Generic name: Citalopram

Why is this medication prescribed?
Citalopram is used to treat depression. Citalopram is in a class of antidepressants (mood elevators) called selective serotonin reuptake inhibitors (SSRIs). It works by increasing the amount of a certain natural substance in the brain.

How should this medicine be used?
Citalopram comes as a tablet and a solution to take by mouth. It is usually taken once a day with or without food. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take citalopram exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

It may take a few weeks before you feel the full benefit of citalopram. Continue to take citalopram even if you feel well. Do not stop taking citalopram without talking to your doctor, especially if you have taken large doses for a long time. Your doctor probably will want to decrease your dose gradually.

Other uses for this medicine
This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

What special precautions should I follow?
Before taking citalopram,

• tell your doctor and pharmacist if you are allergic to citalopram or any other drugs.
• tell your doctor and pharmacist what prescription and nonprescription drugs you are taking, especially anticoagulants (blood thinners) such as warfarin (Coumadin); other antidepressants; metoprolol (Lopressor); antihistamines; carbamazepine (Tegretol); cimetidine (Tagamet); estrogens; fluoxetine (Prozac); itraconazole (Sporanox); ketoconazole (Nizoral); levodopa (Sinemet, Larodopa); lithium (Eskalith, Lithobid); medications for high blood pressure, seizures, Parkinson's disease, diabetes, asthma, colds, or allergies; medications to treat an infection (bacterial or fungal); methylphenidate (Ritalin); muscle relaxants; oral contraceptives (birth control pills); sedatives; sleeping pills; thyroid medications; tranquilizers; and vitamins. Do not take citalopram if you have taken an MAO inhibitor (phenelzine [Nardil] or tranylcypromine [Parnate]) in the last 2 weeks.
• tell your doctor if you have or have ever had glaucoma; an enlarged prostate; difficulty urinating; seizures; an overactive thyroid gland; 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 immediately.
• if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking citalopram.
• you should know that this drug may make you drowsy. Do not drive a car or operate machinery until you know how citalopram will affect you.
• remember that alcohol can add to the drowsiness caused by this drug.
• tell your doctor if you use tobacco products. Cigarette smoking may decrease the effectiveness of this drug.
• plan to avoid unnecessary or prolonged exposure to sunlight and to wear protective clothing, sunglasses, and sunscreen. Citalopram may make your skin sensitive to sunlight.

What should I do if I forget a dose?
If you take citalopram once a day in the morning, take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. If you take citalopram once a day at bedtime and do not remember to take it until the next morning, skip the missed dose. Do not take a double dose to make up for a missed one.

What side effects can this medication cause?
Side effects from citalopram are common:

• upset stomach
• drowsiness
• weakness, tiredness, or anxiety
• excitement
• difficulty falling asleep or staying asleep
• nightmares
• dry mouth

• changes in appetite or weight

Tell your doctor if any of these symptoms are severe or do not go away:

• constipation
• difficulty urinating
• frequent urination
• blurred vision
• changes in sex drive or ability
• excessive sweating

If you experience any of the following symptoms, call your doctor immediately:

• jaw, neck, and back muscle spasms
• slow or difficult speech
• shuffling walk
• persistent fine tremor or inability to sit still
• fever
• difficulty breathing or swallowing
• severe skin rash
• yellowing of the skin or eyes
• irregular heartbeat

What storage conditions are needed for this medicine?
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

In case of emergency/overdose
In case of overdose, call your local poison controlcenter at 1-800-222-1222. If the victim has collapsedor is not breathing, call local emergency services at911.

Symptoms of overdose may include:

• dizziness
• sweating
• upset stomach
• vomiting
• tremor
• drowsiness
• rapid, irregular, or pounding heartbeat
• memory loss
• confusion
• seizures
• coma
• rapid breathing

What other information should I know?
Keep all appointments with your doctor and the laboratory.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.