Drug interactions
Citalopram + Erythromycin
Severity: Major
Citalopram and Erythromycin: 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
Both drugs prolong the QT interval, and erythromycin may also modestly increase citalopram levels. The combination raises the risk of torsades de pointes, especially in patients with risk factors.
What this interaction means in plain words
Citalopram and Erythromycin 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 belongs to Anti Bacterial.
Why it happens
Additive QT prolongation with possible CYP3A4/2C19 inhibition raising citalopram levels.
What to do
Prefer a non-QT-prolonging antibiotic. If combined, obtain an ECG, correct electrolytes and keep the citalopram dose within labeled limits.
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 Erythromycin
- Conivaptan + Erythromycin Contraindicated
- Dihydroergotamine intranasal + Erythromycin Contraindicated
- Dihydroergotamine + Erythromycin Contraindicated
- Domperidone + Erythromycin Contraindicated
- Dronedarone + Erythromycin Contraindicated
- Droperidol + Erythromycin Contraindicated
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 Erythromycin?
MediHelp rates the interaction as major. Citalopram and Erythromycin 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 prolong the QT interval, and erythromycin may also modestly increase citalopram levels. The combination raises the risk of torsades de pointes, especially in patients with risk factors.
How serious is the interaction between Citalopram and Erythromycin?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Prefer a non-QT-prolonging antibiotic. If combined, obtain an ECG, correct electrolytes and keep the citalopram dose within labeled limits.
What other medicines interact with Erythromycin?
MediHelp also lists interactions of Erythromycin with, for example, Conivaptan, Dihydroergotamine intranasal, Dihydroergotamine. The full list is on the Erythromycin page.
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