Adult Dosing
Major depressive disorder (MDD)
- Initial: 20 mg PO qd
- Titrate: Increase to 40 mg PO qd at an interval of not less than 1 wk
- Range: 20-40 mg PO qd (Max: 40 mg/day)
- Elderly: 20 mg PO qd with titration to 40 mg qd for non-responding patients
Obsessive-compulsive disorder [Non-FDA Approved]
- Start 20 mg/day PO, titrate up to 40-60 mg/day
- Max: 80 mg/day
Note: Doses >40 mg/day are associated with QT prolongation and Torsades de pointes
Pediatric Dosing
- Safety and effectiveness in pediatric patients have not been established
[Outline]
See Supplemental Patient Information
- Antidepressants increase the risk of suicidal thinking and behavior in children, adolescents, and young adults with major depressive disorder and other psychiatric disorders; consider risk prior to prescribing [US Black Box Warning]
- Gradually taper when discontinuing SSRIs to avoid withdrawal symptoms
- Observe patients for worsening depression or the emergence of suicidality, anxiety, agitation, panic attacks, particularly early in therapy or after increases in dose [US Black Box Warning]
- Use in 3rd trimester of pregnancy has been associated with respiratory, gastrointestinal and feeding problems in the neonate
- Prescribe small quantity of tablets consistent with good patient management, to reduce risk of overdose
- Do not prescribe in doses > 40 mg/day due to increased risk of QT prolongation and Torsades de pointes. Patients with underlying heart conditions and those who are predisposed to low levels of potassium and magnesium are at increased risk of developing abnormal heart rhythms
- Increase risk of bleeding events with NSAIDS, aspirin, warfarin and other anticoagulants
- Discontinue if symptoms of serotonin syndrome, including symptoms that resemble neuroleptic malignant syndrome, develop
Cautions: Use cautiously in
- Renal impairment (severe)
- Hepatic impairment (dose reduction recommended; refer dosing adjustment section)
- MAO inhibitor use (can cause fatal reactions; use after 14 days of stopping treatment with MAO inhibitors)
- Hx of seizure disorder
- Hx of cardiac disease
- Hx of manic disorder
- Hx of bleeding disorders
- Pregnancy >20 wks gestation (may cause severe complications in the neonate)
- Geriatric population
Supplemental Patient Information
- Advise patient (especially child or adolescent) to immediately report suicidal thoughts or extreme depression
- Advise family to observe patient closely for the emergence of agitation, irritability, unusual changes in behavior, as well as the emergence of suicidality and communicate with prescriber as needed
Pregnancy Category:C. (caution in 3rd trimester)
Breastfeeding: Secreted in breast milk. Infants receive an average of 7% of the plasma levels of the mother. The breastfed infant should be monitored for behavioral side effects and weight loss. An alternative agent may be preferred; especialy when nursing a newborn or preterm infant. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 10 January 2011).
US Trade Name(s)
US Availability
citalopram (generic)
- TABS: 10, 20, 40 mg
- CAPS: 10, 20, 40 mg
- SOLN: 2 mg/mL
- ODT: 40 mg
Celexa
- TABS: 10, 20, 40 mg
- SOLN: 2 mg/mL
Canadian Trade Name(s)
Canadian Availability
citalopram (generic)
Celexa
CTP-30
Ran-Citalo
UK Trade Name(s)
UK Availability
citalopram (generic)
- TABS: 10, 20, 40 mg
- SUSP: 40 mg/mL
Cipramil
- TABS: 10, 20, 40 mg
- SUSP: 40 mg/mL
Australian Trade Name(s)
- Celepram
- Celica
- Ciazil
- Cipramil
- Citalobell
- Talam
Australian Availability
citalopram (generic)
Celepram
Celica, Ciazil, Cipramil, Citalobell, Talam
[Outline]
Pricing data from www.DrugStore.com in U.S.A.
- CeleXA 20 MG TABS [Bottle] (FOREST)
30 mg = $125.99
90 mg = $365.96 - CeleXA 40 MG TABS [Bottle] (FOREST)
30 mg = $135.61
90 mg = $384.93 - CeleXA 10 MG TABS [Bottle] (FOREST)
30 mg = $120.43
90 mg = $336.33
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.
