Drug reference

Citalopram

BNF 80 (2020–2021)

Source: BNF 80 (2020–2021)
PDF pages: 404

Review source pages for extracted sections and age labels. BNF dose snippets show only their first line.

Overview

Indications And Dose

Depressive illness ▶BY MOUTH USING TABLETS ▶Adult: 20 mg once daily, increased in steps of 20 mg daily if required, dose to be increased at intervals of 3–4 weeks; maximum 40 mg per day ▶Elderly: 10–20 mg once daily; maximum 20 mg per day ▶BY MOUTH USING ORAL DROPS ▶Adult: 16 mg once daily, increased in steps of 16 mg daily if required, dose to be increased at intervals of 3–4 weeks; maximum 32 mg per day ▶Elderly: 8–16 mg daily; maximum 16 mg per day Panic disorder ▶BY MOUTH USING TABLETS ▶Adult: Initially 10 mg daily, increased in steps of 10 mg daily if required, dose to be increased gradually; usual dose 20–30 mg daily; maximum 40 mg per day ▶Elderly: Initially 10 mg daily, increased in steps of 10 mg daily if required, dose to be increased gradually; maximum 20 mg per day ▶BY MOUTH USING ORAL DROPS ▶Adult: Initially 8 mg once daily, increased in steps of 8 mg if required, dose to be increased gradually; usual dose 16–24 mg daily; maximum 32 mg per day ▶Elderly: Initially 8 mg once daily, increased in steps of 8 mg if required, dose to be increased gradually; maximum 16 mg per day DOSE EQUIVALENCE AND CONVERSION ▶4 oral drops (8 mg) is equivalent in therapeutic effect to 10 mg tablet.

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Contra Indications

QT-interval prolongation

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Cautions

Susceptibility to QT-interval prolongation

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Safety

Interactions

→Appendix 1: SSRIs

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Side Effects

▶Common or very common Acute angle closure glaucoma. apathy. ﬂatulence. hypersalivation. migraine. rhinitis ▶Uncommon Oedema ▶Rare or very rare Cough. generalised tonic-clonic seizure ▶Frequency not known Hypokalaemia

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Breast Feeding

Present in milk—use with caution.

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Hepatic Impairment

Dose adjustments For tablets manufacturer advises initial dose of 10 mg daily for the ﬁrst two weeks in mild to moderate impairment—dose may be increased to max. 20 mg daily; use with extra caution and careful dose titration in severe impairment. For oral drops manufacturer advises initial dose of 8 mg daily for the ﬁrst two weeks in mild to moderate impairment—dose may be increased to max. 16 mg daily; use with extra caution and careful dose titration in severe impairment.

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Renal Impairment

No information available for eGFR less than 20 mL/minute/1.73 m2.

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Dose and formulations

Directions For Administration

Cipramil ® oral drops should be mixed with water, orange juice, or apple juice before taking.

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Medicinal Forms

There can be variation in the licensing of different medicines containing the same drug. Oral drops EXCIPIENTS: May contain Alcohol ▶Citalopram (Non-proprietary) Citalopram (as Citalopram hydrochloride) 40 mg per 1 ml Citalopram 40mg/ml oral drops sugar free sugar-free | 15 ml P £18.17 DT = £15.16 ▶Cipramil (Lundbeck Ltd) Citalopram (as Citalopram hydrochloride) 40 mg per 1 ml Cipramil 40mg/ml drops sugar-free | 15 ml P £10.08 DT = £15.16 Tablet ▶Citalopram (Non-proprietary) Citalopram (as Citalopram hydrobromide) 10 mg Citalopram 10mg tablets | 28 tablet P £12.36 DT = £0.90 Citalopram (as Citalopram hydrobromide) 20 mg Citalopram 20mg tablets | 28 tablet P £14.66 DT = £0.95 Citalopram (as Citalopram hydrobromide) 40 mg Citalopram 40mg tablets | 28 tablet P £16.47 DT = £1.11 ▶Cipramil (Lundbeck Ltd) Citalopram (as Citalopram hydrobromide) 20 mg Cipramil 20mg tablets | 28 tablet P £8.95 DT = £0.95 eiiii F 381

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Clinical care

Treatment Cessation

The dose should preferably be reduced gradually over about 4 weeks, or longer if withdrawal symptoms emerge (6 months in patients who have been on long-term maintenance treatment).

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Patient And Carer Advice

Counselling on administration of oral drops is advised. Driving and skilled tasks Patients should be advised of the effects of citalopram on driving and skilled tasks.

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Dose text by age group

Adult

20 mg once daily, increased in steps of 20 mg

First-line fragment. Read the complete Indications and Dose section above.

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Elderly

10–20 mg once daily; maximum 20 mg per day

First-line fragment. Read the complete Indications and Dose section above.

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Adult

16 mg once daily, increased in steps of 16 mg

First-line fragment. Read the complete Indications and Dose section above.

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Elderly

8–16 mg daily; maximum 16 mg per day

First-line fragment. Read the complete Indications and Dose section above.

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Adult

Initially 10 mg daily, increased in steps of 10 mg

First-line fragment. Read the complete Indications and Dose section above.

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Elderly

Initially 10 mg daily, increased in steps of

First-line fragment. Read the complete Indications and Dose section above.

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Adult

Initially 8 mg once daily, increased in steps of

First-line fragment. Read the complete Indications and Dose section above.

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Elderly

Initially 8 mg once daily, increased in steps of

First-line fragment. Read the complete Indications and Dose section above.

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Age labels are extracted for navigation. Check the complete source section and current local guidance before clinical use.

Drug reference

Citalopram

BNF 80 (2020–2021)

Source: BNF 80 (2020–2021)
PDF pages: 404

Review source pages for extracted sections and age labels. BNF dose snippets show only their first line.

Overview

Indications And Dose

PDF page 404

Contra Indications

QT-interval prolongation

PDF page 404

Cautions

Susceptibility to QT-interval prolongation

PDF page 404

Safety

Interactions

→Appendix 1: SSRIs

PDF page 404

Side Effects

PDF page 404

Breast Feeding

Present in milk—use with caution.

PDF page 404

Hepatic Impairment

PDF page 404

Renal Impairment

No information available for eGFR less than 20 mL/minute/1.73 m2.

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Dose and formulations

Directions For Administration

Cipramil ® oral drops should be mixed with water, orange juice, or apple juice before taking.

PDF page 404

Medicinal Forms

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Clinical care

Treatment Cessation

The dose should preferably be reduced gradually over about 4 weeks, or longer if withdrawal symptoms emerge (6 months in patients who have been on long-term maintenance treatment).

PDF page 404

Patient And Carer Advice

Counselling on administration of oral drops is advised. Driving and skilled tasks Patients should be advised of the effects of citalopram on driving and skilled tasks.

PDF page 404

Dose text by age group

Adult

20 mg once daily, increased in steps of 20 mg

First-line fragment. Read the complete Indications and Dose section above.

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Elderly

10–20 mg once daily; maximum 20 mg per day

First-line fragment. Read the complete Indications and Dose section above.

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Adult

16 mg once daily, increased in steps of 16 mg

First-line fragment. Read the complete Indications and Dose section above.

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Elderly

8–16 mg daily; maximum 16 mg per day

First-line fragment. Read the complete Indications and Dose section above.

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Adult

Initially 10 mg daily, increased in steps of 10 mg

First-line fragment. Read the complete Indications and Dose section above.

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Elderly

Initially 10 mg daily, increased in steps of

First-line fragment. Read the complete Indications and Dose section above.

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Adult

Initially 8 mg once daily, increased in steps of

First-line fragment. Read the complete Indications and Dose section above.

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Elderly

Initially 8 mg once daily, increased in steps of

First-line fragment. Read the complete Indications and Dose section above.

PDF page 404

Age labels are extracted for navigation. Check the complete source section and current local guidance before clinical use.