Talopram
Generic Name
Citalopram 5 mg Tablet
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| talopram 5 mg tablet | ৳ 5.30 | ৳ 53.00 |
Description
Overview of the medicine
Talopram 5 mg tablet contains Citalopram, a selective serotonin reuptake inhibitor (SSRI) used to treat depression, panic disorder, and other anxiety disorders by increasing the level of serotonin in the brain.
Uses & Indications
Dosage
Adults
Initial dose is usually 10 mg once daily, which may be increased to a maximum of 40 mg daily. The 5 mg tablet may be used as a starting dose for very sensitive patients or for titration.
Elderly
Initial dose 10 mg once daily; maximum recommended dose is 20 mg daily due to reduced metabolism and increased risk of QT prolongation.
Renal_impairment
No dosage adjustment needed for mild to moderate renal impairment. Caution is advised in severe renal impairment (creatinine clearance <20 mL/min).
How to Take
Take orally once daily, in the morning or evening, with or without food. Swallow the tablet whole with water.
Mechanism of Action
Citalopram selectively inhibits the reuptake of serotonin by neurons in the central nervous system, thereby increasing the concentration of serotonin in the synaptic cleft and enhancing serotonergic neurotransmission.
Pharmacokinetics
Onset
Therapeutic effects typically begin within 2-4 weeks of consistent treatment.
Excretion
Approximately 12-15% of the dose is excreted in the urine as unchanged citalopram and metabolites. The remaining is excreted via feces.
Half life
Approximately 35 hours.
Absorption
Well absorbed from the gastrointestinal tract, with peak plasma concentrations occurring 2-4 hours after oral administration. Bioavailability is approximately 80%.
Metabolism
Extensively metabolized in the liver, primarily by CYP2C19, CYP3A4, and CYP2D6 enzymes, into active (demethylcitalopram, didemethylcitalopram) and inactive metabolites.
Side Effects
Contraindications
- Hypersensitivity to citalopram or any excipients
- Concomitant use with MAO inhibitors (MAOIs) or within 14 days of stopping MAOI treatment
- Concomitant use with pimozide
- Congenital long QT syndrome or known QT prolongation
Drug Interactions
MAOIs
Concurrent use is contraindicated due to risk of serotonin syndrome.
Pimozide
Concurrent use is contraindicated due to risk of QT prolongation and arrhythmias.
Warfarin
May increase anticoagulant effect; monitor INR.
NSAIDs/Aspirin
Increased risk of gastrointestinal bleeding.
QT Prolonging Drugs
Increased risk of QT prolongation (e.g., antiarrhythmics, antipsychotics, certain antibiotics).
SSRIs/SNRIs/Triptans
Increased risk of serotonin syndrome.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include dizziness, nausea, vomiting, tremor, somnolence, sinus tachycardia, and rarely, QT prolongation, arrhythmia, seizure, and serotonin syndrome. Management is primarily supportive; maintain airway, monitor cardiac rhythm and vital signs. Activated charcoal may be considered.
Pregnancy & Lactation
Pregnancy Category C/D (depending on trimester, particularly D in third trimester due to risk of persistent pulmonary hypertension of the newborn). Use only if potential benefit outweighs risk. Excreted into breast milk; caution advised during lactation.
Side Effects
Contraindications
- Hypersensitivity to citalopram or any excipients
- Concomitant use with MAO inhibitors (MAOIs) or within 14 days of stopping MAOI treatment
- Concomitant use with pimozide
- Congenital long QT syndrome or known QT prolongation
Drug Interactions
MAOIs
Concurrent use is contraindicated due to risk of serotonin syndrome.
Pimozide
Concurrent use is contraindicated due to risk of QT prolongation and arrhythmias.
Warfarin
May increase anticoagulant effect; monitor INR.
NSAIDs/Aspirin
Increased risk of gastrointestinal bleeding.
QT Prolonging Drugs
Increased risk of QT prolongation (e.g., antiarrhythmics, antipsychotics, certain antibiotics).
SSRIs/SNRIs/Triptans
Increased risk of serotonin syndrome.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include dizziness, nausea, vomiting, tremor, somnolence, sinus tachycardia, and rarely, QT prolongation, arrhythmia, seizure, and serotonin syndrome. Management is primarily supportive; maintain airway, monitor cardiac rhythm and vital signs. Activated charcoal may be considered.
Pregnancy & Lactation
Pregnancy Category C/D (depending on trimester, particularly D in third trimester due to risk of persistent pulmonary hypertension of the newborn). Use only if potential benefit outweighs risk. Excreted into breast milk; caution advised during lactation.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24-36 months from the date of manufacture.
Availability
Available in pharmacies and hospitals
Approval Status
Approved by regulatory authorities (e.g., FDA, DGDA)
Patent Status
Patent expired for generic Citalopram
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. Ongoing research explores its use in other conditions.
Lab Monitoring
- Serum sodium levels (especially in elderly patients, those on diuretics, or those who are volume depleted) for hyponatremia.
- ECG monitoring for QTc prolongation, especially at higher doses or in patients with cardiac risk factors.
Doctor Notes
- Monitor patients, especially young adults, for worsening depression and suicidality during initial therapy or dose changes.
- Assess for QT prolongation risk, especially in patients with pre-existing cardiac conditions or on other QT-prolonging drugs.
- Educate patients on potential discontinuation symptoms and the importance of gradual tapering.
Patient Guidelines
- Take Talopram exactly as prescribed by your doctor.
- Do not stop taking Talopram abruptly, as this may lead to withdrawal symptoms. Consult your doctor for gradual dose reduction.
- Report any worsening depression, suicidal thoughts, or unusual changes in mood or 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.
Driving Precautions
Talopram may cause dizziness, drowsiness, or visual disturbances. Patients should be cautioned about operating hazardous machinery, including automobiles, until they are reasonably certain that Talopram does not adversely affect their ability to engage in such activities.
Lifestyle Advice
- Avoid alcohol consumption while on Talopram treatment.
- Engage in regular physical activity and maintain a balanced diet.
- Practice good sleep hygiene to help manage insomnia.
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