SEROPRAM (Citalopram) 20mg

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SEROPRAM (Citalopram) 20mg


What is Celexa (Citalopram)?
Celexa (Citalopram) is an antidepressant in a group of drugs called selective serotonin reuptake inhibitors (SSRIs). It affects a naturally occuring chemical in the brain called serotonin, which helps to improve certain mood problems, but may become unbalanced and cause depression.Celexa (Citalopram) is used to treat depression.Celexa (Citalopram) may also be used for purposes other than those listed in this medication guide.


Important information about Celexa (Citalopram)
Do not take Celexa (Citalopram) together with a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate). You must wait at least 14 days after stopping an MAOI before you can take Celexa (Citalopram). After you stop taking this medication, you must wait at least 14 days before you start taking an MAOI.You may have thoughts about suicide when you first start taking an antidepressant, especially if you are younger than 24 years old. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment with Celexa (Citalopram).Call your doctor at once if you have any new or worsening symptoms such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself. Some antidepressants may cause serious or life-threatening lung problems in newborn babies whose mothers take the medication during pregnancy. However, you may have a relapse of depression if you stop taking your antidepressant during pregnancy. If you are planning a pregnancy, or if you become pregnant while taking Celexa (Citalopram), do not stop taking the medication without first talking to your doctor.
 


Before taking Celexa (Citalopram)
Do not use Celexa (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 Celexa (Citalopram). You must wait at least 14 days after stopping an MAO inhibitor before you can take Celexa (Citalopram). After you stop taking this medication, you must wait at least 14 days before you start taking an MAOI.Before taking this medicine, 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); ora 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 Celexa (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 Celexa (Citalopram).FDA pregnancy category C. SSRI antidepressants may cause serious or life-threatening lung problems in newborn babies whose mothers take the medication during pregnancy. However, you may have a relapse of depression if you stop taking your antidepressant during pregnancy. If you are planning a pregnancy, or if you become pregnant while taking this medication, do not stop taking the medication without first talking to your doctor. Celexa (Citalopram) can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby. Do not give this medicine to anyone younger than 18 years old without the advice of a doctor.


How should I take Celexa (Citalopram)?
Take Celexa (Citalopram) exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Your doctor may occasionally change your dose to make sure you get the best results from the medication.Try to take Celexa (Citalopram) at the same time each day. Follow the directions on your prescription label.To be sure you get the correct dose of liquid Celexa (Citalopram), measure the liquid with a marked measuring spoon or medicine cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.It may take 4 weeks or longer before you start feeling better. Do not stop using Celexa (Citalopram) without first talking to your doctor. You may have unpleasant side effects if you stop taking Celexa (Citalopram) suddenly. 


Store this medication at room temperature away from moisture and heat.


What happens if I miss a dose?
Take the missed dose as soon as you remember. However, if it is almost time for the next regularly scheduled dose, skip the missed dose and take the next one as directed. Do not take extra medicine to make up the missed dose.


What happens if I overdose?
Seek emergency medical attention if you think you have taken too much of Celexa (Citalopram). Symptoms of a Celexa (Citalopram) overdose may include nausea, vomiting, tremor, sweating, rapid heartbeat, confusion, dizziness, seizures, and coma.


What should I avoid while taking Celexa (Citalopram)?
Avoid drinking alcohol, which can increase some of the side effects of Celexa (Citalopram).Celexa (Citalopram) can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.Tell your doctor if you regularly use other medicines that make you sleepy (such as cold or allergy medicine, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures or anxiety). They can add to sleepiness caused by Celexa (Citalopram).


Side effects of Celexa (Citalopram) 
Get emergency medical help if you have any of these signs of an allergic reaction: skin rash or hives; difficulty breathing; swelling of your face, lips, tongue, or throat.Call your doctor at once if you have any new or worsening symptoms such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.Call your doctor at once if you have any of these serious side effects:very stiff (rigid) muscles, high fever, sweating, fast or uneven heartbeats, tremors, overactive reflexes;nausea, vomiting, diarrhea, loss of appetite, feeling unsteady, loss of coordination; orheadache, trouble concentrating, memory problems, weakness, confusion, hallucinations, fainting, seizure, shallow breathing or breathing that stops.


Less serious Celexa (Citalopram) side effects may include:
drowsiness;sleep problems (insomnia);mild nausea, gas, upset stomach;weight changes;urinating more than usual;decreased sex drive, impotence, or difficulty having an orgasm;dry or watery mouth, yawning; orcold symptoms such as stuffy nose, sneezing, sore throat.This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. 


What other drugs will affect Celexa (Citalopram)?
Talk to your doctor before taking any medicine for pain, arthritis, fever, or swelling. This includes aspirin and NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), diclofenac (Voltaren), indomethacin, piroxicam (Feldene), nabumetone (Relafen), etodolac (Lodine), and others. Taking any of these drugs with Celexa (Citalopram) may cause you to bruise or bleed easily.


Before taking Celexa (Citalopram), tell your doctor if you are using any of the following medicines:
carbamazepine (Tegretol); cimetidine (Tagamet);lithium (Lithobid, Eskalith);a blood thinner such as warfarin (Coumadin);any other antidepressants such as amitriptyline (Elavil), esCelexa (Citalopram) (Lexapro), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), imipramine (Tofranil), nortriptyline (Pamelor), paroxetine (Paxil), or sertraline (Zoloft); oralmotriptan (Axert), frovatriptan (Frova), sumatriptan (Imitrex), naratriptan (Amerge), rizatriptan (Maxalt), or zolmitriptan (Zomig).If you are using any of these drugs, you may not be able to use Celexa (Citalopram), or you may need dosage adjustments or special tests during treatment.There may be other drugs not listed that can affect Celexa (Citalopram). Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.


Generic Name Citalopram
Search Name Celexa Brand 20mg TAB
Supply Name SEROPRAM
Brand Generic BRAND NAME
Presentation Foil in Box
Dosage TAB
USA Brand Celexa
Manufacture Lundbeck
Strength 20mg
Search Terms Celexa ,SEROPRAM ,Citalopram
Origin India

Use spaces to separate tags. Use single quotes (') for phrases.

For the Consumer

Applies to citalopram: oral solution, oral tablet

Along with its needed effects, citalopram may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking citalopram:

Less common
- Agitation
- blurred vision
- confusion
- fever
- increase in the frequency of urination or amount of urine produced
- lack of emotion
- loss of memory
- menstrual changes
- skin rash or itching
- trouble with breathing

Rare
- Behavior change similar to drunkenness
- bleeding gums
- breast tenderness or enlargement or unusual secretion of milk (in females)
- chills
- convulsions (seizures)
- diarrhea
- difficulty with concentrating
- dizziness or fainting
- drowsiness
- increased hunger
- increased thirst
- irregular heartbeat
- lack of energy
- lethargy
- nosebleed
- overactive reflexes
- painful urination
- poor coordination
- purple or red spots on the skin
- rapid weight gain
- red or irritated eyes
- redness, tenderness, itching, burning, or peeling of the skin
- shivering
- slow or irregular heartbeat (less than 50 beats per minute)
- sore throat
- stupor
- sweating
- swelling of the face, ankles, or hands
- talking or acting with excitement you cannot control
- trembling, shaking, or twitching
- trouble with holding or releasing urine
- unusual or sudden body or facial movements or postures
- unusual tiredness or weakness

Incidence not known
- Abdominal or stomach pain
- back or leg pains
- black, tarry stools
- bloating
- bloody stools
- chest pain
- confusion as to time, place, or person
- constipation
- cough
- darkened urine
- difficult or fast breathing
- difficulty with swallowing
- drooling
- fast, slow, or irregular heartbeat
- general body swelling
- hive-like swelling on the face, eyelids, lips, tongue, or throat
- hives
- holding false beliefs that cannot be changed by fact
- impaired consciousness, ranging from confusion to coma
- indigestion
- itching, puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
- loss of appetite
- loss of bladder control
- loss of consciousness
- muscle cramps or spasms
- muscle tightness
- muscle twitching or jerking
- pale skin
- penile erections, frequent or continuing
- recurrent fainting
- rhythmic movement of the muscles
- seeing, hearing, or feeling things that are not there
- shortness of breath
- swelling of the breasts or unusual milk production
- tenderness, pain, swelling, warmth, skin discoloration, and prominent superficial veins over the affected area
- tightness in the chest
- total body jerking
- twitching, twisting, uncontrolled repetitive movements of the tongue, lips, face, arms, or legs
- uncontrolled jerking or twisting movements
- unusual excitement
- vomiting of blood or material that looks like coffee grounds
- yellowing of the eyes or skin

Some side effects of citalopram may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common
- Decrease in sexual desire or ability
- sleepiness or unusual drowsiness

Less common
- Body aches or pain
- change in sense of taste
- gas
- headache (severe and throbbing)
- heartburn
- increased sweating
- increased yawning
- loss of voice
- pain in the muscles or joints
- sneezing
- stuffy or runny nose
- tingling, burning, or prickly feelings on the skin
- tooth grinding
- unusual increase or decrease in weight
- watering of the mouth

Incidence not known
- Bruising
- inability to sit still
- large, flat, blue or purplish patches in the skin
- need to keep moving
- uncontrolled eye movements
USUAL ADULT DOSE FOR DEPRESSION

Initial dose: 20 mg orally once a day.
Maintenance dose: 20 to 40 mg/day. The initial dose may be increased in 20 mg increments not more often than once a week up to a maximum of 40 mg per day.

USUAL GERIATRIC DOSE FOR DEPRESSION

20 mg/day orally is the maximum recommended dose for patients who are greater than 60 years of age.

USUAL PEDIATRIC DOSE FOR DEPRESSION

Children Up To 11 Years:
Initial dose: 10 mg orally once daily; increase dose slowly by 5 mg/day every 2 weeks as clinically needed; dosage range: 20 to 40 mg/day

12 to 18 Years:
Initial: 20 mg orally once daily; increase dose slowly by 10 mg/day every 2 weeks as clinically needed; dosage range: 20 to 40 mg/day

USUAL PEDIATRIC DOSE FOR OBSESSIVE COMPULSIVE DISORDER

Children Up To 11 years: Initial: 5-10 mg/day given once daily; increase dose slowly by 5 mg/day every 2 weeks as clinically needed; dosage range: 10 to 40 mg/day.
12 to 18 years: Initial: 10 to 20 mg/day given once daily; increase dose slowly by 10 mg/day every 2 weeks as clinically needed; dosage range: 10 to 40 mg/day.

RENAL DOSE ADJUSTMENTS

CrCl 20 mL/min or more: no adjustment recommended.
CrCl less than 20 mL/min: no information is available.

LIVER DOSE ADJUSTMENTS

20 mg per day is recommended in adult patients with hepatic impairment.

PRECAUTIONS

Citalopram is contraindicated in patients with congenital long QT syndrome.

20 mg/day is the maximum recommended dose for patients who are CYP450 2C19 poor metabolizers or those patients taking cimetidine or another CYP450 2C19 inhibitor.

Citalopram should not be used at doses greater than 40 mg per day because it can cause abnormal prolongation of the QT interval which can lead to an abnormal heart rhythms (including Torsade de Pointes), which can be fatal. Patients at particular risk for developing prolongation of the QT interval include those with underlying heart conditions and those who are predisposed to low levels of potassium and magnesium in the blood.

Children, adolescents, and young adults (18 to 24 years of age) with major depressive disorder and other psychiatric disorders may be at an increased risk of suicidal thinking and suicidality with antidepressant use, particularly during the first few months of treatment. Medical evidence has not shown this increased risk to exist in adults older than 24 years of age, but adults 65 years of age and older taking antidepressants appear to have a decreased risk of suicidality. The results of a meta-analysis indicate an overall favorable risk-to-benefit profile for the use of antidepressants (i.e., selective serotonin and/or norepinephrine reuptake inhibitors) in the treatment of pediatric patients (less than 19- years- old) with major depressive disorders (MDD), obsessive-compulsive disorder (OCD), or non- OCD anxiety disorders. Although this study also reports an overall increased risk of suicidal ideation/suicide attempt associated with the use of antidepressants in pediatric patients, the risk may be less than originally estimated. Additional prospective studies are warranted in order to confirm these findings.

Controlled clinical trials on children and adolescents treated with citalopram have reported that suicide attempts have occurred more often by citalopram treated patients than by placebo treated patients. These trials also reported 16 cases of adolescents self- harm.

Worsening of depression and/or increased suicidal thinking or behavior may always be a possibility in patients treated with antidepressant medications, particularly those being treated for depression. Anxiety, agitation, panic attacks, insomnia, irritability, hostility, impulsivity, akathisia (severe restlessness), hypomania, and mania have been reported in patients being treated with antidepressants for major depressive disorder as well as for other indications, both psychiatric and nonpsychiatric. It is unknown if these symptoms are a precursor to either worsening of depression or the emergence of suicidal impulses; however, there is concern that patients who experience one or more of these symptoms may be at increased risk for worsening depression or suicidality. Although the FDA has not concluded that antidepressant drugs cause worsening depression or suicidality, health care providers should be aware that worsening of symptoms could be due to the underlying disease or might be a result of drug therapy.

Health care providers should carefully monitor patients receiving antidepressants for possible and/or persistent worsening of depression or emergent suicidality, especially at the beginning of therapy or when the dose either increases or decreases. If symptoms are severe, abrupt in onset, or were not part of the patient's presenting symptoms, the health care provider will need to determine what intervention, including discontinuing or modifying the current drug therapy, is indicated. Prescriptions should be written for small quantities of drug to reduce the risk of an attempt to overdose. Health care providers should instruct patients, their families and their caregivers to be alert for the emergence of agitation, irritability, and the other symptoms described above, as well as the emergence of suicidality and worsening depression, and to report such symptoms immediately to their health care provider.

Because antidepressants are believed to have the potential for inducing manic episodes in patients with bipolar disorder, there is a concern about using antidepressants alone in this population. Therefore, patients should be adequately screened to determine if they are at risk for bipolar disorder before initiating antidepressant treatment so that they can be appropriately monitored during treatment. Such screening should include a detailed psychiatric history, including a family history of suicide, bipolar disorder, and depression.

The concurrent use of citalopram and MAO inhibitors is contraindicated. At least 14 days should elapse between discontinuation of an MAO inhibitor and initiation of citalopram, or vice versa.

DIALYSIS

Caution is recommended for use in patients with severe renal dysfunction.
Hemodialysis, hemoperfusion or exchange transfusion are not expected to remove citalopram.