Citalam
Generic Name
Citalopram
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
Loading images...
Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| citalam 10 mg tablet | ৳ 13.00 | ৳ 130.00 |
Description
Overview of the medicine
Citalam 10 mg Tablet contains Citalopram, a selective serotonin reuptake inhibitor (SSRI) used to treat major depressive disorder and, in some cases, panic disorder. It works by increasing the level of serotonin in the brain, which helps to improve mood and alleviate symptoms of depression.
Uses & Indications
Dosage
Adults
Initial dose is 10-20 mg once daily, usually in the morning or evening. May be increased to a maximum of 40 mg once daily. Doses above 20 mg are generally not recommended for individuals over 60 years or with certain conditions.
Elderly
A maximum dose of 20 mg once daily is recommended due to potential for increased plasma levels and risk of QT prolongation.
Renal_impairment
No dosage adjustment is generally required for mild to moderate renal impairment. Caution is advised in severe renal impairment (creatinine clearance < 20 mL/min).
How to Take
Take orally, with or without food. It can be taken at any time of day, but taking it at the same time each day is recommended.
Mechanism of Action
Citalopram selectively inhibits the reuptake of serotonin (5-HT) by presynaptic neurons in the central nervous system, leading to an increase in serotonin concentration in the synaptic cleft. This enhanced serotonergic neurotransmission is believed to mediate its antidepressant effects.
Pharmacokinetics
Onset
Clinical improvement typically begins within 2-4 weeks of treatment. Full therapeutic effects may take longer.
Excretion
Approximately 20% excreted in urine and 80% in feces, mainly as metabolites.
Half life
Approximately 35 hours (range: 27-42 hours).
Absorption
Well-absorbed orally, with approximately 80% bioavailability. Peak plasma concentrations are reached within 2-4 hours.
Metabolism
Extensively metabolized in the liver, primarily by CYP2C19, CYP2D6, and CYP3A4 into less active or inactive metabolites (demethylcitalopram, didemethylcitalopram, citalopram N-oxide).
Side Effects
Contraindications
- Hypersensitivity to Citalopram or any excipients.
- Concomitant use with Monoamine Oxidase Inhibitors (MAOIs) or within 14 days of discontinuing MAOIs.
- Concomitant use with pimozide.
- Congenital long QT syndrome or other conditions that prolong the QT interval.
- Concomitant use with other medicinal products known to prolong the QT interval.
Drug Interactions
MAOIs
Serious, sometimes fatal, reactions (e.g., serotonin syndrome) can occur. Avoid concomitant use.
Alcohol
Enhances sedative effects and may worsen depression. Avoid.
Warfarin and other anticoagulants
Increased risk of bleeding. Monitor INR closely.
Cimetidine, Omeprazole, Esomeprazole (CYP2C19 inhibitors)
May increase Citalopram plasma levels. Dose reduction may be necessary.
Serotonergic drugs (e.g., Triptans, Tramadol, other SSRIs)
Increased risk of serotonin syndrome. Use with caution, monitor for symptoms.
QT-prolonging drugs (e.g., Class IA and III antiarrhythmics, antipsychotics, certain antibiotics)
Increased risk of QT prolongation and cardiac arrhythmias. Avoid concomitant use if possible.
Storage
Store in a cool, dry place below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include dizziness, nausea, vomiting, tremor, somnolence, sinus tachycardia, QTc prolongation, and convulsions. Rarely, rhabdomyolysis, severe metabolic acidosis, and coma have occurred. Treatment is supportive; ensure airway, breathing, and circulation. Activated charcoal and gastric lavage may be considered. Continuous ECG monitoring is recommended due to the risk of QT prolongation.
Pregnancy & Lactation
Pregnancy Category C. Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. Citalopram is excreted in breast milk; therefore, caution should be exercised when administered to a nursing woman. Consult a doctor.
Side Effects
Contraindications
- Hypersensitivity to Citalopram or any excipients.
- Concomitant use with Monoamine Oxidase Inhibitors (MAOIs) or within 14 days of discontinuing MAOIs.
- Concomitant use with pimozide.
- Congenital long QT syndrome or other conditions that prolong the QT interval.
- Concomitant use with other medicinal products known to prolong the QT interval.
Drug Interactions
MAOIs
Serious, sometimes fatal, reactions (e.g., serotonin syndrome) can occur. Avoid concomitant use.
Alcohol
Enhances sedative effects and may worsen depression. Avoid.
Warfarin and other anticoagulants
Increased risk of bleeding. Monitor INR closely.
Cimetidine, Omeprazole, Esomeprazole (CYP2C19 inhibitors)
May increase Citalopram plasma levels. Dose reduction may be necessary.
Serotonergic drugs (e.g., Triptans, Tramadol, other SSRIs)
Increased risk of serotonin syndrome. Use with caution, monitor for symptoms.
QT-prolonging drugs (e.g., Class IA and III antiarrhythmics, antipsychotics, certain antibiotics)
Increased risk of QT prolongation and cardiac arrhythmias. Avoid concomitant use if possible.
Storage
Store in a cool, dry place below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include dizziness, nausea, vomiting, tremor, somnolence, sinus tachycardia, QTc prolongation, and convulsions. Rarely, rhabdomyolysis, severe metabolic acidosis, and coma have occurred. Treatment is supportive; ensure airway, breathing, and circulation. Activated charcoal and gastric lavage may be considered. Continuous ECG monitoring is recommended due to the risk of QT prolongation.
Pregnancy & Lactation
Pregnancy Category C. Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. Citalopram is excreted in breast milk; therefore, caution should be exercised when administered to a nursing woman. Consult a doctor.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 24-36 months from the date of manufacture.
Availability
Available in pharmacies, hospitals, and clinics
Approval Status
Approved by major regulatory bodies (e.g., FDA, DGDA)
Patent Status
Off-patent (generic available)
Clinical Trials
Citalopram has been extensively studied in numerous clinical trials demonstrating its efficacy and safety in the treatment of major depressive disorder and other conditions. Post-marketing surveillance continues to monitor its effects.
Lab Monitoring
- No routine lab monitoring is typically required, but electrolytes (especially sodium) should be monitored in patients at risk of hyponatremia. ECG monitoring is recommended, especially in patients with pre-existing cardiac conditions or those on concomitant QT-prolonging medications.
Doctor Notes
- Monitor patients for signs of suicidal ideation, especially during initial therapy and dose changes. Periodically assess cardiac status, particularly for QT interval prolongation. Counsel patients on the importance of gradual discontinuation to avoid withdrawal symptoms.
Patient Guidelines
- Take the medicine exactly as prescribed by your doctor. Do not stop taking it suddenly, as this can cause withdrawal symptoms. It may take several weeks to feel the full benefits. Report any new or worsening symptoms, especially mood changes or suicidal thoughts, 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 continue with your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
Citalam may cause drowsiness, dizziness, or blurred vision. Patients should be cautioned about operating hazardous machinery, including automobiles, until they are reasonably certain that Citalam therapy does not affect their ability to engage in such activities.
Lifestyle Advice
- Avoid alcohol consumption while taking Citalam, as it may worsen side effects and depression. Engage in regular physical activity and maintain a balanced diet. Practice stress-reduction techniques like meditation or yoga. Prioritize adequate sleep.
Alternative Medicines in Bangladesh
Similar medicines available in the market
Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.
Other Medicines in Citalam Brand
Other medicines available under the same brand name
