Drug interactions
Citalopram + Venlafaxine
Severity: Major
Citalopram and Venlafaxine: 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 increase synaptic serotonin, so combined use raises the risk of serotonin syndrome. Venlafaxine can also raise blood pressure and has been linked to QT prolongation in overdose.
What this interaction means in plain words
Citalopram and Venlafaxine 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; Venlafaxine belongs to Central Nervous System.
Why it happens
Additive inhibition of serotonin reuptake leading to excess serotonergic activity.
What to do
Avoid the combination in routine practice and use one agent at an optimized dose. If cross-tapering is required, do so gradually and monitor for 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 Citalopram
- Cisapride + Citalopram Contraindicated
- Citalopram + Dronedarone Contraindicated
- Citalopram + Escitalopram Contraindicated
- Citalopram + Isocarboxazid Contraindicated
- Citalopram + Methylene blue Contraindicated
- Citalopram + Phenelzine Contraindicated
Other interactions of Venlafaxine
- Isocarboxazid + Venlafaxine Contraindicated
- Methylene blue + Venlafaxine Contraindicated
- Phenelzine + Venlafaxine Contraindicated
- Procarbazine + Venlafaxine Contraindicated
- Rasagiline + Venlafaxine Contraindicated
- Safinamide + Venlafaxine Contraindicated
Frequently asked questions
Can I take Citalopram with Venlafaxine?
MediHelp rates the interaction as major. Citalopram and Venlafaxine 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 increase synaptic serotonin, so combined use raises the risk of serotonin syndrome. Venlafaxine can also raise blood pressure and has been linked to QT prolongation in overdose.
How serious is the interaction between Citalopram and Venlafaxine?
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 in routine practice and use one agent at an optimized dose. If cross-tapering is required, do so gradually and monitor for serotonin toxicity.
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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