Pharmacy

Celexa Major Interaction Major Interactions
5-HTP, 5-hydroxytryptophan, Actiq, Acutrim 16 Hour, Acutrim II, Maximum Strength, Acutrim Late Day, Adapin, Adipex-P, Adipost, Alfenta, alfentanil, almotriptan, Amerge, amitriptyline, amoxapine, amphetamine, Anafranil, Anorex-SR, Appecon, Asendin, Atapryl, Aventyl HCl, Axert, Azilect, Babee Cof, Balminil DM, Balminil DM Pour Enfants, Balminil DM Sans Sucrose, Benadryl for the Family Dry Forte, Benylin, Benylin Adult Formula, Benylin DM, Benylin DM Pediatric, Benylin Dry Coughs, Benylin Pediatric, benzphetamine, Bisolvon Dry, Bisolvon Dry Junior, Bontril PDM, Bontril Slow Release, Buckley’s Mixture Cough Suppressant, Buckleys Mixture, Budeprion SR, Budeprion XL, buPROPion, buPROPion 24 hour extended release, buPROPion extended release, BuSpar, BuSpar Dividose, busPIRone, Calmylin, Carbex, Chem Mart Tramadol, clomiPRAMINE, Contac Cough, Control, Cough Syrup DM, Covonia Bronchial Balsam, Creo-Terpin, Creomulsion, Creomulsion Children, Cymbalta, D.H.E. 45, Darvon, Darvon-N, Delsym, Delsym 12 Hour Cough Relief, Delsym 12 Hour Cough Relief for Children & Adults, Demerol HCl, desipramine, Desoxyn, Desoxyn Gradumet, desvenlafaxine, Desyrel, Desyrel Dividose, DexAlone, Dexatrim, Dexatrim Caffeine Free, Dexedrine, Dexedrine Spansule, dexfenfluramine, Dexi-Tuss, dextroamphetamine, dextroamphetamine extended release, dextromethorphan, dextromethorphan extended release, Dextromethorphan HBr Adult Formula, Dextrostat, Didrex, diethylpropion, diethylpropion extended release, dihydroergotamine, dihydroergotamine nasal, Dimetapp Cold Cough & Flu Day & Night Liquid Caps, doxepin, doxepin topical, Dristan DM, Dromadol SR, Dromadol XL, Dry Cough, duloxetine, Duragesic, Duragesic-100, Duragesic-12, Duragesic-25, Duragesic-50, Duragesic-75, Effexor, Effexor XR, Elavil, Eldepryl, eletriptan, Elixsure Cough, Empro, Emsam, Endep, ephedra, Ergomar, ergonovine, ergotamine, Ergotrate Maleate, Eskalith, Eskalith-CR, Fastin, fenfluramine, fentanyl, fentanyl topical, Fentora, Frova, frovatriptan, furazolidone, Furoxone, GenRx Tramadol, GHB, Hold DM, hypericum perforatum, imipramine, imipramine pamoate, Imitrex, Imitrex Nasal, Imitrex Statdose, Imitrex Statdose Refill, iohexol, Ionamin, Ionsys, iopamidol, Iopamidol-370, isocarboxazid, Isovue-128, Isovue-200, Isovue-250, Isovue-300, Isovue-370, Isovue-M-200, Isovue-M-300, Jack & Jill Thin Strips Cough, Jumex, l-tryptophan, Larapam SR, levomethadyl acetate, linezolid, lisdexamfetamine, lithium, lithium carbonate, lithium carbonate extended release, lithium citrate, Lithobid, Lithonate, Lithotabs, Lloydspharmacy Dry Adult Cough, ma huang, Marplan, Matulane, Maxalt, Maxalt-MLT, Mazanor, mazindol, Mega-Trim, Melfiat, Mellaril, Mellaril-S, meperidine, Meridia, methamphetamine, methamphetamine extended release, metrizamide, Migranal, mirtazapine, Myelo-Kit, naratriptan, Nardil, nefazodone, Neocitran Thin Strips Cough, Norpramin, nortriptyline, Novahistine DM, Nucosef DM, Obephen, Obezine, Oby-Cap, Oby-Trim, Omnipaque 140, Omnipaque 180, Omnipaque 180 Redi-Unit, Omnipaque 210, Omnipaque 240, Omnipaque 240 Redi-Unit, Omnipaque 300, Omnipaque 350, Omnipaque Flexipak, Orlaam, Pamelor, Panshape M, Parnate, Pedia Relief, Pediacare, pentazocine, Pertussin CS Childrens, Pertussin DM, Pertussin ES, Phendiet, Phendiet-105, phendimetrazine, phendimetrazine extended release, phenelzine, Phentercot, phentermine, phentermine hydrochloride, phentermine hydrochloride extended release, phentermine resin extended release, Phentride, Phenyldrine, phenylpropanolamine, Plegine, Pondimin, PP-Cap, Prelu-2, Pristiq, Pro-Fast HS, Pro-Fast SA, Pro-Fast SR, procarbazine, Propagest, Propan, propoxyphene, propoxyphene hydrochloride, propoxyphene napsylate, protriptyline, Prudoxin, rasagiline, Redux, Relpax, Remeron, Remeron SolTab, remifentanil, Rhindecon, rizatriptan, Robafen Cough Liquidgels, Robafen Pediatric Cough & Cold, Robitussin Cough Calmers, Robitussin CoughGels, Robitussin Dry Cough, Robitussin DX Cough Control, Robitussin DX Cough Control Forte, Robitussin DX Dry Cough Forte, Robitussin Honey Cough, Robitussin Junior Persistent Cough, Robitussin Maximum Strength, Robitussin Pediatric Cough Suppressant, Robitussin Soft Pastilles, Sanorex, Scot-Tussin Diabetic, Scot-Tussin DM Cough Chasers, selegiline, Selgene, Serzone, sibutramine, Silphen DM, Sinequan, sodium biphosphate, sodium oxybate, St. John’s wort, St. Joseph Cough Suppressant, Statobex, Strepsils Cough, Strepsils Cough Relief, Sublimaze, Sucrets DM Cough, Sufenta, sufentanil, sumatriptan, sumatriptan nasal, Surmontil, T-Diet, Talwin Lactate, Tenuate, Tenuate Dospan, Teramine, Teramine ER, Terry White Chemists Tramadol, Theraflu Thin Strips Cough, thioridazine, Tofranil, Tofranil-PM, traMADOL, traMADOL extended release, Tramahexal, Tramahexal SR, Tramake, Tramake Insts, Tramal, Tramal SR, Tramedo, tranylcypromine, traZODONE, Triaminic DM, Triaminic Long Acting Cough, Triaminic Long Acting Cough(obs), Triaminic Softchew, Triaminic Thin Strips Cough, Triaminic Thin Strips Nasal Congestion(obsolete), Triaminic Toddler Congestion Thin Strips(obsolete), trimipramine, Tryptan, tryptophan, Tussin Pediatric, Tussinol for Dry Coughs, Tylenol Simply Cough, Ultiva, Ultram, Ultram ER, Vanatrip, venlafaxine, venlafaxine extended release, Vicks 44 Cough Medicine, Vicks 44 Cough Relief, Vicks Formula 44, Vicks Formula 44 for Dry Coughs, Vivactil, Vyvanse, Wellbutrin, Wellbutrin SR, Wellbutrin XL, Westrim, Westrim LA, Xyrem, Zamadol, Zamadol 24hr, Zamadol Melt, Zamadol SR, Zantryl, Zelapar, zolmitriptan, Zomig, Zomig-ZMT, Zonalon, Zyban, Zyban Advantage Pack, Zydol, Zydol SR, Zydol XL, Zyvox

Celexa Moderate Interaction Moderate Interactions
40 Winks, Abbokinase, Abbokinase Open-Cath, abciximab, Abilify, Abilify Discmelt, Accolate, Accupril, acebutolol, Aceon, acetoHEXAMIDE, acetylcarbromal, Acetylsalicylic Acid, Acova, Activase, Actron, Acuprin 81, Adgan, Advil, Advil Childrens, Advil Junior Strength, Advil Liquigel, Advil Migraine, Advil Pediatric, Aflaxen, Aggrastat, Agrylin, AHist, Akineton HCl, alcohol, alcohol, ethyl, Aldactone, Aler-Dryl, Aler-Tab, Aleve, Aleve Caplet, Aleve Easy Open Arthritis, Aleve Gelcap, alfuzosin, alfuzosin extended release, All Day Allergy, Aller-Chlor, Allergia-C, Allerhist-1, Allermax, Alphagan, Alphagan P, alprazolam, alprazolam extended release, Altace, Altaryl, alteplase, Amaryl, Ambien, Ambien CR, Amigesic, amiloride, amobarbital, Amrix, amyl nitrite, Amytal Sodium, Anaflex, anagrelide, Anaprox, Anaprox-DS, Anergan 50, Angiomax, anisindione, anistreplase, Ansaid, Antiflex, Antinaus 50, antithrombin III, Anturane, Apidra, Apidra OptiClik Cartridge, APO-Go, APO-Go Pen, Apokyn, apomorphine, apraclonidine ophthalmic, Apresoline, Aquachloral Supprettes, Aquacot, Aquatensen, Aquazide H, ardeparin, Arfonad, argatroban, Argesic-SA, aripiprazole, Arixtra, Arixtra 10 mg/dose, Arixtra 5 mg/dose, Arixtra 7.5 mg/dose, Artane, Arthritis Pain, Arthropan, ASA, Ascriptin Enteric, Aspergum Cherry, Aspergum Orginal, Aspir-Low, aspirin, aspirin extended release, Aspirin Lite Coat, Aspirin Litecoat, Aspirin Low Strength, Aspirtab, Astramorph PF, Atacand, Atarax, atenolol, Ativan, Atnativ, Avapro, Avinza, B-Vex, baclofen, Banaril, Banflex, Banophen, Bayer Aspirin, Bayer Aspirin Regimen, Bayer Aspirin Sugar Free, Bayer Aspirin with Calcium, Bayer Childrens Aspirin, Bayer Low Strength, Bayer Plus, Bayer Select Backache Pain Formula, Beldin, Belix, Ben-Tann, Benadryl, Benadryl Allergy, Benadryl Child Dye Free, Benadryl Childrens Allergy Fastmelt, Benadryl DF, Benadryl Dye Free Allergy, Benadryl Ultratab, Benahist-10, Benahist-50, benazepril, bendroflumethiazide, Benicar, Benoject-50, Benzacot, benzthiazide, benztropine, Betapace, Betapace AF, Betapace AF(obsolete), betaxolol, Bexxar Dosimetric, Bexxar I 131 Dosimetric, Bexxar I 131 Therapeutic, BexxarTherapeutic, Biaxin, Biaxin XL, Biaxin XL-Pak, Bidhist, biperiden, Bismarex, Bismatrol, Bismatrol Maximum Strength, bismuth subsalicylate, bisoprolol, bivalirudin, Blocadren, bosentan, Brevibloc, brimonidine ophthalmic, Bromaphen, bromfenac, bromocriptine, bromodiphenhydramine, brompheniramine, brompheniramine extended release, BroveX, BroveX CT, Buffered Aspirin, Bufferin, Bufferin Arthritis Strength, Bufferin Extra Strength, Buffex, bumetanide, Bumex, Buprenex, buprenorphine, Busodium, butabarbital, butalbital, Butisol Sodium, butorphanol, Bydramine, Bystolic, C.P.M., Calan, Calan SR, Calm-Aid, candesartan, Capoten, captopril, Carbacot, carbetapentane, carbinoxamine, carbinoxamine extended release, Carbinoxamine PD, Carboxine, Cardioquin, Cardizem, Cardizem CD, Cardizem LA, Cardizem Monovial, Cardizem SR, Cardura, Cardura XL, Carduran, carisoprodol, Carozide, carteolol, Cartia XT, Cartrol, carvedilol, carvedilol extended release, Cascor, Cataflam, Catapres, Catapres-TTS-1, Catapres-TTS-2, Catapres-TTS-3, Cathflo Activase, Celebrex, celecoxib, Celontin, Cesamet, cetirizine, Childrens Ibuprofen Berry, Childrens Kaopectate, Chlo-Amine, Chlor-Al Rel, Chlor-Mal, Chlor-Phen, Chlor-Phenit, Chlor-Trimeton, Chlor-Trimeton Allergy SR, chloral hydrate, chlordiazepoxide, chlormezanone, chlorothiazide, Chlorphen, chlorphenesin, chlorpheniramine, Chlorpheniramine (Allergy), chlorpheniramine 24 hour extended release, chlorpheniramine extended release, chlorproMAZINE, chlorproMAZINE extended release, chlorproPAMIDE, ChlorTan, chlorthalidone, chlorzoxazone, choline salicylate, cilostazol, cimetidine, clarithromycin, clarithromycin extended release, clemastine, Clexane, Clexane Forte, Clinoril, clonazepam, clonidine, clonidine topical, clopidogrel, Clopine, clorazepate, clorazepate extended release, clotrimazole, clozapine, Clozapine Synthon, Clozaril, codeine, codeine phosphate, codeine sulfate, Codimal A, Cogentin, Compazine, Compazine Spansule, Compoz Nighttime Sleep Aid, Compro, Concerta, Contac 12 Hour Allergy, Cophene B, Cordron NR, Coreg, Coreg CR, Corgard, Corlopam, Coumadin, Covera-HS, Cozaar, Crixivan, cyclizine, cyclobenzaprine, cyclobenzaprine extended release, cyproheptadine, Dailyhist-1, dalfopristin, Dalgan, Dalmane, dalteparin, danaparoid, danazol, Danocrine, Dantrium, Dantrium Intravenous, dantrolene, dasatinib, Daypro, Daytrana, Dazidox, DDAVP, DDAVP Nasal, DDAVP Rhinal Tube, Dehydrated Alcohol, delavirdine, Demadex, Demadex I.V., Denzapine, Depacon, Depakene, DepoDur, Deponit, deserpidine, desirudin, desmopressin, dexbrompheniramine, dexmedetomidine, dexmethylphenidate, dexmethylphenidate extended release, dezocine, Di-Phen, DiaBeta, Diabinese, Diaqua, Diaqua-2, Diastat, Diastat AcuDial, Diastat Pediatric, diazepam, diazoxide, Dibenzyline, diclofenac, diclofenac potassium, diclofenac sodium, diclofenac sodium extended release, dicumarol, Diflucan, diflunisal, dihydrocodeine, Dilacor XR, Dilantin, Dilantin Infatabs, Dilantin Kapseals, Dilantin-125, Dilatrate-SR, Dilaudid, Dilaudid-5, Dilaudid-HP, Diltia XT, diltiazem, diltiazem 24 hour extended release, diltiazem extended release, Diltiazem Hydrochloride CD, Diltiazem Hydrochloride SR, Diltiazem Hydrochloride XR, Diltiazem Hydrochloride XT, Dimetane, Dimetane Extentab, Dimetapp Allergy, Dimetapp Allergy Liquigel, Diphedryl, Diphen, Diphen AF, Diphen Cough, Diphenadryl, Diphendryl, Diphenhist, diphenhydrAMINE, diphenhydrAMINE citrate, diphenhydrAMINE tannate, Diphenmax, Diphenydramine Quick Melt, Diphenyl, Diphenylin, Diprivan, dipyridamole, Disalcid, Diskets, Diucardin, Diurese, Diuril, Diuril Sodium, Dizac, Doans Pills, Doans Pills Extra Strength, Dolobid, Dolophine, Doloral, Doloral Sirop, Doral, Doxadura, doxazosin, doxazosin extended release, doxylamine, DPH, dronabinol, droperidol, drotrecogin, drotrecogin alfa, Duraclon, DurAct, Duramorph PF, Dymelor, Dyrenium, Dytan, Dytuss, E-Mycin, E.E.S. Granules, E.E.S.-200, E.E.S.-400, E.E.S.-400 Filmtab, Easprin, EC-Naprosyn, Ecotrin, Ecotrin Adult Low Strength, Ecotrin Maximum Strength, Ed Chlor-Tan, Ed ChlorPed, Edecrin, Edecrin Sodium, efavirenz, Efidac-24 Chlorpheniramine, Empirin, enalapril, enalaprilat, Endocodone, Enduron, enoxaparin, Entaprin, Entercote, eplerenone, epoprostenol, eprosartan, eptifibatide, Equanil, Ery-Tab, Eryc, EryPed, EryPed 200, EryPed 400, Erythrocin Lactobionate, Erythrocin Stearate Filmtab, Erythrocot, erythromycin, erythromycin base, erythromycin estolate, erythromycin ethylsuccinate, erythromycin lactobionate, erythromycin stearate, escitalopram, Esidrix, esmolol, estazolam, eszopiclone, ETH-Oxydose, ethacrynic acid, ethanol, ethosuximide, ethotoin, Ethyl Alcohol, etodolac, etodolac extended release, Exna, Extra Strength Bayer, EXUBERA, EXUBERA Combination Pack 12, EXUBERA Combination Pack 15, EXUBERA Kit, Eze D.S., Ezide, Fasprin, FazaClo, felbamate, Felbatol, Feldene, fenoldopam, fenoprofen, Fexmid, FK506, flavoxate, Flexeril, Flexoject, Flexon, Flolan, fluconazole, fluoxetine, fluoxetine extended release, fluphenazine, fluphenazine decanoate, fluphenazine enanthate, fluphenazine hydrochloride, flurazepam, flurbiprofen, fluvoxamine, fluvoxamine extended release, Focalin, Focalin XR, fondaparinux, Fortovase, fosinopril, Fragmin, furosemide, gabapentin, Gabarone, Genacote, Genahist, Gennin-FC, Genpril, Genprin, Geodon, Gleevec, glimepiride, glipiZIDE, glipiZIDE extended release, GlipiZIDE XL, Glucotrol, Glucotrol XL, glyBURIDE, glyBURIDE micronized, Glynase PresTab, grepafloxacin, guanabenz, guanadrel, guanethidine, guanfacine, halazepam, Halcion, Haldol, Haldol Decanoate, Halfprin, haloperidol, haloperidol decanoate, Haltran, Harmonyl, HCTZ, Hep-Lock, Hep-Pak, Hep-Pak CVC, heparin, Heparin Lock Flush, Histaject, Histex CT, Histex I/E, Histex PD, Histex Pd 12, Humalog, Humalog KwikPen, Humalog Pen, Humulin L, Humulin N, Humulin N Pen, Humulin R, Humulin R (Concentrated), Humulin U, hydrALAZINE, Hydramine, Hydramine Compound, Hydramine Cough Syrup, Hydro Par, hydrochlorothiazide, hydrocodone, HydroDIURIL, hydroflumethiazide, Hydromorph Contin, hydromorphone, hydromorphone extended release, Hydrostat IR, hydrOXYzine, hydrOXYzine hydrochloride, hydrOXYzine pamoate, Hygroton, Hylorel, Hyperstat, Hyrexin, Hytrin, Hyzine, ibritumomab, Ibu, IBU-200, Ibu-4, Ibu-6, Ibu-8, Ibu-Tab, ibuprofen, Ibuprofen PMR, Iletin II Lente Pork, Iletin II NPH Pork, Iletin II Regular Pork, Iletin Lente, Iletin NPH, Iletin Regular, iloprost, Ilosone, Ilotycin Gluceptate, imatinib, Imdur, In-111 Zevalin, Inapsine, indapamide, Inderal, Inderal LA, indinavir, Indocin, Indocin SR, indomethacin, indomethacin extended release, Infumorph, Innohep, InnoPran XL, Inspra, insulin, insulin analog, insulin aspart, insulin aspart protamine, insulin detemir, insulin glargine, insulin glulisine, insulin inhalation, rapid acting, insulin isophane, Insulin Lente Pork, insulin lispro, insulin lispro protamine, Insulin Purified NPH Pork, Insulin Purified Regular Pork, insulin regular, insulin zinc, insulin zinc extended, insulin, lente, insulin, NPH, insulin, ultralente, Integrilin, Invega, Invirase, iodine I 131 tositumomab, Iopidine, Iprivask, irbesartan, ISDN, Ismelin, ISMO, Isochron, Isoptin, Isoptin I.V., Isoptin SR, Isordil, Isordil Tembids, Isordil Titradose, isosorbide dinitrate, isosorbide dinitrate extended release, isosorbide mononitrate, isosorbide mononitrate extended release, itraconazole, J-Tan, J-Tan PD, Jantoven, K-Pek, Kabikinase, Kadian, Kao-Tin Bismuth Subsalicylate Formula, Kaopectate, Kaopectate Anti-Diarrheal Upset Stomach Reliever, Kaopectate Extra Strength, Kapectolin (New Formula), Kemadrin, Kerlone, Ketalar, ketamine, ketoconazole, ketoprofen, ketoprofen extended release, ketorolac, Kinlytic, Klonopin, Klonopin Wafer, labetalol, Lantus, Lantus OptiClik Cartridge, Lantus Solostar Pen, Largon, Lasix, Leader Naproxen Sodium, Lente insulin, lepirudin, Levatol, Levemir, Levemir FlexPen, Levemir InnoLet, Levemir PenFill, Levo-Dromoran, levocetirizine, levorphanol, LEVRIX, Lexapro, Librium, lindane topical, Lioresal, Lioresal Intrathecal, lisinopril, Litecoat Aspirin, Lo-Aqua, Lodine, Lodine XL, Lodrane 12 Hour, Lodrane 24, Lodrane XR, Loniten, Lopressor, Loqua, lorazepam, losartan, Lotensin, Lovenox, Lovenox HP, Low Dose ASA, loxapine, Loxitane, Loxitane C, Loxitane IM, Lozol, Ludiomil, Luminal, Lunesta, Luvox, Luvox CR, Lyrica, M-Eslon, M-Oxy, M. O. S., Maalox Total Stomach Relief, Magan, magnesium salicylate, Maolate, maprotiline, Marezine, Marinol, Marthritic, Mavik, Maximum Strength Stress, MB-TAB, Mebaral, meclofenamate, Meclomen, mefenamic acid, meloxicam, Menadol, mephenytoin, mephobarbital, meprobamate, Mesantoin, mesoridazine, Metadate CD, Metadate ER, Metahydrin, metaxalone, methadone, Methadose, methocarbamol, methsuximide, methyclothiazide, Methylin, Methylin ER, methylphenidate, methylphenidate 24 hour extended release, methylphenidate extended release, methysergide maleate, metoclopramide, metolazone, metoprolol, metoprolol extended release, metoprolol succinate, Metoprolol Succinate ER, metoprolol tartrate, mibefradil, Micardis, miconazole, Micronase, Microzide, Midamor, midazolam, Midol Extended Relief, Midol IB, Midol Maximum Strength Cramp Formula, Mifeprex, mifepristone, Milontin, Miltown, Minipress, Minirin, Minitabs, Minitran, minoxidil, Mio-Rel, Miradon, Mithracin, Mitran, Moban, Mobic, Mobidin, moexipril, molindone, Monistat I.V., Mono-Gesic, Monoket, Monopril, morphine, morphine 24 hour extended release, morphine extended release, Morphine IR, morphine liposomal, Morphine LP Epidural, morphine preservative-free, Morphine Rapi-Ject, Morphitec, Motrin, Motrin Childrens, Motrin IB, Motrin Infant Drops, Motrin Junior Strength, Motrin Migraine Pain, MS, MS Contin, MS/S, MSIR, MST, MY-E, Mycelex Troche, Mykrox, Myolin, Mysoline, nabilone, nabumetone, nadolol, nalbuphine, Nalfon, Naprelan ‘375′, Naprelan ‘500′, Naprosyn, naproxen, naproxen sodium, Naproxen Sodium DS, naproxen sodium extended release, Naqua, Nasahist B, nateglinide, Naturetin-10, Naturetin-5, Navane, ND-Stat, nebivolol, nelfinavir, Nembutal, Nembutal Sodium, NeoProfen, Nervine, Neupro, Neurontin, Nightime Sleepaid, Niravam, Nitrek, Nitro TD Patch-A, Nitro-Bid, Nitro-Bid IV, Nitro-Dur, Nitro-Par, Nitro-Time, Nitrocot, Nitrodisc, Nitrogard, nitroglycerin, Nitroglyn E-R, Nitrol, Nitrol Appli-Kit, Nitrolingual, Nitrong, Nitropress, nitroprusside, Nitroquick, Nitrostat, Nizoral, Norflex, Norflex Injectable, Normiflo, Normodyne, Norvir, Norvir Soft Gelatin, Norwich Aspirin, Novolin L, Novolin N, Novolin N Innolet, Novolin N PenFill, Novolin R, Novolin R Innolet, Novolin R PenFill, NovoLog, NovoLog FlexPen, NovoLog PenFill, NPH insulin, NTG, Nu-Med, Nubain, Numorphan HCl, Nuprin, Nuprin Backache Caplet, Nytol Caplet, Nytol Maximum Strength, olmesartan, olopatadine nasal, omeprazole, OMS, Opana, Opana ER, opium, Opium Deodorized, Oramorph SR, Orap, Oretic, Orfro, Orgaran, Orinase, Ormazine, orphenadrine, orphenadrine extended release, Orphenate, Orudis, Orudis KT, Oruvail, oxaprozin, oxazepam, oxcarbazepine, oxycodone, oxycodone extended release, OxyContin, Oxyfast, OxyIR, oxymorphone, oxymorphone extended release, P-Tann, P-Tex, Palgic, paliperidone, Palladone, Palladone SR, Paradione, Paraflex, Parafon Forte DSC, Paral, paraldehyde, paramethadione, Pardryl, Paregoric, Parlodel, Patanase, Paxarel, PBZ, PBZ-SR, PCE Dispertab, Pediacare Fever, PediaTan, Pediatex, Pediatex 12, Pediox, Pediox-S, Peganone, penbutolol, Pentazine, pentobarbital, Peptic Relief, Pepto-Bismol, Pepto-Bismol Maximum Strength, Percolone, pergolide, Periactin, perindopril, Permax, Permitil, perphenazine, Persantine, Persantine IV, phenacemide, Phenadoz, Phenazine 50, Phenergan, Phenergan Fortis, phenobarbital, Phenoject-50, phenoxybenzamine, phensuximide, phentolamine, Phenurone, phenyl salicylate, phenylbutazone, Phenytek, phenytoin, phenytoin extended release, Phenytoin Sodium, Prompt, pimozide, pindolol, Pink Bismuth, piroxicam, Plavix, Pletal, plicamycin, polythiazide, Ponstel, Posicor, Prandin, prazosin, Precedex, pregabalin, Prialt, Priftin, Prilosec, Prilosec OTC, primidone, Prinivil, Pro-Med, prochlorperazine, prochlorperazine extended release, Procot, procyclidine, Proglycem, Prograf, Prolixin, Prolixin Decanoate, Prolixin Enanthate, Promacot, promazine, promethazine, Promethegan, Prop-A-Tane, propiomazine, propofol, propranolol, propranolol extended release, Prorex, Prosom, prostacyclin, protamine zinc insulin, Prozac, Prozac Weekly, Q-Dryl, Q-Dryl A/F, Q-Profen, QDALL AR, quazepam, Quenalin, Quin-G, Quin-Release, Quinaglute Dura-Tabs, quinapril, Quinidex Extentabs, quinidine, quinidine extended release, Quinora, ramipril, Rapamune, Rapiflux, Rauwolfemms, Rauwolfia 1X, rauwolfia serpentina, Raxar, Refludan, Reglan, regular insulin, Relafen, Relaxazone, ReliOn/Novolin N, ReliOn/Novolin R, Remodulin, Remular, Remular-S, Renese, Reopro, repaglinide, Rescriptor, Rescudose, reserpine, Restoril, Retavase, reteplase, Rexolate, Rezine, Ridramin, rifapentine, Risperdal, Risperdal Consta, Risperdal M-Tab, risperidone, Ritalin, Ritalin LA, Ritalin-SR, ritonavir, RMS, Robaxin, Robaxin-750, Robimycin, Rohist, rotigotine, Roxanol, Roxanol 100, Roxanol-T, Roxicodone, Roxicodone Intensol, RU-486, Rufen, Saleto-200, Saleto-400, Saleto-600, Saleto-800, Salflex, salsalate, Salsitab, Saluron, Sansert, saquinavir, saquinavir mesylate, Sarafem, Scot-Tussin Allergy Relief Formula, secobarbital, Seconal Sodium, Sectral, Serax, Serentil, sertraline, Siladryl, Siladryl DAS, Siladyl SA, Silphen Cough, Siltane, Simply Sleep, sirolimus, Skelaxin, Skelex, Sleep Tab II, Sleep Tabs, Sleep-ettes, Sleep-Eze-3, Sleepinal, Sloprin, sodium nitroprusside, sodium salicylate, sodium thiosalicylate, sodium valproate, Solfoton, solotuss, Soma, Sominex, Sominex Maximum Strength Caplet, Somnicaps, Somnote, Sorbitrate, Sorine, sotalol, Sotalol Hydrochloride AF, Sotalol Hydrochloride AF(obsolete), Sparine, spironolactone, Sporanox, Sprycel, St. Joseph Aspirin, St. Joseph Aspirin Adult Chewable, St. Joseph Aspirin Adult EC, Stadol, Stadol NS, Stanback Analgesic, Starlix, Statex, Stelazine, Stimate, Streptase, streptokinase, Stress Maximum Strength, Strifon Fort, Subutex, sulfinpyrazone, sulindac, Sustiva, tacrolimus, Tagamet, Tagamet HB, Tanacof-XR, TanaHist-PD, Tao, Tavist, Tavist Allergy, Tavist-1, 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Celexa Minor Interaction Minor Interactions
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Antidepressant Medicines, Depression and other Serious Mental Illnesses, and Suicidal Thoughts or Actions

Read the Medication Guide that comes with you or your family member’s antidepressant medicine. This Medication Guide is only about the risk of suicidal thoughts and actions with antidepressant medicines. Talk to your, or your family member’s, healthcare provider about:

* all risks and benefits of treatment with antidepressant medicines
* all treatment choices for depression or other serious mental illness

What is the most important information I should know about antidepressant medicines, depression and other serious mental illnesses, and suicidal thoughts or actions?

1. Antidepressant medicines may increase suicidal thoughts or actions in some children, teenagers, and young adults when the medicine is first started.
2. Depression and other serious mental illnesses are the most important causes of suicidal thoughts and actions. Some people may have a particularly high risk of having suicidal thoughts or actions. These include people who have (or have a family history of) bipolar illness (also called manic-depressive illness) or suicidal thoughts or actions.
3. How can I watch for and try to prevent suicidal thoughts and actions in myself or a family member?
* Pay close attention to any changes, especially sudden changes, in mood, behaviors, thoughts, or feelings. This is very important when an antidepressant medicine is first started or when the dose is changed.
* Call the healthcare provider right away to report new or sudden changes in mood, behavior, thoughts, or feelings.
* Keep all follow-up visits with the healthcare provider as scheduled. Call the healthcare provider between visits as needed, especially if you have concerns about symptoms.

Call a healthcare provider right away if you or your family member has any of the following symptoms, especially if they are new, worse, or worry you:

* thoughts about suicide or dying
* attempts to commit suicide
* new or worse depression
* new or worse anxiety
* feeling very agitated or restless
* panic attacks
* trouble sleeping (insomnia)
* new or worse irritability
* acting aggressive, being angry, or violent
* acting on dangerous impulses
* an extreme increase in activity and talking
(mania)
* other unusual changes in behavior or mood

What else do I need to know about antidepressant medicines?

* Never stop an antidepressant medicine without first talking to a healthcare provider. Stopping an antidepressant medicine suddenly can cause other symptoms.
* Antidepressants are medicines used to treat depression and other illnesses. It is important to discuss all the risks of treating depression and also the risks of not treating it. Patients and their families or other caregivers should discuss all treatment choices with the healthcare provider, not just the use of antidepressants.
* Antidepressant medicines have other side effects. Talk to the healthcare provider about the side effects of the medicine prescribed for you or your family member.
* Antidepressant medicines can interact with other medicines. Know all of the medicines that you or your family member takes. Keep a list of all medicines to show the healthcare provider. Do not start new medicines without first checking with your healthcare provider.
* Not all antidepressant medicines prescribed for children are FDA approved for use in children. Talk to your child’s healthcare provider for more information.

This Medication Guide has been approved by the U.S. Food and Drug Administration for all antidepressants.

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Retinal Changes in Rats

Pathologic changes (degeneration/atrophy) were observed in the retinas of albino rats in the 2-year carcinogenicity study with citalopram. There was an increase in both incidence and severity of retinal pathology in both male and female rats receiving 80 mg/kg/day (13 times the maximum recommended daily human dose of 60 mg on a mg/m2 basis). Similar findings were not present in rats receiving 24 mg/kg/day for two years, in mice treated for 18 months at doses up to 240 mg/kg/day, or in dogs treated for one year at doses up to 20 mg/kg/day (4, 20, and 10 times, respectively, the maximum recommended daily human dose on a mg/m2 basis).

Additional studies to investigate the mechanism for this pathology have not been performed, and the potential significance of this effect in humans has not been established.

Cardiovascular Changes in Dogs

In a one-year toxicology study, 5 of 10 beagle dogs receiving oral doses of 8 mg/kg/day (4 times the maximum recommended daily human dose of 60 mg on a mg/m2 basis) died suddenly between weeks 17 and 31 following initiation of treatment. Although appropriate data from that study are not available to directly compare plasma levels of citalopram (CT) and its metabolites, demethylcitalopram (DCT) and didemethylcitalopram (DDCT), to levels that have been achieved in humans, pharmacokinetic data indicate that the relative dog-to-human exposure was greater for the metabolites than for citalopram. Sudden deaths were not observed in rats at doses up to 120 mg/kg/day, which produced plasma levels of CT, DCT, and DDCT similar to those observed in dogs at doses of 8 mg/kg/day. A subsequent intravenous dosing study demonstrated that in beagle dogs, DDCT caused QT prolongation, a known risk factor for the observed outcome in dogs. This effect occurred in dogs at doses producing peak DDCT plasma levels of 810 to 3250 nM (39-155 times the mean steady state DDCT plasma level measured at the maximum recommended human daily dose of 60 mg). In dogs, peak DDCT plasma concentrations are approximately equal to peak CT plasma concentrations, whereas in humans, steady state DDCT plasma concentrations are less than 10% of steady state CT plasma concentrations. Assays of DDCT plasma concentrations in 2020 citalopram-treated individuals demonstrated that DDCT levels rarely exceeded 70 nM; the highest measured level of DDCT in human overdose was 138 nM. While DDCT is ordinarily present in humans at lower levels than in dogs, it is unknown whether there are individuals who may achieve higher DDCT levels. The possibility that DCT, a principal metabolite in humans, may prolong the QT interval in dogs has not been directly examined because DCT is rapidly converted to DDCT in that species.

Forest Pharmaceuticals, Inc.
Subsidiary of Forest Laboratories, Inc.
St. Louis, MO 63045 USA

Licensed from H. Lundbeck A/S
Rev. 05/07
© 2007 Forest Laboratories, Inc.

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Initial Treatment
Celexa (citalopram HBr) should be administered at an initial dose of 20 mg once daily, generally with an increase to a dose of 40 mg/day. Dose increases should usually occur in increments of 20 mg at intervals of no less than one week. Although certain patients may require a dose of 60 mg/day, the only study pertinent to dose response for effectiveness did not demonstrate an advantage for the 60 mg/day dose over the 40 mg/day dose; doses above 40 mg are therefore not ordinarily recommended.

Celexa should be administered once daily, in the morning or evening, with or without food.

Special Populations
20 mg/day is the recommended dose for most elderly patients and patients with hepatic impairment, with titration to 40 mg/day only for nonresponding patients.

No dosage adjustment is necessary for patients with mild or moderate renal impairment. Celexa should be used with caution in patients with severe renal impairment.

Treatment of Pregnant Women During the Third Trimester
Neonates exposed to Celexa and other SSRIs or SNRIs, late in the third trimester, have developed complications requiring prolonged hospitalization, respiratory support, and tube feeding. When treating pregnant women with Celexa during the third trimester, the physician should carefully consider the potential risks and benefits of treatment. The physician may consider tapering Celexa in the third trimester.

Maintenance Treatment
It is generally agreed that acute episodes of depression require several months or longer of sustained pharmacologic therapy. Systematic evaluation of Celexa in two studies has shown that its antidepressant efficacy is maintained for periods of up to 24 weeks following 6 or 8 weeks of initial treatment (32 weeks total). In one study, patients were assigned randomly to placebo or to the same dose of Celexa (20-60 mg/day) during maintenance treatment as they had received during the acute stabilization phase, while in the other study, patients were assigned randomly to continuation of Celexa 20 or 40 mg/day, or placebo, for maintenance treatment. In the latter study, the rates of relapse to depression were similar for the two dose groups. Based on these limited data, it is not known whether the dose of citalopram needed to maintain euthymia is identical to the dose needed to induce remission. If adverse reactions are bothersome, a decrease in dose to 20 mg/day can be considered.

Discontinuation of Treatment with Celexa
Symptoms associated with discontinuation of Celexa and other SSRIs and SNRIs have been reported. Patients should be monitored for these symptoms when discontinuing treatment. A gradual reduction in the dose rather than abrupt cessation is recommended whenever possible. If intolerable symptoms occur following a decrease in the dose or upon discontinuation of treatment, then resuming the previously prescribed dose may be considered. Subsequently, the physician may continue decreasing the dose but at a more gradual rate.

Switching Patients To or From a Monoamine Oxidase Inhibitor
At least 14 days should elapse between discontinuation of an MAOI and initiation of Celexa therapy. Similarly, at least 14 days should be allowed after stopping Celexa before starting an MAOI.

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Human Experience
In clinical trials of citalopram, there were reports of citalopram overdose, including overdoses of up to 2000mg, with no associated fatalities. During the postmarketing evaluation of citalopram, Celexa overdoses, including overdoses of up to 6000 mg, have been reported. As with other SSRI’s, a fatal outcome in a patient who has taken an overdose of citalopram has been rarely reported.

Symptoms most often accompanying citalopram overdose, alone or in combination with other drugs and/or alcohol, included dizziness, sweating, nausea, vomiting, tremor, somnolence, and sinus tachycardia. In more rare cases, observed symptoms included amnesia, confusion, coma, convulsions, hyperventilation, cyanosis, rhabdomyolysis, and ECG changes (including QTc prolongation, nodal rhythm, ventricular arrhythmia, and very rare cases of torsade de pointes). Acute renal failure has been very rarely reported accompanying overdose.

Management of Overdose
Establish and maintain an airway to ensure adequate ventilation and oxygenation. Gastric evacuation by lavage and use of activated charcoal should be considered. Careful observation and cardiac and vital sign monitoring are recommended, along with general symptomatic and supportive care. Due to the large volume of distribution of citalopram, forced diuresis, dialysis, hemoperfusion, and exchange transfusion are unlikely to be of benefit. There are no specific antidotes for Celexa.

In managing overdosage, consider the possibility of multiple-drug involvement. The physician should consider contacting a poison control center for additional information on the treatment of any overdose.

Controlled Substance Class
Celexa (citalopram HBr) is not a controlled substance.

Physical and Psychological Dependence
Animal studies suggest that the abuse liability of Celexa is low. Celexa has not been systematically studied in humans for its potential for abuse, tolerance, or physical dependence. The premarketing clinical experience with Celexa did not reveal any drug-seeking behavior. However, these observations were not systematic and it is not possible to predict, on the basis of this limited experience, the extent to which a CNS-active drug will be misused, diverted, and/or abused once marketed. Consequently, physicians should carefully evaluate Celexa patients for history of drug abuse and follow such patients closely, observing them for signs of misuse or abuse (e.g., development of tolerance, incrementations of dose, drug-seeking behavior).

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Of 4422 patients in clinical studies of Celexa, 1357 were 60 and over, 1034 were 65 and over, and 457 were 75 and over. No overall differences in safety or effectiveness were observed between these subjects and younger subjects, and other reported clinical experience has not identified differences in responses between the elderly and younger patients, but greater sensitivity of some older individuals cannot be ruled out. Most elderly patients treated with Celexa in clinical trials received daily doses between 20 and 40 mg.

In two pharmacokinetic studies, citalopram AUC was increased by 23% and 30%, respectively, in elderly subjects as compared to younger subjects, and its half-life was increased by 30% and 50%, respectively.

20 mg/day is the recommended dose for most elderly patients.

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Safety and effectiveness in the pediatric population have not been established. Two placebo-controlled trials in 407 pediatric patients with MDD have been conducted with Celexa, and the data were not sufficient to support a claim for use in pediatric patients. Anyone considering the use of Celexa in a child or adolescent must balance the potential risks with the clinical need.

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As has been found to occur with many other drugs, citalopram is excreted in human breast milk. There have been two reports of infants experiencing excessive somnolence, decreased feeding, and weight loss in association with breastfeeding from a citalopram-treated mother; in one case, the infant was reported to recover completely upon discontinuation of citalopram by its mother and in the second case, no follow-up information was available. The decision whether to continue or discontinue either nursing or Celexa therapy should take into account the risks of citalopram exposure for the infant and the benefits of Celexa treatment for the mother.

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Pregnancy Category C

In animal reproduction studies, citalopram has been shown to have adverse effects on embryo/fetal and postnatal development, including teratogenic effects, when administered at doses greater than human therapeutic doses.

In two rat embryo/fetal development studies, oral administration of citalopram (32, 56, or 112 mg/kg/day) to pregnant animals during the period of organogenesis resulted in decreased embryo/fetal growth and survival and an increased incidence of fetal abnormalities (including cardiovascular and skeletal defects) at the high dose, which is approximately 18 times the MRHD of 60 mg/day on a body surface area (mg/m2) basis. This dose was also associated with maternal toxicity (clinical signs, decreased body weight gain). The developmental, no-effect dose of 56 mg/kg/day is approximately 9 times the MRHD on a mg/m2 basis. In a rabbit study, no adverse effects on embryo/fetal development were observed at doses of up to 16 mg/kg/day, or approximately 5 times the MRHD on a mg/m2 basis. Thus, teratogenic effects were observed at a maternally toxic dose in the rat and were not observed in the rabbit.

When female rats were treated with citalopram (4.8, 12.8, or 32 mg/kg/day) from late gestation through weaning, increased offspring mortality during the first 4 days after birth and persistent offspring growth retardation were observed at the highest dose, which is approximately 5 times the MRHD on a mg/m2 basis. The no-effect dose of 12.8 mg/kg/day is approximately 2 times the MRHD on a mg/m2 basis. Similar effects on offspring mortality and growth were seen when dams were treated throughout gestation and early lactation at doses ≥ 24 mg/kg/day, approximately 4 times the MRHD on a mg/m2 basis. A no-effect dose was not determined in that study.

There are no adequate and well-controlled studies in pregnant women; therefore, citalopram should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

Pregnancy-Nonteratogenic Effects

Neonates exposed to Celexa and other SSRIs or SNRIs, late in the third trimester, have developed complications requiring prolonged hospitalization, respiratory support, and tube feeding. Such complications can arise immediately upon delivery. Reported clinical findings have included respiratory distress, cyanosis, apnea, seizures, temperature instability, feeding difficulty, vomiting, hypoglycemia, hypotonia, hypertonia, hyperreflexia, tremor, jitteriness, irritability, and constant crying. These features are consistent with either a direct toxic effect of SSRIs and SNRIs or, possibly, a drug discontinuation syndrome. It should be noted that, in some cases, the clinical picture is consistent with serotonin syndrome.

Infants exposed to SSRIs in late pregnancy may have an increased risk for persistent pulmonary hypertension of the newborn (PPHN). PPHN occurs in 1—2 per 1000 live births in the general population and is associated with substantial neonatal morbidity and mortality. In a retrospective, case-control study of 377 women whose infants were born with PPHN and 836 women whose infants were born healthy, the risk for developing PPHN was approximately six-fold higher for infants exposed to SSRIs after the 20th week oaf gestation compared to infants who had not been exposed to antidepressants during pregnancy. There is currently no corroborative evidence regarding the risk for PPHN following exposure to SSRIs in pregnancy; this is the first study that has investigated the potential risk. The study did not include enough cases with exposure to individual SSRIs to determine if all SSRIs posed similar levels of PPHN risk.

When treating a pregnant woman with Celexa during the third trimester, the physician should carefully consider both the potential risks and benefits of treatment. Physicians should note that in a prospective longitudinal study of 201 women with a history of major depression who were euthymic at the beginning of pregnancy, women who discontinued antidepressant medication during pregnancy were more likely to experience a relapse of major depression than women who continued antidepressant medication.

Labor and Delivery
The effect of Celexa on labor and delivery in humans is unknown.

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