Drug interactions
Citalopram + Itraconazole
Severity: Major
Citalopram and Itraconazole: major interaction.
Last updated Sources: Health Canada product monograph
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 agents can prolong the QT interval, and itraconazole may modestly raise citalopram levels via CYP3A4 and CYP2C19 inhibition. Together they raise the risk of torsades de pointes.
What this interaction means in plain words
Citalopram and Itraconazole 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; Itraconazole belongs to Anti Fungals.
Why it happens
Additive QT prolongation with possible pharmacokinetic increase in citalopram exposure.
What to do
Prefer an alternative antifungal or antidepressant. If combined, keep citalopram at or below the labeled maximum, check an ECG and correct electrolytes.
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 Itraconazole
- Alfuzosin + Itraconazole Contraindicated
- Alprazolam + Itraconazole Contraindicated
- Avanafil + Itraconazole Contraindicated
- Conivaptan + Itraconazole Contraindicated
- Dihydroergotamine intranasal + Itraconazole Contraindicated
- Dihydroergotamine + Itraconazole 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 Itraconazole?
MediHelp rates the interaction as major. Citalopram and Itraconazole 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 agents can prolong the QT interval, and itraconazole may modestly raise citalopram levels via CYP3A4 and CYP2C19 inhibition. Together they raise the risk of torsades de pointes.
How serious is the interaction between Citalopram and Itraconazole?
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 an alternative antifungal or antidepressant. If combined, keep citalopram at or below the labeled maximum, check an ECG and correct electrolytes.
What other medicines interact with Itraconazole?
MediHelp also lists interactions of Itraconazole with, for example, Alfuzosin, Alprazolam, Avanafil. The full list is on the Itraconazole page.
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