No adjustment of dosage on the basis of gender is recommended.Reduced hepatic function - Citalopram oral clearance was reduced by 37% and half-life was doubled in patients with reduced hepatic function compared to normal subjects.

Citalopram should be used with caution in patients with severe renal impairment.Neonates exposed to citalopram and other SSRIs or SNRIs, late in the third trimester, have developed complications requiring prolonged hospitalization, respiratory support, and tube feeding (see It is generally agreed that acute episodes of depression require several months or longer of sustained pharmacologic therapy.

Case reports and epidemiological studies (case-control and cohort design) have demonstrated an association between use of drugs that interfere with serotonin reuptake and the occurrence of gastrointestinal bleeding. For the full list of excipients, see Section 6.1 List of excipients. In three additional placebo-controlled depression trials, the difference in response to treatment between patients receiving citalopram and patients receiving placebo was not statistically significant, possibly due to high spontaneous response rate, smaller sample size, or, in the case of one study, too low a dose.In two long-term studies, depressed patients who had responded to citalopram during an initial 6 or 8 weeks of acute treatment (fixed doses of 20 or 40 mg/day in one study and flexible doses of 20-60 mg/day in the second study) were randomized to continuation of citalopram or to placebo. Acute renal failure has been very rarely reported accompanying overdose.Establish and maintain an airway to ensure adequate ventilation and oxygenation.

If these happen and are a problem for you, go back to your doctor to see if there's another treatment you can try.You can drink alcohol while taking citalopram, but it may make you feel sleepy. Some people feel worse during the first few weeks of treatment before they begin to feel better.Once you're feeling better it's likely that you'll continue to take citalopram for several more months to prevent the symptoms returning.You'll need to discuss with your doctor the pros and cons of continuing to take citalopram for longer than a few months. But it may be started at a lower dose and increased to a maximum dose of 40mg a day. This Medication Guide summarizes the most important information about Citalopram Tablets. In the citalopram group 1.9% of the patients had a change from baseline in QTcF >60 msec compared to 1.2% of the patients in the placebo group. Get medical help right away if you have any of these symptoms:have a heart problem including congenital long QT syndromeWhat should I tell my healthcare provider before takingCitalopram Tablets may cause serious side effects, including:See “What is the most important information I should know aboutCALL YOUR DOCTOR FOR MEDICAL ADVICE ABOUT SIDE EFFECTS.

Breastfeeding will also benefit both you and your baby.If you notice that your baby isn't feeding as well as usual or seems unusually sleepy, or you have any other concerns about your baby, talk to your health visitor or doctor as soon as possible.Some medicines and citalopram can interfere with each other and increase the chances of you having side effects.Do not take St John's wort, the herbal remedy for depression, while you're being treated with citalopram as this will increase your risk of side effects.Tell your doctor or pharmacist if you're taking any other medicines, including herbal remedies, vitamins or supplements.Citalopram is one of a group of antidepressants called selective serotonin reuptake inhibitors, or SSRIs. These analyses did not reveal any clinically important changes in vital signs associated with citalopram treatment.

In humans, unchanged citalopram is the predominant compound in plasma. In one study, patients were assigned randomly to placebo or to the same dose of citalopram (20 to 60 mg/day) during maintenance treatment as they had received during the acute stabilization phase, while in the other study, patients were assigned randomly to continuation of citalopram 20 or 40 mg/day, or placebo, for maintenance treatment. Open-angle glaucoma is not a risk factor for angle closure glaucoma. The premarketing clinical experience with citalopram did not reveal any drug-seeking behavior. Patients being considered for citalopram treatment who are at risk for significant electrolyte disturbances should have baseline serum potassium and magnesium measurements with periodic monitoring. Women who discontinued antidepressant medication during pregnancy showed a significant increase in relapse of their major depression compared to those women who remained on antidepressant medication throughout pregnancy.When treating a pregnant woman with citalopram, the physician should carefully consider both the potential risks of taking an SSRl, along with the established benefits of treating depression with an antidepressant.

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