Drug interactions
Citalopram + Pimavanserin
Severity: Major
Citalopram and Pimavanserin: major interaction.
Last updated Sources: Health Canada product monograph
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
Pimavanserin prolongs the QT interval, and citalopram does so in a dose-dependent manner. Combined use may increase the risk of torsades de pointes, particularly in older patients with cardiac disease.
What this interaction means in plain words
Citalopram and Pimavanserin 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; Pimavanserin belongs to Central Nervous System.
Why it happens
Additive prolongation of ventricular repolarization.
What to do
Avoid the combination if possible, or obtain a baseline ECG and keep electrolytes normal. Monitor the ECG and consider an alternative antidepressant with less QT effect.
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
Other interactions of Pimavanserin
- Lefamulin + Pimavanserin Contraindicated
- Pimavanserin + Pimozide Contraindicated
- Pimavanserin + Vandetanib Contraindicated
- Adagrasib + Pimavanserin Major
- Amiodarone + Pimavanserin Major
- Amisulpride + Pimavanserin Major
Frequently asked questions
Can I take Citalopram with Pimavanserin?
MediHelp rates the interaction as major. Citalopram and Pimavanserin 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. Pimavanserin prolongs the QT interval, and citalopram does so in a dose-dependent manner. Combined use may increase the risk of torsades de pointes, particularly in older patients with cardiac disease.
How serious is the interaction between Citalopram and Pimavanserin?
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, or obtain a baseline ECG and keep electrolytes normal. Monitor the ECG and consider an alternative antidepressant with less QT effect.
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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