Drug interactions
Citalopram + Esomeprazole
Severity: Major
Citalopram and Esomeprazole: major 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
Esomeprazole inhibits CYP2C19, which clears citalopram, so citalopram concentrations rise. Higher exposure increases the risk of dose-related QT prolongation and arrhythmia.
What this interaction means in plain words
Citalopram and Esomeprazole 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; Esomeprazole belongs to Gastrointestinal Tract.
Why it happens
Esomeprazole inhibits CYP2C19, reducing citalopram metabolism.
What to do
Limit citalopram to 20 mg daily with a CYP2C19 inhibitor. Consider ECG monitoring in patients with other QT risk factors, or use pantoprazole as an alternative PPI.
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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Other interactions of Esomeprazole
- Esomeprazole + Mavacamten Contraindicated
- Esomeprazole + Rilpivirine Contraindicated
- Acalabrutinib + Esomeprazole Major
- Atazanavir + Esomeprazole Major
- Clopidogrel + Esomeprazole Major
- Dacomitinib + Esomeprazole 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 Esomeprazole?
MediHelp rates the interaction as major. Citalopram and Esomeprazole 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. Esomeprazole inhibits CYP2C19, which clears citalopram, so citalopram concentrations rise. Higher exposure increases the risk of dose-related QT prolongation and arrhythmia.
How serious is the interaction between Citalopram and Esomeprazole?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Limit citalopram to 20 mg daily with a CYP2C19 inhibitor. Consider ECG monitoring in patients with other QT risk factors, or use pantoprazole as an alternative PPI.
What other medicines interact with Esomeprazole?
MediHelp also lists interactions of Esomeprazole with, for example, Mavacamten, Rilpivirine, Acalabrutinib. The full list is on the Esomeprazole page.
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