Drug interactions
Citalopram + Doxepin
Severity: Major
Citalopram and Doxepin: major interaction.
Last updated Sources: US FDA label
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
Citalopram with doxepin increases the risk of serotonin syndrome and QT prolongation, and citalopram may raise tricyclic concentrations. Risk is greater at antidepressant doses of doxepin than at low sleep doses.
What this interaction means in plain words
Citalopram and Doxepin 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; Doxepin belongs to Dermatology.
Why it happens
Additive serotonergic and QT-prolonging effects, with citalopram inhibition of CYP2D6 modestly raising doxepin levels.
What to do
Avoid combining at antidepressant doses; if needed, use low doses and obtain an ECG. Monitor for serotonin toxicity and anticholinergic effects.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Citalopram and Doxepin, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
References
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 Doxepin
- Doxepin + Isocarboxazid Contraindicated
- Doxepin + Phenelzine Contraindicated
- Doxepin + Procarbazine Contraindicated
- Doxepin + Safinamide Contraindicated
- Doxepin + Selegiline Contraindicated
- Doxepin + Tranylcypromine Contraindicated
Frequently asked questions
Can I take Citalopram with Doxepin?
MediHelp rates the interaction as major. Citalopram and Doxepin 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 with doxepin increases the risk of serotonin syndrome and QT prolongation, and citalopram may raise tricyclic concentrations. Risk is greater at antidepressant doses of doxepin than at low sleep doses.
How serious is the interaction between Citalopram and Doxepin?
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 combining at antidepressant doses; if needed, use low doses and obtain an ECG. Monitor for serotonin toxicity and anticholinergic effects.
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.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
