Drug interactions
Citalopram + Remifentanil
Severity: Moderate
Citalopram and Remifentanil: 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
Combining an opioid with an SSRI can raise the risk of serotonin syndrome, presenting with agitation, tremor, clonus, hyperthermia and autonomic instability. Remifentanil has weaker serotonergic activity than some other opioids, so reports are rare, but the label warns about the combination.
What this interaction means in plain words
Citalopram and Remifentanil 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; Remifentanil belongs to Musculoskeletal.
Why it happens
Additive serotonergic effects, with SSRI-mediated serotonin reuptake inhibition combined with opioid serotonergic activity.
What to do
Monitor for neuromuscular, autonomic and mental status changes after starting or increasing either drug. Stop the serotonergic agents and give supportive care if serotonin syndrome is suspected.
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 Remifentanil
- Alvimopan + Remifentanil Contraindicated
- Isocarboxazid + Remifentanil Contraindicated
- Olanzapine / samidorphan + Remifentanil Contraindicated
- Phenelzine + Remifentanil Contraindicated
- Benzhydrocodone / acetaminophen + Remifentanil Major
- Brexanolone + Remifentanil 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 Remifentanil?
MediHelp rates the interaction as moderate. Citalopram and Remifentanil 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. Combining an opioid with an SSRI can raise the risk of serotonin syndrome, presenting with agitation, tremor, clonus, hyperthermia and autonomic instability. Remifentanil has weaker serotonergic activity than some other opioids, so reports are rare, but the label warns about the combination.
How serious is the interaction between Citalopram and Remifentanil?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for neuromuscular, autonomic and mental status changes after starting or increasing either drug. Stop the serotonergic agents and give supportive care if serotonin syndrome is suspected.
What other medicines interact with Remifentanil?
MediHelp also lists interactions of Remifentanil with, for example, Alvimopan, Isocarboxazid, Olanzapine / samidorphan. The full list is on the Remifentanil page.
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