Drug interactions
Citalopram + Fentanyl transdermal
Severity: Major
Citalopram and Fentanyl transdermal: 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
Combining an SSRI with fentanyl can raise the risk of serotonin syndrome, which may present with agitation, tremor, hyperthermia, clonus and autonomic instability. Fentanyl also adds CNS and respiratory depression to the sedating effects of some patients' therapy.
What this interaction means in plain words
Citalopram and Fentanyl transdermal 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.
Why it happens
Additive serotonergic activity from SSRI-mediated serotonin reuptake inhibition and the weak serotonergic effect of fentanyl.
What to do
Use only if needed, start with the lowest effective fentanyl dose and monitor for serotonin syndrome features, especially after initiation or dose increases. Stop both agents and give supportive care if toxicity develops.
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
Frequently asked questions
Can I take Citalopram with Fentanyl transdermal?
MediHelp rates the interaction as major. Citalopram and Fentanyl transdermal 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. Combining an SSRI with fentanyl can raise the risk of serotonin syndrome, which may present with agitation, tremor, hyperthermia, clonus and autonomic instability. Fentanyl also adds CNS and respiratory depression to the sedating effects of some patients' therapy.
How serious is the interaction between Citalopram and Fentanyl transdermal?
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 only if needed, start with the lowest effective fentanyl dose and monitor for serotonin syndrome features, especially after initiation or dose increases. Stop both agents and give supportive care if toxicity develops.
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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