Drug interactions
Citalopram + Omeprazole
Severity: Major
Citalopram and Omeprazole: 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
Omeprazole inhibits CYP2C19 and increases citalopram exposure, which raises the risk of dose-related QT prolongation. Labeling limits the citalopram dose when used with CYP2C19 inhibitors.
What this interaction means in plain words
Citalopram and Omeprazole 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; Omeprazole belongs to Gastrointestinal Tract.
Why it happens
Omeprazole inhibits CYP2C19-mediated metabolism of citalopram.
What to do
Limit citalopram to 20 mg daily, or use an alternative PPI such as pantoprazole or another antidepressant; monitor ECG and electrolytes in patients at QT risk.
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 Omeprazole
- Mavacamten + Omeprazole Contraindicated
- Omeprazole + Rilpivirine Contraindicated
- Acalabrutinib + Omeprazole Major
- Atazanavir + Omeprazole Major
- Clopidogrel + Omeprazole Major
- Dacomitinib + Omeprazole Major
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 Omeprazole?
MediHelp rates the interaction as major. Citalopram and Omeprazole 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. Omeprazole inhibits CYP2C19 and increases citalopram exposure, which raises the risk of dose-related QT prolongation. Labeling limits the citalopram dose when used with CYP2C19 inhibitors.
How serious is the interaction between Citalopram and Omeprazole?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Limit citalopram to 20 mg daily, or use an alternative PPI such as pantoprazole or another antidepressant; monitor ECG and electrolytes in patients at QT risk.
What other medicines interact with Omeprazole?
MediHelp also lists interactions of Omeprazole with, for example, Mavacamten, Rilpivirine, Acalabrutinib. The full list is on the Omeprazole page.
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