In addition, because citalopram is a substrate for cyp2c19, the maximum daily dose of citalopram should not exceed 20 mg day in patients receiving cyp2c19 inhibitors such as efavirenz.

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TABLE 3Treatment-Emergent Adverse EventsIncidence in Placebo-Controlled Clinical Trials

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Patients with major depressive disorderMDDboth adult and pediatricmay experience worsening of their depression and/or the emergence of suicidal ideation and behaviorsuicidalityor unusual changes in behaviorwhether or not they are taking antidepressant medicationsand this risk may persist until significant remission occursSuicide is a known risk of depression and certain other psychiatric disordersand these disorders themselves are the strongest predictors of suicideThere has been a long-standing concernhoweverthat antidepressants may have a role in inducing worsening of depression and the emergence of suicidality in certain patients during the early phases of treatment.

Because citalopram is extensively metabolizedexcretion of unchanged drug in urine is a minor route of eliminationUntil adequate numbers of patients with severe renal impairment have been evaluated during chronic treatment with Celexahoweverit should be used with caution in such patientssee DOSAGE AND ADMINISTRATION

If the decision has been made to discontinue treatmentmedication should be taperedas rapidly as is feasiblebut with recognition that abrupt discontinuation can be associated with certain symptomssee PRECAUTIONS and DOSAGE AND ADMINISTRATIONDiscontinuation of Treatment with Celexafor a description of the risks of discontinuation of Celexa

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Sexual side effects should pass after the first couple of weeksIf they don’tand this a problem for yougo back to your doctor to see if there’s another antidepressant you can try.

Citalopram and similar antidepressants have been linked with a small risk of problems for the unborn baby when they’re taken in early or late pregnancy.

No medicines for depression are considered completely safe to take in pregnancy or while breastfeedingYour doctor will want to prescribe citalopram only when the benefits of you taking the medicine outweigh the risks.

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After intragastric administration, the half-life of the racemic mixture of citalopram was increased by about 287 .

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A serious allergic reaction is an emergencyContact a doctor straight away if you think you or someone around you is having a serious allergic reaction.

Measure liquid medicine with the dosing syringe providedor with a special dose-measuring spoon or medicine cupIf you do not have a dose-measuring deviceask your pharmacist for one.

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