Drug interactions
Citalopram + Protriptyline
Severity: Major
Citalopram and Protriptyline: 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
Citalopram and tricyclic antidepressants both carry QT-prolonging and serotonergic effects, and citalopram may modestly raise tricyclic concentrations through CYP2D6 inhibition. The combination increases the risk of serotonin syndrome, arrhythmia and anticholinergic toxicity.
What this interaction means in plain words
Citalopram and Protriptyline 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 and QT-prolonging effects, with possible CYP2D6 inhibition raising protriptyline levels.
What to do
Avoid the combination if possible. If used, obtain a baseline ECG, monitor for serotonin toxicity, and consider tricyclic dose reduction.
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 Protriptyline?
MediHelp rates the interaction as major. Citalopram and Protriptyline 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 and tricyclic antidepressants both carry QT-prolonging and serotonergic effects, and citalopram may modestly raise tricyclic concentrations through CYP2D6 inhibition. The combination increases the risk of serotonin syndrome, arrhythmia and anticholinergic toxicity.
How serious is the interaction between Citalopram and Protriptyline?
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. If used, obtain a baseline ECG, monitor for serotonin toxicity, and consider tricyclic dose reduction.
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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