Drug interactions
Citalopram + Diflunisal
Severity: Moderate
Citalopram and Diflunisal: moderate 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
SSRIs combined with NSAIDs increase the risk of gastrointestinal bleeding, particularly upper GI bleeding, beyond that seen with either drug alone. The risk is greater in older patients and those with prior ulcers.
What this interaction means in plain words
Citalopram and Diflunisal can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Citalopram belongs to Central Nervous System; Diflunisal belongs to Musculoskeletal.
Why it happens
SSRIs deplete platelet serotonin and impair aggregation, while NSAIDs inhibit platelet thromboxane and injure gastric mucosa.
What to do
Avoid the combination where possible, or add gastroprotection with a proton pump inhibitor in at-risk patients. Advise patients to report black stools or other signs of bleeding.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Diflunisal
- Diflunisal + Ketorolac Contraindicated
- Diflunisal + Ketorolac intranasal Contraindicated
- Acemetacin + Diflunisal Major
- Acetazolamide + Diflunisal Major
- Alteplase + Diflunisal Major
- Amiloride + Diflunisal Major
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 Diflunisal?
MediHelp rates the interaction as moderate. Citalopram and Diflunisal can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. SSRIs combined with NSAIDs increase the risk of gastrointestinal bleeding, particularly upper GI bleeding, beyond that seen with either drug alone. The risk is greater in older patients and those with prior ulcers.
How serious is the interaction between Citalopram and Diflunisal?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination where possible, or add gastroprotection with a proton pump inhibitor in at-risk patients. Advise patients to report black stools or other signs of bleeding.
What other medicines interact with Diflunisal?
MediHelp also lists interactions of Diflunisal with, for example, Ketorolac, Ketorolac intranasal, Acemetacin. The full list is on the Diflunisal page.
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