Drug interactions
Citalopram + Meperidine
Severity: Major
Citalopram and Meperidine: 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 increases synaptic serotonin and meperidine has weak serotonin reuptake inhibiting activity, so combining them may cause serotonin syndrome. Symptoms can range from tremor and agitation to hyperthermia and rigidity.
What this interaction means in plain words
Citalopram and Meperidine 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; Meperidine belongs to Musculoskeletal.
Why it happens
Additive serotonergic effects from SSRI reuptake inhibition and meperidine's serotonergic activity.
What to do
Use an alternative opioid with no serotonergic activity, such as morphine or hydromorphone. If the combination is unavoidable, use the lowest dose and monitor for serotonin toxicity.
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 Meperidine
- Alvimopan + Meperidine Contraindicated
- Isocarboxazid + Meperidine Contraindicated
- Meperidine + Methylene blue Contraindicated
- Meperidine + Olanzapine / samidorphan Contraindicated
- Meperidine + Phenelzine Contraindicated
- Meperidine + Procarbazine 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 Meperidine?
MediHelp rates the interaction as major. Citalopram and Meperidine 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 increases synaptic serotonin and meperidine has weak serotonin reuptake inhibiting activity, so combining them may cause serotonin syndrome. Symptoms can range from tremor and agitation to hyperthermia and rigidity.
How serious is the interaction between Citalopram and Meperidine?
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 an alternative opioid with no serotonergic activity, such as morphine or hydromorphone. If the combination is unavoidable, use the lowest dose and monitor for serotonin toxicity.
What other medicines interact with Meperidine?
MediHelp also lists interactions of Meperidine with, for example, Alvimopan, Isocarboxazid, Methylene blue. The full list is on the Meperidine page.
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