Drug interactions
Citalopram + Saquinavir
Severity: Major
Citalopram and Saquinavir: 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
Saquinavir inhibits CYP3A4 and itself prolongs the QT and PR intervals, and citalopram is partly metabolized by CYP3A4. Higher citalopram exposure combined with the intrinsic QT effect of saquinavir raises the risk of torsades de pointes.
What this interaction means in plain words
Citalopram and Saquinavir 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
CYP3A4 inhibition increases citalopram levels, together with additive QT prolongation.
What to do
Avoid the combination and consider an antidepressant with less QT risk. If unavoidable, obtain an ECG and cap the citalopram dose conservatively.
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 Saquinavir?
MediHelp rates the interaction as major. Citalopram and Saquinavir 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. Saquinavir inhibits CYP3A4 and itself prolongs the QT and PR intervals, and citalopram is partly metabolized by CYP3A4. Higher citalopram exposure combined with the intrinsic QT effect of saquinavir raises the risk of torsades de pointes.
How serious is the interaction between Citalopram and Saquinavir?
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 and consider an antidepressant with less QT risk. If unavoidable, obtain an ECG and cap the citalopram dose conservatively.
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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