
Citalopram treats depression and panic disorders but it will not work straight away. Like all medicines, it can have side-effects. It is important that you and your doctor talk about the benefits and the possible unwanted effects of the medicine before you start taking it.
1. What citalopram is and what it is used for
2. What you need to know before you take citalopram
3. How to take citalopram
4. Stopping citalopram
5. Possible side effects
6. Children and adolescents under 18
7. How to store citalopram
8. Contents of the pack and other information
Citalopram belongs to a group of antidepressants called SSRIs (selective serotonin reuptake inhibitors). Citalopram is used to treat:
Other medicines or psychotherapy can also treat these conditions. Treating your condition properly is important to help you get better. Without treatment your condition may get worse and be more difficult to treat.
Do not take this medicine if any of the above apply to you. If you are not sure, talk to your doctor or pharmacist before taking citalopram.
As with other medicines used to treat depression or related diseases, the improvement is not achieved immediately. After the start of Citalopram treatment it may take several weeks before you experience any improvement. In the beginning of the treatment certain patients may experience increased anxiety, which will disappear during continued treatment. Therefore, it is very important that you follow exactly your doctor’s orders and do not stop the treatment or change the dose without consulting your doctor.
If you are depressed and/or have anxiety disorders you can sometimes have thoughts of harming or killing yourself. These may be increased when first starting antidepressants, since these medicines all take time to work, usually about two weeks but sometimes longer.
You may be more likely to think like this:
If you have thoughts of harming or killing yourself at any time, contact your doctor or go to a hospital straight away.
You may find it helpful to tell a relative or close friend that you are depressed or have an anxiety disorder, and ask them to read this leaflet. You might ask them to tell you if they think your depression or anxiety is getting worse, or if they are worried about changes in your behaviour.
Talk to your doctor or pharmacist before taking citalopram if:
If you are not sure if any of the above apply to you, talk to your doctor or pharmacist before taking this medicine.
Some patients with manic-depressive illness may enter into a manic phase. This is characterized by unusual and rapidly changing ideas, inappropriate happiness and excessive physical activity. If you experience this, contact your doctor.
Symptoms such as restlessness or difficulty in sitting or standing still can also occur during the first weeks of the treatment. Tell your doctor immediately if you experience these symptoms.
A combination of symptoms such as feeling restless (agitation), shaking, with brief, involuntary twitching of a muscle, including the muscles that control movement of the eye (myoclonus), hallucinations, coma, excessive sweating, exaggeration of reflexes, increased muscle tension and elevated body temperature due to failed thermoregulation (hyperthermia) may indicate development of a severe condition called Serotonin syndrome. You should tell your doctor immediately, if these signs occur.
Medicines like citalopram (so called SSRIs/SNRIs) may cause symptoms of sexual dysfunction (see section 4). In some cases, these symptoms have continued after stopping treatment.
Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines.
DO NOT TAKE CITALOPRAM if you take medicines for heart rhythm problems or medicines that may affect the heart’s rhythm, e.g. such as Class IA and III antiarrhythmics, antipsychotics (e.g. fentiazine derivatives, pimozide, haloperidol), tricyclic antidepressants, certain antimicrobial agents (e.g. sparfloxacin, moxifloxacin, erythromycin IV, pentamidine, antimalarian treatment particularly halofantrine), certain antihistamines (astemizole, mizolastine). If you have any further questions about this you should speak to your doctor.
Tell your doctor if you are taking any of the following:
Citalopram can be taken with or without food.
As with all antidepressants, it is sensible to avoid drinking alcohol whilst receiving treatment although citalopram has not been shown to increase the effects of alcohol.
If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advise before taking this medicine.
Do not take citalopram if you are pregnant unless you and your doctor have discussed the risks and benefits involved.
Make sure your midwife and doctor know you are taking citalopram. When taken during pregnancy, particularly in the last 3 months of pregnancy, medicines like citalopram may increase the risk of a serious condition in babies, called persistent pulmonary hypertension of the newborn (PPHN), making the baby breathe faster and appear bluish. These symptoms usually begin during the first 24 hours after the baby is born. If this happens to your baby you should contact your midwife and/ or doctor immediately. Also, if you take citalopram during the last 3 months of your pregnancy and until the date of birth you should be aware that the following effects may be seen in your newborn: trouble with breathing, stiff or loose muscles, jitteriness, a bluish skin or being too hot or cold. If your newborn baby gets any of these symptoms please contact your midwife and/or doctor immediately.
If you take citalopram near the end of your pregnancy there may be an increased risk of heavy vaginal bleeding shortly after birth, especially if you have a history of bleeding disorders. Your doctor or midwife should be aware that you are taking citalopram so they can advise you.
Citalopram may get into breast milk in very small amounts and may affect your baby. Talk to your doctor before you start breast-feeding.
Citalopram has been shown to reduce the quality of sperm in animal studies. Theoretically, this could affect fertility, but impact on human fertility has not been observed as yet.
Citalopram has a minor or moderate influence on the ability to drive and use machines. You should be careful when driving, operating machinery or performing jobs that need you to be alert. Do not drive or use machines if you feel you are affected.
Always take this medicine exactly as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are not sure.
Your doctor will tell you how much to take when you first start taking this medicine. Most people start to feel better after 2 to 3 weeks. If you do not feel any better after this time, talk to your doctor. He or she may tell you to take more of the medicine each day.
If you think that you or anyone else may have taken too many citalopram tablets, contact your doctor or go to the nearest hospital straight away. Do this even if there are no signs of discomfort or poisoning. Signs could include: feeling sick (nausea), being sick (vomiting), dizziness, sweating, fits, being very sleepy, passing out or going into a coma, tremor, having a blue colour to the skin, fast short breathing, changes in blood pressure, a staring or fixed look on the face, changes in heart rhythm, a fast or irregular heartbeat, agitation, enlarged eye pupils or serotonin syndrome (see Section 4) Take the carton and any tablets left with you. This is so that the doctor knows what you have taken.
If you have any further question on the use of this product, ask your doctor or pharmacist.
Do not stop taking citalopram until your doctor tells you to.
When stopping citalopram, your doctor will help you to gradually take less of the medicine. This will be over a period of weeks or months. As you take less citalopram you may notice some side effects. If you notice any effects when you are stopping citalopram, tell your doctor. Your doctor may then ask you to start taking it again and reduce the dose more slowly.
Possible effects when stopping: feeling dizzy, feelings like pins and needles, feeling sick (nausea) or vomiting, feeling agitated or being anxious or having headaches, difficulty in falling asleep or staying asleep, vivid dreams, nightmares, tremor, confusion or disorientation, sweating, diarrhoea, palpitations, emotional instability, irritability and visual disturbances.
Like all medicines, this medicine can cause side effects, although not everybody gets them. Several of the effects listed below can also be symptoms of your illness and may disappear as you start to get better.
Very common (may affect more than 1 in 10 people):
Common (may affect up to1 in 10 people):
Uncommon (may affect up to 1 in 100 people):
Rare (may affect up to 1 in 1000 people):
Not known (frequency cannot be estimated from the available data):
SSRIs can, very rarely increase the risk of bleeding, including stomach or intestinal bleeding. Let your doctor know if you vomit blood or develop black or blood stained stools.
Also let your doctor know if you continue to have other symptoms associated with your depression.
This might include hallucinations, anxiety, mania or confusion.
Any side effects that do occur will usually disappear after a few days. If they are troublesome or persistent, or if you develop any other unusual side effects while taking this medicine, please tell your doctor.
You should inform your doctor if any of the symptoms listed below start or get worse when patients under 18 are taking citalopram.
Among children and teenagers under 18 given citalopram, these side effects are common:
If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme at www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store
By reporting side effects you can help provide more information on the safety of this medicine.
Citalopram should normally not be used for children and adolescents under 18 years. Also, you should know that patients under 18 have an increased risk of side-effects such as suicide and suicidal behaviour when they take this type of medicine. Despite this, your doctor may prescribe citalopram for patients under 18 because he/she decides that this is in their best interests. If your doctor has prescribed citalopram for a patient under 18 and you want to discuss this, please go back to your doctor. You should inform your doctor if any of the symptoms listed below start or get worse when patients under 18 are taking citalopram. Also, the long-term safety effects concerning growth, maturation and cognitive and behavioural development of Citalopram in this age group have not yet been demonstrated.
Among children and teenagers under 18 given citalopram, these side effects are common
The active substance is citalopram hydrobromide
Citalopram tablets contain 10 mg, 20 mg or 40 mg of citalopram (as citalopram hydrobromide). The other ingredients are mannitol, microcrystalline cellulose, colloidal anhydrous silica, magnesium stearate. The film-coating contains hypromellose, titanium dioxide (E171) and macrogol 6000.
This medicine comes in blister packs of 28 film-coated tablets.
This leaflet was last revised in February 2023.
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