Drug interactions
Citalopram + Dextromethorphan
Severity: Major
Citalopram and Dextromethorphan: major interaction.
Last updated Sources: UK SmPC
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
Dextromethorphan combined with citalopram may produce additive serotonergic effects and serotonin syndrome. Risk rises with higher doses of either drug.
What this interaction means in plain words
Citalopram and Dextromethorphan 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; Dextromethorphan belongs to Respiratory.
Why it happens
Additive serotonergic effects from SSRI reuptake inhibition and dextromethorphan's serotonin reuptake inhibition.
What to do
Avoid dextromethorphan-containing cough products where possible and use an alternative antitussive. If combined, use the lowest dose and monitor for serotonin toxicity.
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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References
Other interactions of Dextromethorphan
- Dextromethorphan + Isocarboxazid Contraindicated
- Dextromethorphan + Linezolid Contraindicated
- Dextromethorphan + Phenelzine Contraindicated
- Dextromethorphan + Rasagiline Contraindicated
- Dextromethorphan + Safinamide Contraindicated
- Dextromethorphan + Selegiline Contraindicated
Other interactions of Citalopram
- Cisapride + Citalopram Contraindicated
- Citalopram + Dronedarone Contraindicated
- Citalopram + Escitalopram Contraindicated
- Citalopram + Isocarboxazid Contraindicated
- Citalopram + Methylene blue Contraindicated
- Citalopram + Phenelzine Contraindicated
Frequently asked questions
Can I take Citalopram with Dextromethorphan?
MediHelp rates the interaction as major. Citalopram and Dextromethorphan 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. Dextromethorphan combined with citalopram may produce additive serotonergic effects and serotonin syndrome. Risk rises with higher doses of either drug.
How serious is the interaction between Citalopram and Dextromethorphan?
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 dextromethorphan-containing cough products where possible and use an alternative antitussive. If combined, use the lowest dose and monitor for serotonin toxicity.
What other medicines interact with Dextromethorphan?
MediHelp also lists interactions of Dextromethorphan with, for example, Isocarboxazid, Linezolid, Phenelzine. The full list is on the Dextromethorphan page.
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