Drug interactions
Citalopram + Procainamide
Severity: Major
Citalopram and Procainamide: 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
Procainamide is a class IA antiarrhythmic that prolongs the QT interval and can cause torsades de pointes. Combined with citalopram, the risk of QT-related arrhythmia is increased.
What this interaction means in plain words
Citalopram and Procainamide 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 prolongation of cardiac repolarization.
What to do
Avoid if possible; otherwise monitor ECG and keep potassium and magnesium normal. Use the lowest citalopram dose or 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
Frequently asked questions
Can I take Citalopram with Procainamide?
MediHelp rates the interaction as major. Citalopram and Procainamide 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. Procainamide is a class IA antiarrhythmic that prolongs the QT interval and can cause torsades de pointes. Combined with citalopram, the risk of QT-related arrhythmia is increased.
How serious is the interaction between Citalopram and Procainamide?
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 if possible; otherwise monitor ECG and keep potassium and magnesium normal. Use the lowest citalopram dose or 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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