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To reduce your risk of side effects, your doctor may direct you to start taking this drug at a low dose and gradually increase your dose. Follow your doctor’s instructions carefully. Do not increase your dose or use this drug more often or for longer than prescribed. Your condition will not improve any faster, and your risk of side effects will increase. Take this medication regularly to get the most benefit from it. To help you remember, take it at the same time each day.
Depression in patients whose diagnosis corresponds most closely to the DSM-III and DSM-III-R category of major depressive disorder
Initial dose: 20 mg PO qDay
If needed, may increase to 40 mg/day after at least 1 week
Doses above 40 mg/day are not recommended, because of risk for QT prolongation without additional benefit for treating depression
Dosing Modifications
Poor CYP2C19 metabolizers or coadministration with CYP2C19 inhibitors (eg, cimetidine, fluconazole, omeprazole): Do not exceed 20 mg/day
Hepatic impairment decreases clearance and therefore increases risk of QT prolongation; do not exceed 20 mg/day
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Dosing Modifications
Poor CYP2C19 metabolizers or coadministration with CYP2C19 inhibitors (eg, cimetidine, fluconazole, omeprazole): Do not exceed 20 mg/day
Hepatic impairment decreases clearance and therefore increases risk of QT prolongation; do not exceed 20 mg/day
MAO inhibitors
Not for administration within 14 days of administering a MAO inhibitor
Linezolid or Methylene Blue Therapy
Not for administration to patients that are receiving linezolid or IV methylene blue; consider other forms of therapy; if therapy required and benefits outweigh risks discontinue citalopram therapy, administer linezolid or methylene blue and monitor for serotonin syndrome for 2 weeks or 24 hr after last dose of linezolid or methylene blue
Renal impairment
Mild to moderate renal impairment: No dosage adjustment required
Severe renal impairment (CrCl <20 mL/min): Not studied; use with caution
Alcoholism (Off-label)
20-40 mg PO qDay
Binge-eating Disorder (Off-label)
20-60 PO qDay
Generalized Anxiety Disorder (Off-label)
Initial: 10 mg PO qDay; may titrate to 40 mg/day
Panic Disorder (Off-label)
20 mg PO qDay initially; after 1 week, may increase to 40 mg/day if warranted
Not to exceed 40 mg/day because of increased risk for QT prolongation
Hot Flashes (Off-label)
Initial: 10 mg PO qDay; may increase to 20 mg/day after 1 week
Obsessive-Compulsive Disorder (Off-label)
Initial: 20 mg PO qDay; may titrate to 40-60 mg/day; improvement may be seen 4-6 weeks after initiating therapy
Premenstrual Dysphoric Disorder (Off-label)
5 mg PO on the estimated day of ovulation; increase dose by 5 mg each day thereafter to maximum 30 mg; continue thereafter until menstruation begins; decrease dose to 20 mg on the first day of menstruation; the next day, decrease to 10 mg; stop the treatment from day 3 until ovulation begins
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How to use Celexa
Read the Medication Guide and, if available, the Patient Information Leaflet provided by your pharmacist before you start taking citalopram and each time you get a refill. If you have any questions, ask your doctor or pharmacist.
Take this medication with or without food as directed by your doctor, usually once daily in the morning or evening. The dosage is based on your medical condition, response to treatment, age, laboratory tests, and other medications you may be taking. Be sure to tell your doctor and pharmacist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products). The maximum dosage for citalopram is 40 milligrams per day.
If you are using the liquid form of this medication, carefully measure the dose using a special measuring device/spoon. Do not use a household spoon because you may not get the correct dose.
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