Drug interactions
Citalopram + Ponesimod
Severity: Moderate
Citalopram and Ponesimod: moderate 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
Ponesimod can cause bradycardia and atrioventricular conduction delay after the first dose, and citalopram prolongs the QT interval. Together they may raise the risk of arrhythmia, since bradycardia is a risk factor for torsades de pointes.
What this interaction means in plain words
Citalopram and Ponesimod can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Citalopram belongs to Central Nervous System; Ponesimod belongs to Central Nervous System.
Why it happens
Sphingosine-1-phosphate receptor-mediated bradycardia combined with citalopram's QT prolongation.
What to do
Obtain an ECG before starting ponesimod and seek specialist advice in patients taking QT-prolonging drugs. Monitor heart rate and rhythm during treatment initiation.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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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 Ponesimod
- Fingolimod + Ponesimod Contraindicated
- Ponesimod + Siponimod Contraindicated
- Amiodarone + Ponesimod Major
- Amisulpride + Ponesimod Major
- Anagrelide + Ponesimod Major
- Anti-thymocyte + Ponesimod Major
Frequently asked questions
Can I take Citalopram with Ponesimod?
MediHelp rates the interaction as moderate. Citalopram and Ponesimod can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Ponesimod can cause bradycardia and atrioventricular conduction delay after the first dose, and citalopram prolongs the QT interval. Together they may raise the risk of arrhythmia, since bradycardia is a risk factor for torsades de pointes.
How serious is the interaction between Citalopram and Ponesimod?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Obtain an ECG before starting ponesimod and seek specialist advice in patients taking QT-prolonging drugs. Monitor heart rate and rhythm during treatment initiation.
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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