Drug interactions
Citalopram + Cocaine
Severity: Major
Citalopram and Cocaine: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Cocaine blocks reuptake of serotonin, norepinephrine and dopamine, so combining it with an SSRI may increase serotonergic toxicity. Cocaine also has sympathomimetic and arrhythmogenic effects that may add to cardiac risk.
What this interaction means in plain words
Citalopram and Cocaine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Citalopram belongs to Central Nervous System; Cocaine belongs to Central Nervous System.
Why it happens
Additive serotonergic effects from monoamine reuptake inhibition, with added sympathomimetic and QT-related cardiac effects.
What to do
Avoid concurrent use and counsel patients accordingly. Watch for features of serotonin toxicity and cardiovascular instability if exposure occurs.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Citalopram
- Cisapride + Citalopram Contraindicated
- Citalopram + Dronedarone Contraindicated
- Citalopram + Escitalopram Contraindicated
- Citalopram + Isocarboxazid Contraindicated
- Citalopram + Methylene blue Contraindicated
- Citalopram + Phenelzine Contraindicated
Other interactions of Cocaine
- Cocaine + Isocarboxazid Contraindicated
- Cocaine + Phenelzine Contraindicated
- Cocaine + Procarbazine Contraindicated
- Amitriptyline + Cocaine Major
- Bisoprolol + Cocaine Major
- Clomipramine + Cocaine Major
Frequently asked questions
Can I take Citalopram with Cocaine?
MediHelp rates the interaction as major. Citalopram and Cocaine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Cocaine blocks reuptake of serotonin, norepinephrine and dopamine, so combining it with an SSRI may increase serotonergic toxicity. Cocaine also has sympathomimetic and arrhythmogenic effects that may add to cardiac risk.
How serious is the interaction between Citalopram and Cocaine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid concurrent use and counsel patients accordingly. Watch for features of serotonin toxicity and cardiovascular instability if exposure occurs.
What other medicines interact with Citalopram?
MediHelp also lists interactions of Citalopram with, for example, Cisapride, Dronedarone, Escitalopram. The full list is on the Citalopram page.
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