Drug interactions
Citalopram + Enalapril-hydrochlorothiazide
Severity: Moderate
Citalopram and Enalapril-hydrochlorothiazide: 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
Both thiazide diuretics and SSRIs can cause hyponatremia, and the risk is greater when combined, particularly in older adults. Hypokalemia and hypomagnesemia from the diuretic may also add to the QT risk of citalopram.
What this interaction means in plain words
Citalopram and Enalapril-hydrochlorothiazide 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; Enalapril-hydrochlorothiazide belongs to Cardiovascular.
Why it happens
Additive hyponatremia through diuretic-induced sodium loss and SSRI-related SIADH, plus electrolyte disturbance that increases QT vulnerability.
What to do
Check serum sodium and potassium at baseline and after starting, and correct deficits. Watch for confusion, falls or seizures, and consider an ECG in patients with other QT risk factors.
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 Enalapril-hydrochlorothiazide
- Aliskiren + Enalapril-hydrochlorothiazide Contraindicated
- Dofetilide + Enalapril-hydrochlorothiazide Contraindicated
- Enalapril-hydrochlorothiazide + Protein a column Contraindicated
- Enalapril-hydrochlorothiazide + Sacubitril / valsartan Contraindicated
- Amifostine + Enalapril-hydrochlorothiazide Major
- Amiloride + Enalapril-hydrochlorothiazide 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 Enalapril-hydrochlorothiazide?
MediHelp rates the interaction as moderate. Citalopram and Enalapril-hydrochlorothiazide 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. Both thiazide diuretics and SSRIs can cause hyponatremia, and the risk is greater when combined, particularly in older adults. Hypokalemia and hypomagnesemia from the diuretic may also add to the QT risk of citalopram.
How serious is the interaction between Citalopram and Enalapril-hydrochlorothiazide?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Check serum sodium and potassium at baseline and after starting, and correct deficits. Watch for confusion, falls or seizures, and consider an ECG in patients with other QT risk factors.
What other medicines interact with Enalapril-hydrochlorothiazide?
MediHelp also lists interactions of Enalapril-hydrochlorothiazide with, for example, Aliskiren, Dofetilide, Protein a column. The full list is on the Enalapril-hydrochlorothiazide page.
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