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Selective serotonin reuptake inhibitor (SSRI)

Citalopram with antibiotics: interactions and safety

Antibiotic courses are common, short-term and often combined with chronic medications such as Citalopram (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 Selective serotonin reuptake inhibitor (SSRI) 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 Citalopram 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 Citalopram 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 Citalopram regimen.

Will antibiotics make Citalopram stop working?

Most antibiotics do not affect Citalopram 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.

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