Drug interactions
Citalopram + Voriconazole
Severity: Major
Citalopram and Voriconazole: major interaction.
Last updated Sources: Health Canada product monograph
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
Voriconazole increases citalopram exposure and both can prolong the QT interval, raising the risk of torsades de pointes.
What this interaction means in plain words
Citalopram and Voriconazole 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; Voriconazole belongs to Anti Fungals.
Why it happens
Voriconazole inhibits CYP2C19 and CYP3A4 metabolism of citalopram, with additive QT prolongation.
What to do
Keep citalopram at or below the maximum labeled dose for CYP2C19 inhibitors, and monitor ECG and electrolytes. Consider an alternative antidepressant such as sertraline.
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 Voriconazole
- Avanafil + Voriconazole Contraindicated
- Butabarbital + Voriconazole Contraindicated
- Carbamazepine + Voriconazole Contraindicated
- Conivaptan + Voriconazole Contraindicated
- Dihydroergotamine intranasal + Voriconazole Contraindicated
- Dihydroergotamine + Voriconazole 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 Voriconazole?
MediHelp rates the interaction as major. Citalopram and Voriconazole 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. Voriconazole increases citalopram exposure and both can prolong the QT interval, raising the risk of torsades de pointes.
How serious is the interaction between Citalopram and Voriconazole?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Keep citalopram at or below the maximum labeled dose for CYP2C19 inhibitors, and monitor ECG and electrolytes. Consider an alternative antidepressant such as sertraline.
What other medicines interact with Voriconazole?
MediHelp also lists interactions of Voriconazole with, for example, Avanafil, Butabarbital, Carbamazepine. The full list is on the Voriconazole page.
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