Drug interactions
Citalopram + Loperamide
Severity: Major
Citalopram and Loperamide: 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
Citalopram has dose-dependent QT prolongation and loperamide at high doses can also prolong QT. The combination increases the risk of torsades de pointes.
What this interaction means in plain words
Citalopram and Loperamide 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; Loperamide belongs to Gastrointestinal Tract.
Why it happens
Additive QT prolongation via cardiac ion channel effects.
What to do
Avoid the combination if possible and keep loperamide at labeled doses. Check ECG and electrolytes in patients with risk factors.
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 Loperamide
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 Loperamide?
MediHelp rates the interaction as major. Citalopram and Loperamide 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 has dose-dependent QT prolongation and loperamide at high doses can also prolong QT. The combination increases the risk of torsades de pointes.
How serious is the interaction between Citalopram and Loperamide?
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 if possible and keep loperamide at labeled doses. Check ECG and electrolytes in patients with risk factors.
What other medicines interact with Loperamide?
MediHelp also lists interactions of Loperamide with, for example, Amiodarone, Amisulpride, Anagrelide. The full list is on the Loperamide page.
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