Drug interactions
Citalopram + Trimipramine
Severity: Major
Citalopram and Trimipramine: 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 are serotonergic and both can prolong the QT interval, so the risks of serotonin syndrome and arrhythmia are higher together. Citalopram may also modestly raise tricyclic levels through CYP2D6 inhibition.
What this interaction means in plain words
Citalopram and Trimipramine 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; Trimipramine belongs to Central Nervous System.
Why it happens
Additive serotonergic activity and QT prolongation, with weak CYP2D6 inhibition by citalopram raising trimipramine exposure.
What to do
Avoid combining them where possible. If it is unavoidable, use the lowest effective doses, monitor the ECG and electrolytes, and watch for signs of serotonin toxicity.
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 Trimipramine
- Disopyramide + Trimipramine Contraindicated
- Dofetilide + Trimipramine Contraindicated
- Ibutilide + Trimipramine Contraindicated
- Isocarboxazid + Trimipramine Contraindicated
- Pentamidine + Trimipramine Contraindicated
- Phenelzine + Trimipramine 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 Trimipramine?
MediHelp rates the interaction as major. Citalopram and Trimipramine 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 are serotonergic and both can prolong the QT interval, so the risks of serotonin syndrome and arrhythmia are higher together. Citalopram may also modestly raise tricyclic levels through CYP2D6 inhibition.
How serious is the interaction between Citalopram and Trimipramine?
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 combining them where possible. If it is unavoidable, use the lowest effective doses, monitor the ECG and electrolytes, and watch for signs of serotonin toxicity.
What other medicines interact with Trimipramine?
MediHelp also lists interactions of Trimipramine with, for example, Disopyramide, Dofetilide, Ibutilide. The full list is on the Trimipramine page.
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