Drug interactions
Citalopram + Erythromycin lactobionate
Severity: Major
Citalopram and Erythromycin lactobionate: 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
Intravenous erythromycin prolongs the QT interval and inhibits CYP3A4, and citalopram is partly metabolized by CYP3A4. Together they increase the risk of torsades de pointes, especially with high IV exposure.
What this interaction means in plain words
Citalopram and Erythromycin lactobionate 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; Erythromycin lactobionate belongs to Anti Bacterial.
Why it happens
Additive QTc prolongation, with erythromycin's CYP3A4 inhibition raising citalopram levels.
What to do
Use a non-QT-prolonging antibiotic when possible. If IV erythromycin is required, monitor ECG and electrolytes and consider holding or reducing citalopram.
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 Erythromycin lactobionate
- Cisapride + Erythromycin lactobionate Contraindicated
- Dihydroergotamine + Erythromycin lactobionate Contraindicated
- Dronedarone + Erythromycin lactobionate Contraindicated
- Eletriptan + Erythromycin lactobionate Contraindicated
- Ergotamine + Erythromycin lactobionate Contraindicated
- Erythromycin lactobionate + Flibanserin Contraindicated
Frequently asked questions
Can I take Citalopram with Erythromycin lactobionate?
MediHelp rates the interaction as major. Citalopram and Erythromycin lactobionate 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. Intravenous erythromycin prolongs the QT interval and inhibits CYP3A4, and citalopram is partly metabolized by CYP3A4. Together they increase the risk of torsades de pointes, especially with high IV exposure.
How serious is the interaction between Citalopram and Erythromycin lactobionate?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use a non-QT-prolonging antibiotic when possible. If IV erythromycin is required, monitor ECG and electrolytes and consider holding or reducing citalopram.
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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