Celexa with antibiotics: interactions and safety

Antibiotic courses are common, short-term and often combined with chronic medications such as Celexa (Citalopram). Most antibiotics do not interfere meaningfully with Citalopram at 10mg, 20mg, 40mg, but a few classes do, and a small number of combinations are best avoided.

Common antibiotic interactions

Macrolides (clarithromycin, erythromycin) and certain antifungals can inhibit hepatic metabolism (CYP3A4) and raise plasma levels of many medications including some Anti-Depressants agents. Rifampicin has the opposite effect, accelerating metabolism. Most penicillins, cephalosporins, fluoroquinolones and tetracyclines have no clinically meaningful interaction with Citalopram at 10mg, 20mg, 40mg.

Practical guidance

According to the prescribing information for Citalopram, an antibiotic course should be reviewed by the prescriber or pharmacist for known interactions before Celexa is co-administered. Adjusted 10mg, 20mg, 40mg dosing or temporary substitution is sometimes preferred for the duration of the antibiotic course.

Frequently asked questions

Can I take Celexa during an antibiotic course? ▾

For most common antibiotics, yes. A few classes — notably macrolides and azole antifungals — alter how Citalopram is metabolised and may need a temporary 10mg, 20mg, 40mg adjustment. The prescribing pharmacist should review any new antibiotic against the existing Celexa regimen.

Will antibiotics make Celexa stop working? ▾

Most antibiotics do not affect Celexa efficacy. Rifampicin and a few others can lower Citalopram levels and reduce effect; in those cases the prescriber may adjust the dose during and shortly after the antibiotic course.

More on Celexa

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