Drug interactions
Citalopram + Mifepristone
Severity: Major
Citalopram and Mifepristone: major 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
Mifepristone inhibits CYP3A4, which contributes to citalopram metabolism, and may raise citalopram levels. Both drugs can prolong the QT interval, so the combination may raise the risk of torsades de pointes, particularly with the chronic higher mifepristone doses used for Cushing's syndrome.
What this interaction means in plain words
Citalopram and Mifepristone 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; Mifepristone belongs to Endocrine.
Why it happens
Additive QT prolongation, with mifepristone inhibition of CYP3A4 and CYP2C19 contributions raising citalopram exposure.
What to do
Use an alternative antidepressant if possible, and keep citalopram at or below the recommended maximum if combined. Monitor ECG and electrolytes during therapy.
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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Other interactions of Citalopram
- Cisapride + Citalopram Contraindicated
- Citalopram + Dronedarone Contraindicated
- Citalopram + Escitalopram Contraindicated
- Citalopram + Isocarboxazid Contraindicated
- Citalopram + Methylene blue Contraindicated
- Citalopram + Phenelzine Contraindicated
Other interactions of Mifepristone
- Apixaban + Mifepristone Contraindicated
- Argatroban + Mifepristone Contraindicated
- Cisapride + Mifepristone Contraindicated
- Cortisone + Mifepristone Contraindicated
- Cyclosporin + Mifepristone Contraindicated
- Dabigatran etexilate + Mifepristone Contraindicated
Frequently asked questions
Can I take Citalopram with Mifepristone?
MediHelp rates the interaction as major. Citalopram and Mifepristone 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. Mifepristone inhibits CYP3A4, which contributes to citalopram metabolism, and may raise citalopram levels. Both drugs can prolong the QT interval, so the combination may raise the risk of torsades de pointes, particularly with the chronic higher mifepristone doses used for Cushing's syndrome.
How serious is the interaction between Citalopram and Mifepristone?
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 antidepressant if possible, and keep citalopram at or below the recommended maximum if combined. Monitor ECG and electrolytes during therapy.
What other medicines interact with Citalopram?
MediHelp also lists interactions of Citalopram with, for example, Cisapride, Dronedarone, Escitalopram. The full list is on the Citalopram page.
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