Drug interactions
Citalopram + Hydrocodone
Severity: Moderate
Citalopram and Hydrocodone: 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
Combining an opioid with an SSRI carries a risk of serotonin syndrome, which may present with agitation, tremor, hyperthermia and neuromuscular excitation. The risk is considered low for hydrocodone but is greatest at initiation or dose increases.
What this interaction means in plain words
Citalopram and Hydrocodone 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; Hydrocodone belongs to Musculoskeletal.
Why it happens
Additive serotonergic activity from opioid effects on serotonin reuptake or release combined with SSRI reuptake inhibition.
What to do
Monitor for signs of serotonin syndrome, especially during initiation and dose changes. Stop the agents and provide supportive care if it occurs.
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 Hydrocodone
- Alvimopan + Hydrocodone Contraindicated
- Bupropion-naltrexone + Hydrocodone Contraindicated
- Hydrocodone + Isocarboxazid Contraindicated
- Hydrocodone + Olanzapine / samidorphan Contraindicated
- Hydrocodone + Phenelzine Contraindicated
- Alfentanil + Hydrocodone 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 Hydrocodone?
MediHelp rates the interaction as moderate. Citalopram and Hydrocodone 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. Combining an opioid with an SSRI carries a risk of serotonin syndrome, which may present with agitation, tremor, hyperthermia and neuromuscular excitation. The risk is considered low for hydrocodone but is greatest at initiation or dose increases.
How serious is the interaction between Citalopram and Hydrocodone?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for signs of serotonin syndrome, especially during initiation and dose changes. Stop the agents and provide supportive care if it occurs.
What other medicines interact with Hydrocodone?
MediHelp also lists interactions of Hydrocodone with, for example, Alvimopan, Bupropion-naltrexone, Isocarboxazid. The full list is on the Hydrocodone page.
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