Drug interactions
Citalopram + Ibuprofen
Severity: Major
Citalopram and Ibuprofen: 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
Combining an SSRI with an NSAID substantially raises the risk of gastrointestinal bleeding compared with either drug alone. The risk is highest in older patients and those with prior ulcers or on anticoagulants.
What this interaction means in plain words
Citalopram and Ibuprofen 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; Ibuprofen belongs to Musculoskeletal.
Why it happens
SSRIs deplete platelet serotonin and impair platelet aggregation while NSAIDs inhibit platelet function and damage gastric mucosa, giving additive bleeding risk.
What to do
Avoid the combination where possible and use paracetamol for analgesia. If needed, add a proton pump inhibitor and monitor for signs of GI bleeding.
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
- Anadin Joint Pain 200mg Tablets - SmPC sections 4.3/4.5 (class statement: selective serotonin reuptake inhibitors (SSRIs); "Anti-platelet agents and selective serotonin reuptake inhibitors (SSRIs): increased risk of gastrointestinal bleeding (see section 4.4).") — electronic medicines compendium (UK SmPC)
Other interactions of Ibuprofen
- Ibuprofen + Ketorolac Contraindicated
- Ibuprofen + Ketorolac intranasal Contraindicated
- Acemetacin + Ibuprofen Major
- Alteplase + Ibuprofen Major
- Amiloride + Ibuprofen Major
- Apixaban + Ibuprofen 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 Ibuprofen?
MediHelp rates the interaction as major. Citalopram and Ibuprofen 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 an NSAID substantially raises the risk of gastrointestinal bleeding compared with either drug alone. The risk is highest in older patients and those with prior ulcers or on anticoagulants.
How serious is the interaction between Citalopram and Ibuprofen?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination where possible and use paracetamol for analgesia. If needed, add a proton pump inhibitor and monitor for signs of GI bleeding.
What other medicines interact with Ibuprofen?
MediHelp also lists interactions of Ibuprofen with, for example, Ketorolac, Ketorolac intranasal, Acemetacin. The full list is on the Ibuprofen page.
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