Drug interactions
Citalopram + Nefazodone
Severity: Major
Citalopram and Nefazodone: 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
Nefazodone has serotonergic activity and potently inhibits CYP3A4, which may raise citalopram concentrations. The combination increases risk of serotonin syndrome and QT prolongation.
What this interaction means in plain words
Citalopram and Nefazodone 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.
Why it happens
Additive serotonergic effects and nefazodone inhibition of CYP3A4-mediated citalopram metabolism.
What to do
Avoid combining the two antidepressants. If transitioning, taper one with a washout interval 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 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 Nefazodone?
MediHelp rates the interaction as major. Citalopram and Nefazodone 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. Nefazodone has serotonergic activity and potently inhibits CYP3A4, which may raise citalopram concentrations. The combination increases risk of serotonin syndrome and QT prolongation.
How serious is the interaction between Citalopram and Nefazodone?
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 combining the two antidepressants. If transitioning, taper one with a washout interval and monitor for serotonin toxicity.
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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