Citalam
Generic Name
Citalopram
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| citalam 5 mg tablet | ৳ 7.00 | ৳ 70.00 |
Description
Overview of the medicine
Citalopram is an antidepressant belonging to the Selective Serotonin Reuptake Inhibitor (SSRI) class. It is primarily used to treat major depressive disorder and panic disorder. Citalam 5 mg is often used as a starting dose, especially in sensitive patients, or for titration.
Uses & Indications
Dosage
Adults
Initial dose 5 mg or 10 mg once daily, often titrated upwards to 20-40 mg daily based on response and tolerability. A 5 mg dose may be appropriate for highly sensitive patients or those with hepatic impairment.
Elderly
Initial dose 5 mg or 10 mg once daily, not exceeding 20 mg daily due to increased risk of side effects.
Renal_impairment
No dosage adjustment is generally required for mild to moderate renal impairment. For severe impairment, caution is advised and a lower starting dose (e.g., 5 mg) may be considered.
How to Take
Take orally, once daily, with or without food. It is recommended to take it at the same time each day.
Mechanism of Action
Citalopram selectively inhibits the reuptake of serotonin (5-HT) in the central nervous system, leading to an increase in serotonin concentration in the synaptic cleft. This potentiation of serotonergic neurotransmission is believed to be responsible for its antidepressant effects.
Pharmacokinetics
Onset
Antidepressant effects usually become apparent after 2-4 weeks of consistent treatment.
Excretion
Approximately 20% excreted in urine, and 80% in feces (via bile), primarily as metabolites.
Half life
Approximately 35 hours (range 27-42 hours).
Absorption
Well absorbed orally, peak plasma concentrations reached within 2-4 hours.
Metabolism
Extensively metabolized in the liver by CYP3A4 and CYP2C19, and to a lesser extent by CYP2D6, into active and inactive metabolites.
Side Effects
Contraindications
- Hypersensitivity to Citalopram or any component of the formulation.
- Concomitant use with Monoamine Oxidase Inhibitors (MAOIs) or within 14 days of discontinuing an MAOI.
- Concomitant use with pimozide.
- Congenital long QT syndrome or known acquired long QT interval.
Drug Interactions
MAOIs
Increased risk of serotonin syndrome; contraindicated.
Pimozide
Increased pimozide levels and QT prolongation; contraindicated.
Anticoagulants/Antiplatelet agents (e.g., warfarin, aspirin, NSAIDs)
Increased risk of bleeding.
Drugs that prolong QT interval (e.g., antiarrhythmics, antipsychotics, some antibiotics)
Increased risk of cardiac arrhythmias.
Serotonergic drugs (e.g., triptans, tramadol, fentanyl, lithium, other SSRIs, SNRIs, St. John's wort)
Increased risk of serotonin syndrome.
Storage
Store in a cool and dry place, below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include dizziness, tremor, nausea, vomiting, somnolence, sinus tachycardia, QT prolongation, convulsions, and rarely, serotonin syndrome. Treatment involves supportive care, maintaining an open airway, and monitoring cardiac and vital signs. Activated charcoal may be considered.
Pregnancy & Lactation
Pregnancy Category C. Use only if potential benefit justifies potential risk to the fetus. Citalopram is excreted in breast milk; a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2 to 3 years from the date of manufacture.
Availability
Available in pharmacies and hospitals
Approval Status
Approved
Patent Status
Generic available
WHO Essential Medicine
YesClinical Trials
Citalopram has undergone extensive clinical trials demonstrating its efficacy and safety in the treatment of major depressive disorder and panic disorder. These trials have shown significant improvements in mood, anxiety levels, and overall quality of life.
Lab Monitoring
- No routine lab monitoring is typically required.
- Monitor serum sodium in patients at risk of hyponatremia (e.g., elderly, those on diuretics).
- Consider ECG monitoring in patients with pre-existing cardiac conditions or those on drugs that prolong the QT interval.
Doctor Notes
- Initiate citalopram with a low dose (e.g., 5 mg or 10 mg) and titrate gradually based on patient response and tolerability.
- Monitor patients, especially young adults, for worsening depression, suicidal ideation, or unusual behavioral changes, particularly at the beginning of treatment or after dose changes.
- Educate patients about the delayed onset of action and the importance of continuous treatment.
- Advise against abrupt discontinuation due to the risk of withdrawal symptoms.
Patient Guidelines
- Take the medicine exactly as prescribed by your doctor.
- Do not stop taking citalopram abruptly, as this can lead to withdrawal symptoms. Consult your doctor for gradual dose reduction.
- It may take several weeks (2-4 weeks) to feel the full effects of the medicine.
- Report any new or worsening symptoms of depression, suicidal thoughts, or unusual changes in behavior to your doctor immediately.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not double the dose to catch up.
Driving Precautions
Citalopram may cause drowsiness, dizziness, or blurred vision. Avoid driving or operating machinery until you know how this medicine affects you.
Lifestyle Advice
- Avoid alcohol while taking this medication.
- Engage in regular physical activity and a balanced diet to support mental well-being.
- Practice stress-reduction techniques.
- Maintain regular sleep patterns.
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Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.