Medical warning:
Moderate. These medicines may cause some risk when taken together. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.
How the interaction occurs:
Ticlopidine may slow down how quickly your body processes citalopram or escitalopram.
What might happen:
The amount of citalopram or escitalopram in your blood may increase and cause an irregular heartbeat, which may be life-threatening. Your risk of bleeding may increase.High serotonin levels may cause changes in body temperature, blood pressure, and behavior or mood, leading to a medical condition called Serotonin Syndrome.
What you should do about this interaction:
Let your healthcare professionals (e.g. doctor or pharmacist) know that you are taking these medicines together. Your doctor may want to change your medicine or the dose of your citalopram or escitalopram.Let your doctor know right away if you notice an irregular heartbeat (palpitations) or have any dizziness, fainting episodes, bleeding from your gums, nosebleeds, unusual bruising, dark stools, seizures, muscle twitching, tremors, shivering and stiffness, fever, heavy sweating, restlessness, confusion, agitation, trouble with coordination, or severe diarrhea.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.
- 1.Celexa (citalopram hydrobromide) US prescribing information. Forest Laboratories Inc. August, 2023.
- 2.Lexapro (escitalopram oxalate) US prescribing information. Forest Pharmaceuticals Inc. September, 2021.
- 3.This information is based on an extract from the Certara Drug Interaction Database (DIDB) Platform, Copyright Certara 1999-2023..
- 4.Drew BJ, Ackerman MJ, Funk M, Gibler WB, Kligfield P, Menon V, Philippides GJ, Roden DM, Zareba W. Prevention of torsade de pointes in hospital settings: a scientific statement from the American Heart Association and the American College of Cardiology Foundation. J Am Coll Cardiol 2010 Mar 2;55(9):934-47.
- 5.Castro VM, Clements CC, Murphy SN, Gainer VS, Fava M, Weilburg JB, Erb JL, Churchill SE, Kohane IS, Iosifescu DV, Smoller JW, Perlis RH. QT interval and antidepressant use: a cross sectional study of electronic health records. BMJ 2013;346:f288.
- 6.Gagne M. Dear Canadian Healthcare Professional: Subject: Association of CELEXA (citalopram hydrobromide) with Dose - Dependent QT Prolongation. Lundbeck Canada January 25, 2012.
- 7.Boyer EW, Shannon M. The serotonin syndrome. N Engl J Med 2005 Mar 17; 352(11):1112-20.
- 8.Iwagami M, Tomlinson LA, Mansfield KE, Douglas IJ, Smeeth L, Nitsch D. Gastrointestinal bleeding risk of selective serotonin reuptake inhibitors by level of kidney function: A population-based cohort study. Br J Clin Pharmacol 2018 Sep;84(9):2142-2151.
- 9.Dalton SO, Johansen C, Mellemkjaer L, Norgard B, Sorensen HT, Olsen JH. Use of selective serotonin reuptake inhibitors and risk of upper gastrointestinal tract bleeding: a population-based cohort study. Arch Intern Med 2003 Jan 13;163(1):59-64.
- 10.USFood and Drug Administration. FDA Drug Safety Communication: Revised recommendations for Celexa (citalopram hydrobromide) related to a potential risk of abnormal heart rhythms with high doses. available at: http://www.fda.gov/Drugs/DrugSafety/ucm297391.htm March 28, 2012.
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CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.