Drug interactions
Citalopram + Sotalol
Severity: Major
Citalopram and Sotalol: 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
Both drugs prolong the QT interval, so combining them increases the risk of torsades de pointes. The risk is greater with bradycardia, hypokalemia, hypomagnesemia, renal impairment or higher citalopram doses.
What this interaction means in plain words
Citalopram and Sotalol 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 belongs to Central Nervous System; Sotalol belongs to Cardiovascular.
Why it happens
Additive blockade of cardiac potassium channels (hERG) leading to delayed repolarization and QT prolongation.
What to do
Avoid the combination if possible and consider an SSRI with less QT effect, such as sertraline. If used together, obtain a baseline and follow-up ECG, correct potassium and magnesium, and keep citalopram at the lowest effective dose.
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 Sotalol
- Arsenic trioxide + Sotalol Contraindicated
- Artemether / lumefantrine + Sotalol Contraindicated
- Disopyramide + Sotalol Contraindicated
- Dofetilide + Sotalol Contraindicated
- Dronedarone + Sotalol Contraindicated
- Droperidol + Sotalol Contraindicated
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 Sotalol?
MediHelp rates the interaction as major. Citalopram and Sotalol 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. Both drugs prolong the QT interval, so combining them increases the risk of torsades de pointes. The risk is greater with bradycardia, hypokalemia, hypomagnesemia, renal impairment or higher citalopram doses.
How serious is the interaction between Citalopram and Sotalol?
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 and consider an SSRI with less QT effect, such as sertraline. If used together, obtain a baseline and follow-up ECG, correct potassium and magnesium, and keep citalopram at the lowest effective dose.
What other medicines interact with Sotalol?
MediHelp also lists interactions of Sotalol with, for example, Arsenic trioxide, Artemether / lumefantrine, Disopyramide. The full list is on the Sotalol page.
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