Citalopram Hydrobromide

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Generic Name of Citalopram Hydrobromide - Learn More

Citalopram Hydrobromide

Citalopram Hydrobromide Precaution - What You Need to Know

Citalopram hydrobromide, a selective serotonin reuptake inhibitor (SSRI), is used primarily for the treatment of major depressive disorder and anxiety-related conditions. Before initiating treatment, patients should be assessed for risk factors such as a history of suicidal ideation or behavior, particularly in adolescents and young adults, as SSRIs may increase the risk of suicidal thoughts and actions in this population. It should be used with caution in patients with a history of seizures, as SSRIs can lower the seizure threshold. Citalopram should be avoided in individuals with QT prolongation or those at risk for it, as it can cause dose-dependent prolongation of the QT interval, leading to serious arrhythmias. The drug is contraindicated in patients taking monoamine oxidase inhibitors (MAOIs), and there should be at least a 14-day washout period between discontinuing an MAOI and starting citalopram. For those with liver or renal impairment, dosage adjustments may be necessary. It is also advised to monitor for serotonin syndrome, a rare but life-threatening condition that can result from high serotonin levels. Withdrawal symptoms may occur if citalopram is abruptly discontinued, so tapering is recommended. Pregnant and breastfeeding women should consult their healthcare provider, as citalopram may have risks for fetal development and may pass into breast milk.

Citalopram Hydrobromide Indication - Uses and Benefits

Citalopram hydrobromide is primarily indicated for the treatment of major depressive disorder (MDD) in adults and is commonly prescribed for anxiety-related conditions, such as generalized anxiety disorder (GAD) and panic disorder. Its efficacy has been established in clinical trials, with substantial evidence supporting its use in reducing the symptoms of depression and anxiety. The drug works by increasing serotonin levels in the brain, which is believed to have a positive effect on mood regulation. Citalopram is often used as a first-line treatment for depression due to its relatively favorable side effect profile compared to other antidepressants. Off-label uses include the treatment of obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), and premenstrual dysphoric disorder (PMDD). In some cases, it may also be considered for other anxiety disorders, such as social anxiety disorder, although its use in these contexts may require more individualized assessment.

Citalopram Hydrobromide Contraindications - Important Warnings

Citalopram is contraindicated in patients who are taking monoamine oxidase inhibitors (MAOIs), as the combination can lead to a dangerous increase in serotonin levels, resulting in serotonin syndrome. This condition can cause symptoms such as agitation, confusion, tremors, and in severe cases, it can be fatal. The drug should also not be used in patients with a known hypersensitivity to citalopram or any of its components. Citalopram is contraindicated in patients with congenital long QT syndrome or a history of QT prolongation, as it can exacerbate this condition, increasing the risk of life-threatening arrhythmias. Additionally, in patients with severe hepatic impairment or end-stage renal disease, the use of citalopram is not recommended, or a dose reduction may be necessary. It should also be avoided in individuals who have had a history of suicidality or in children and adolescents without careful monitoring, as there is an increased risk of suicidal thoughts and behaviors in this population. It is essential to consult a healthcare provider before starting treatment to ensure it is appropriate for the individual’s medical history and current health condition.

Citalopram Hydrobromide Side Effects - What to Expect

The side effects of citalopram hydrobromide vary from mild to moderate in severity and may improve over time as the body adjusts to the medication. Common side effects include gastrointestinal symptoms such as nausea, diarrhea, or dry mouth, as well as headaches and fatigue. Sexual side effects, including decreased libido, delayed ejaculation, and erectile dysfunction, are also common with SSRIs. These can significantly impact a patient’s quality of life and may require dose adjustments or the addition of other medications to manage these effects. Serious but less common side effects include serotonin syndrome, which presents with agitation, confusion, increased heart rate, and high blood pressure. If untreated, serotonin syndrome can be fatal. Another serious side effect is the potential for QT prolongation, leading to arrhythmias, especially when taken at high doses or with other QT-prolonging drugs. Weight gain and sleep disturbances, such as insomnia or vivid dreams, may also occur. In some cases, patients may experience increased anxiety or agitation when starting treatment, particularly in the first few weeks. It is crucial to monitor for any signs of worsening depression or suicidal thoughts, particularly in younger patients. Withdrawal symptoms, including dizziness, fatigue, and irritability, may occur if the drug is abruptly discontinued, so tapering the dosage is recommended.

Citalopram Hydrobromide Pregnancy Category ID - Safety Information

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Citalopram Hydrobromide Mode of Action - How It Works

Citalopram exerts its therapeutic effects primarily by inhibiting the reuptake of serotonin (5-HT) in the brain. Serotonin is a neurotransmitter that plays a crucial role in regulating mood, anxiety, and other emotional states. By blocking the reuptake of serotonin, citalopram increases serotonin levels in the synaptic cleft, thereby enhancing neurotransmission. This action is thought to contribute to its antidepressant and anxiolytic effects. Citalopram selectively inhibits the serotonin transporter (SERT) with minimal effects on other neurotransmitter systems, making it a highly selective SSRI. Its pharmacokinetics are characterized by good absorption and a half-life of approximately 35 hours, which supports once-daily dosing. The drug is metabolized in the liver via cytochrome P450 enzymes, particularly CYP2C19, CYP3A4, and CYP2D6. The elimination of citalopram is predominantly renal, with the drug and its metabolites excreted in the urine. Its mode of action helps alleviate the symptoms of depression and anxiety by restoring balance in serotonin signaling, which is often dysregulated in these conditions.

Citalopram Hydrobromide Drug Interactions - What to Avoid

Citalopram has several notable drug-drug interactions that could alter its effectiveness or increase the risk of adverse effects. When taken with other serotonergic drugs, such as other SSRIs, serotonin-norepinephrine reuptake inhibitors (SNRIs), or certain migraine medications (triptans), the risk of serotonin syndrome is heightened. Careful monitoring is required when citalopram is taken with anticoagulants, as it may increase the risk of bleeding, especially in patients on drugs like warfarin or aspirin. Additionally, combining citalopram with other drugs that prolong the QT interval, such as antiarrhythmics, can increase the risk of arrhythmias. Citalopram should not be used in combination with monoamine oxidase inhibitors (MAOIs) due to the risk of serotonin syndrome. Alcohol should be avoided during treatment, as it can increase the sedative effects and potentially worsen the side effects of citalopram, such as dizziness, drowsiness, and impaired judgment. Other interactions include drugs that inhibit cytochrome P450 enzymes, such as fluconazole, which may increase citalopram concentrations, leading to a greater risk of side effects, especially serotonin syndrome. The prescribing doctor may adjust doses or monitor for adverse effects if the patient is taking any of these interacting drugs.

Citalopram Hydrobromide Adult Dose - Recommended Dosage

For adults, the typical starting dose of citalopram is 20 mg once daily, usually taken in the morning, with or without food. If necessary, the dose may be increased in increments of 10 mg at intervals of at least one week, up to a maximum of 40 mg per day. Higher doses may be associated with an increased risk of side effects, particularly QT prolongation, so careful monitoring is required when dosing above 20 mg. In patients over 60 years of age, the maximum recommended dose is 20 mg per day due to age-related changes in drug metabolism and a higher risk of adverse effects. For patients with liver or renal impairment, lower doses may be necessary, and the patient’s response to treatment should be carefully monitored. It is important to follow the prescribed regimen and to consult with a healthcare provider before altering the dose.

Citalopram Hydrobromide Child Dose - Dosage for Children

The use of citalopram in pediatric patients is not recommended for individuals under the age of 18, except in specific cases where the benefits outweigh the risks, and even then, with close monitoring. In children and adolescents who are prescribed citalopram, the starting dose is typically 10 mg per day, which can be gradually increased to a maximum of 20 mg per day, depending on the patient’s response and tolerability. Because SSRIs, including citalopram, have been associated with an increased risk of suicidal thoughts and behaviors in this age group, regular monitoring for any worsening of depression or emergence of suicidal ideation is essential. The risk of side effects such as agitation, sleep disturbances, and gastrointestinal symptoms should be carefully considered. Adjustments for hepatic or renal impairment in pediatric patients should follow similar guidelines as for adults.

Citalopram Hydrobromide Renal Dose - Dosage for Kidney Conditions

In patients with renal impairment, citalopram dosage may need to be reduced to avoid accumulation and the risk of side effects. For individuals with mild to moderate renal impairment (creatinine clearance 30–60 mL/min), the standard starting dose of 20 mg per day can generally be used, but it may be necessary to monitor renal function closely. For those with severe renal impairment (creatinine clearance <30 mL/min), a lower dose of 10 mg per day is recommended. If renal function deteriorates during treatment, the dose should be further adjusted, or the medication should be discontinued. Renal function should be monitored regularly during therapy to ensure that appropriate adjustments are made, especially when starting or increasing the dose.