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PRECAUTIONS
Citalopram hydrobromide CAS Number 59729-32-7
Do not use citalopram if you are using an MAO inhibitor such as
isocarboxazid (Marplan), tranylcypromine (Parnate), phenelzine (Nardil),
rasagiline (Azilect), or selegiline (Eldepryl, Emsam). Serious and sometimes
fatal reactions can occur when these medicines are taken with citalopram.
You must wait at least 14 days after stopping an MAO inhibitor before you
can take citalopram. After you stop taking this medication, you must wait at
least 14 days before you start taking an MAOI.
Before taking citalopram, tell your doctor if you are allergic to any drugs,
or if you have:
* liver or kidney disease;
*seizures or epilepsy;
*bipolar disorder (manic depression); or
*a history of drug abuse or suicidal thoughts.
If you have any of these conditions, you may need a dose adjustment or
special tests to safely take citalopram.
You may have thoughts about suicide when you first start taking an
antidepressant, especially if you are younger than 24 years old. Tell your
doctor if you have worsening symptoms of depression or suicidal thoughts
during the first several weeks of treatment, or whenever your dose is
changed.
Your family or other caregivers should also be alert to changes in your mood
or symptoms. Your doctor will need to check you at regular visits for at
least the first 12 weeks of treatment with citalopram.
Before taking citalopram,
* tell your doctor and pharmacist if you are allergic to citalopram,
escitalopram (Lexapro), or any other medications.
* tell your doctor if you are taking pimozide (Orap) or a monoamine oxidase
(MAO) inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil),
selegiline (Eldepryl, Emsam, Zelapar), and tranylcypromine (Parnate), or if
you have stopped taking an MAO inhibitor within the past 14 days. Your
doctor will probably tell you not to take citalopram. If you stop taking
citalopram, you should wait at least 14 days before you start to take an MAO
inhibitor.
* you should know that citalopram is very similar to another SSRI,
escitalopram (Lexapro). You should not take these two medications together.
* tell your doctor and pharmacist what other prescription and
nonprescription medications, and vitamins you are taking or plan to take. Be
sure to mention any of the following: anticoagulants (blood thinners) such
as warfarin (Coumadin);other antidepressants such as amitriptyline (Elavil),
amoxapine (Asendin), clomipramine (Anafranil), desipramine (Norpramin),
doxepin (Adapin, Sinequan), imipramine (Tofranil), nortriptyline (Aventyl,
Pamelor), protriptyline (Vivactil), and trimipramine (Surmontil); aspirin
and other nonsteroidal anti-inflammatory medications (NSAIDs) such as
ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn); carbamazepine (Tegretol);
cimetidine (Tagamet); ketoconazole (Nizoral); linezolid (Zyvox); lithium (Eskalith,
Lithobid); medications for anxiety, mental illness, Parkinson's disease, and
seizures; medications for migraine headaches such as almotriptan (Axert),
eletriptan (Relpax), frovatriptan (Frova), naratriptan (Amerge), rizatriptan
(Maxalt), sumatriptan (Imitrex), and zolmitriptan (Zomig); metoprolol (Lopressor,
Toprol XL); sedatives; sibutramine (Meridia); sleeping pills; tramadol (Ultram);
and tranquilizers. Your doctor may need to change the doses of your
medications or monitor you carefully for side effects.
* tell your doctor what nutritional supplements and herbal products you are
taking, especially products that contain St. John's wort or tryptophan.
* tell your doctor if you have recently had a heart attack and if you have
or have ever had seizures; or liver, kidney, or heart disease.
* tell your doctor if you are pregnant, plan to become pregnant, or are
breast-feeding. If you become pregnant while taking citalopram, call your
doctor.
* you should know that citalopram may make you drowsy. Do not drive a car or
operate machinery until you know how this medication affects you.
* remember that alcohol can add to the drowsiness caused by this medication.
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