Drug interactions
Citalopram + Duloxetine
Severity: Major
Citalopram and Duloxetine: 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
Both drugs increase serotonergic activity, raising the risk of serotonin syndrome. Duloxetine also inhibits CYP2D6 moderately, which may modestly affect other drugs but has limited effect on citalopram.
What this interaction means in plain words
Citalopram and Duloxetine 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; Duloxetine belongs to Central Nervous System.
Why it happens
Additive serotonin reuptake inhibition.
What to do
Avoid unless clearly necessary. If combined, use the lowest effective doses and monitor for tremor, clonus, agitation and hyperthermia.
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 Citalopram
- Cisapride + Citalopram Contraindicated
- Citalopram + Dronedarone Contraindicated
- Citalopram + Escitalopram Contraindicated
- Citalopram + Isocarboxazid Contraindicated
- Citalopram + Methylene blue Contraindicated
- Citalopram + Phenelzine Contraindicated
Other interactions of Duloxetine
- Duloxetine + Isocarboxazid Contraindicated
- Duloxetine + Linezolid Contraindicated
- Duloxetine + Methylene blue Contraindicated
- Duloxetine + Phenelzine Contraindicated
- Duloxetine + Procarbazine Contraindicated
- Duloxetine + Rasagiline Contraindicated
Frequently asked questions
Can I take Citalopram with Duloxetine?
MediHelp rates the interaction as major. Citalopram and Duloxetine 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. Both drugs increase serotonergic activity, raising the risk of serotonin syndrome. Duloxetine also inhibits CYP2D6 moderately, which may modestly affect other drugs but has limited effect on citalopram.
How serious is the interaction between Citalopram and Duloxetine?
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 unless clearly necessary. If combined, use the lowest effective doses and monitor for tremor, clonus, agitation and hyperthermia.
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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