Citalopram (Jamp Pharma): Uses, Side Effects and Dosage

Serious warnings and precautions box

New or worsened emotional or behaviour problems:

• When you first start taking Citalopram or when your dose is adjusted, you may feel worse instead of better. You may feel new or worsened feelings of agitation, hostility, anxiety, or impulsivity.
• During your treatment with Citalopram, it is important that you and your healthcare professional talk regularly about how you are feeling. They will closely monitor you for signs of new or worsened emotions or behaviours while you are taking Citalopram.

• You may find it helpful to tell a relative or close friend that you are depressed. Ask them to read this leaflet. You might ask them to tell you if they:

  • think your depression is getting worse, or
  • are worried about changes in your behaviour.
• If your depression worsens or you experience changes in your behaviour, tell your healthcare professional right away. Do not stop taking your medicine as it takes time for Citalopram to work.

Self-harm or Suicide

• Antidepressants, such as Citalopram, can increase the risk of suicidal thoughts or actions.
• If you have thoughts of harming or killing yourself at any time, tell your healthcare professional or go to a hospital right away. You will be closely observed by your healthcare professional in this situation.

What Citalopram is used for:

Citalopram is used to relieve the symptoms of depression in adults. Your healthcare professional will keep evaluating if Citalopram is still safe and effective for you if you take it for a long time.

How Citalopram works:

Citalopram is known as an antidepressant and belongs to a group of medicines called selective serotonin reuptake inhibitors (SSRIs).

Citalopram works by increasing the levels of a chemical in the brain called serotonin.

The ingredients in Citalopram are:

Medicinal ingredients: Citalopram hydrobromide

Non-medicinal ingredients: Copovidone, corn starch, croscarmellose sodium, glycerine, hydroxypropyl methylcellulose, lactose monohydrate, magnesium stearate, microcrystalline cellulose, polyethylene glycol 400, titanium dioxide.

Citalopram comes in the following dosage forms:

Tablets: 10 mg, 20 mg or 40 mg of citalopram (as citalopram hydrobromide).

Do not use Citalopram if:

• you are allergic to citalopram hydrobromide.
• you are allergic to any of the other ingredients in Citalopram or to a component of the container.
• you are also taking the medicine pimozide, used to treat schizophrenia.
• you are currently taking or have taken, within 14 days, medicines called monoamine oxidase antidepressants such as phenelzine sulphate, tranylcypromine or moclobemide, or other monoamine oxidase inhibitors such as linezolid, methylene blue, selegiline.
• you have been told that you have QT interval prolongation (abnormal electrical activity of the heart) or have been diagnosed with a condition called a congenital long QT syndrome.

To help avoid side effects and ensure proper use, talk to your healthcare professional before you take Citalopram. Talk about any health conditions or problems you may have, including if you:

• have heart problems.
• have diabetes. Citalopram may make it more difficult to control your blood sugar.
• have liver or kidney problems.
• have or have had a seizure disorder.
• have or have had manic episodes or have been diagnosed with bipolar disorder.
• are receiving electroconvulsive therapy.
• have a bleeding disorder or have been told that you have low platelets.
• have a family history of QT / QTc prolongation (abnormal electrical activity of the heart).
• have electrolyte disturbances like low blood potassium, magnesium, or calcium levels or conditions that could lead to this such as vomiting, diarrhea, dehydration.
• had a recent bone fracture or were told you have osteoporosis or risk factors for osteoporosis.
• are taking other antidepressants, triptans used to treat migraines, lithium, opioids (including to treat pain, or drug dependence), or drugs containing tryptophan.
• have habits of alcohol and / or street drug consumption.
• are taking St. John’s Wort, an herbal product used to treat depression.

Other warnings you should know about:

• It is important that you and your healthcare professional talk regularly about how you are feeling while you are taking Citalopram.

• Citalopram should not be used in children and adolescents under 18 years of age.

Activation of Mania: Tell your healthcare professional if you have or have had manic episodes in the past or if you have been diagnosed with bipolar disorder. Citalopram should be used with caution if you have a history of manic episodes. Some patients with bipolar disorder (also known as manic depression) may enter into a manic phase when they start taking Citalopram. Tell your healthcare professional if you experience symptoms of mania such as excessive physical activity, overactive behaviour or thoughts, increased energy, trouble sleeping, racing thoughts, reckless behaviour, excessive happiness or irritability, talking more or faster than usual.

Bleeding Problems: Before taking Citalopram tell your healthcare professional if you have a bleeding disorder including low blood platelets. Drugs from the class that Citalopram belongs to may increase the chance of a bleeding event such as nosebleeds, bruising and even life-threatening bleeding. This is more likely if you have a history of a bleeding disorder or are taking other drugs that are known to affect blood clotting. Talk to your healthcare professional about drugs that might increase bleeding.

Pregnancy: Before taking Citalopram, tell your healthcare professional if you are pregnant, think you might be pregnant or are planning to become pregnant. You should not take Citalopram if you are pregnant unless you and your healthcare professional have discussed the risks and decided that you should. Tell your healthcare professional right away if you become pregnant while taking Citalopram. If you take Citalopram near the end of your pregnancy, you could have heavy vaginal bleeding shortly after giving birth.

Effects on Newborns: Some newborn babies whose mothers took medications such as Citalopram during pregnancy have developed problems at birth. These problems include prolonged hospitalization, breathing support and tube feeding. Symptoms can include:

• feeding and / or breathing difficulties
• bluish skin
• seizures
• body temperature changes
• vomiting
• low blood sugar
• tense or overly relaxed muscles
• vivid reflexes
• tremor
• jitteriness
• irritability
• sleeping difficulties and constant crying.

In most cases, these medications were taken during the third trimester of pregnancy. These symptoms are caused by the medication itself or from the effects of suddenly stopping the medication. These symptoms normally go away over time. However, if your baby experiences any of these symptoms, contact your healthcare professional as soon as you can.

Persistent Pulmonary Hypertension of the Newborn (PPHN): If you take Citalopram towards the end of your pregnancy, your newborn may be at risk of having a serious lung condition called Persistent Pulmonary Hypertension of the Newborn (PPHN). This causes breathing problems in newborns soon after birth. Newborn babies may breathe faster and appear bluish. These symptoms usually begin during the first 24 hours after the baby is born. If this happens to your newborn baby, get immediate medical help for them.

Breastfeeding: Tell your healthcare professional if you are breastfeeding or planning to breastfeed. Citalopram is released into breast milk. It is not known if this is safe for your baby. You should not breastfeed a baby if you are taking Citalopram unless you and your healthcare professional have discussed the risks and decided that you should.

Effect on the Electrical Activity of the Heart: Citalopram has an effect on the electrical activity of the heart known as QT / QTc prolongation (abnormal electrical activity of the heart). This can lead to disturbances in heart rhythm (arrhythmias / dysrhythmias) that could result in dizziness, palpitations (sensation of rapid, pounding, or irregular heartbeat), fainting or cardiac arrest and death. This is more likely in patients with risk factors, such as heart disease, heart attack, or in the presence of certain drugs that could interact with the activity of the heart. If you experience any symptoms of a possible heart rhythm disturbance (abnormal heart rate or rhythm), such as dizziness, palpitations (sensation of rapid, pounding, or irregular heartbeat), fainting, or seizures, you should seek immediate medical attention.

Serotonin Toxicity or Neuroleptic Malignant Syndrome: Serotonin toxicity (also known as serotonin syndrome): Citalopram can cause serotonin toxicity, a rare but potentially life-threatening condition. It can cause serious changes in how your brain, muscles and digestive system work. You may develop serotonin toxicity if you take Citalopram with certain antidepressants or migraine medications.

Serotonin toxicity or neuroleptic malignant syndrome symptoms include:

• fever, sweating, shivering, diarrhea, nausea, vomiting;
• muscle shakes, jerks, twitches or stiffness, overactive reflexes, loss of coordination;
• fast heartbeat, changes in blood pressure;
• confusion, agitation, restlessness, hallucinations, mood changes, unconsciousness, and coma.

Effects on Sexual Function: Taking medicines like Citalopram may cause symptoms of sexual dysfunction. In some cases these symptoms have continued after stopping Citalopram treatment. Talk to your healthcare professional if you experience symptoms such as a decrease in sexual desire, performance or satisfaction.

Risk of Bone Fractures: Taking Citalopram may increase your risk of breaking a bone if you are elderly, have osteoporosis or other risk factors for breaking a bone. You should take extra care to avoid falls especially if you get dizzy or have low blood pressure.

Angle-closure Glaucoma: Citalopram can cause dilation of the pupil. This may cause an acute glaucoma attack in an individual with narrow ocular angles. Having your eyes examined before you take Citalopram could help identify if you are at risk of having angle-closure glaucoma. Get immediate medical help if you experience:

• eye pain
• changes in vision
• swelling or redness in or around the eye.

Driving and Using Machines: Citalopram may impair your ability to drive or to use machines. Wait until you know how Citalopram affects you before driving or using machines. Do not drive or use machines if Citalopram impairs your ability to do so safely.

Discontinuation Symptoms: Contact your healthcare professional before stopping or reducing your dosage of Citalopram. If you stop or reduce the dosage of Citalopram abruptly, or if you miss a dose, you may experience symptoms such as dizziness, sleep disturbances, abnormal dreams, sensory disturbance like electric shock sensations, agitation, anxiety, headache, tremor (shakiness), nausea, vomiting. Tell your healthcare professional immediately if you have these or any other symptoms. Your healthcare professional may adjust the dosage of Citalopram to reduce the symptoms.

Tell your healthcare professional about all the medicines you take, including any drugs, vitamins, minerals, natural supplements or alternative medicines.

Serious drug interactions:

Serious drug interactions with Citalopram include:

• Monoamine oxidase inhibitors (MAOIs) such as phenelzine, tranylcypromine, moclobemide or selegiline, linezolid (an antibiotic) or Methylene blue (intravenous). Do not use Citalopram if you are taking a MAOI, or have recently taken one in the last 14 days.
• Pimozide.

The following may also interact with Citalopram:

• drugs to treat heart rhythm disturbances (antiarrhythmics)
• antipsychotics, used to treat schizophrenia
• opioids (including for pain, drug dependence or anesthesia) such as methadone, buprenorphine, tramadol, fentanyl, tapentadol, meperidine or pentazocine
• drugs to treat infections
• drugs to treat nausea and vomiting
• cancer drugs
• asthma drugs
• diuretics (water pills)
• carbamazepine, used to treat seizures
• other SSRIs e.g., Cipralex® (escitalopram) or any other antidepressant (e.g., imipramine, desipramine)
• lithium, used to treat mood disorder
• tryptophan, for sleep aid or treating anxiety
• cimetidine, for acidity problems
• triptans (e.g., sumatriptan, zolmitriptan, naratriptan), for migraine
• fluconazole, ketoconazole, itraconazole, for treating fungal infection
• erythromycin, used to treat infections
• warfarin, used to prevent blood clots
• omeprazole, used to treat stomach problems
• any herbal product such as St. John’s Wort
• certain medicines which may affect blood clotting and increase bleeding, such as oral anticoagulants (e.g., warfarin, dabigatran), acetylsalicyIic acid (e.g., Aspirin®) and other nonsteroidal anti-inflammatory drugs (ibuprofen)
• certain medicines used to treat cough, such as dextromethorphan

Avoid drinking alcohol while taking Citalopram.

How to take Citalopram:

• Take Citalopram exactly as your healthcare professional has told you.
• Swallow tablets whole with water. Do not chew them.

• You can take Citalopram with or without food.

• Take Citalopram once a day at the same time every day.
• Continue taking Citalopram even if you do not feel better. It may take several weeks for it to work and improvement may be gradual.
• Keep taking Citalopram for as long as your healthcare professional recommends. Do not stop taking Citalopram abruptly even if you feel better unless your healthcare professional has told you to.
• Never take more Citalopram than your healthcare professional has prescribed for you.
• Follow all instructions given to you by your healthcare professional.

Usual dose:

The usual dose is one 20 mg tablet once a day. Your healthcare professional might prescribe a lower dose if you are elderly, have liver problems or in other situations.

Overdose:

If you think you, or a person you are caring for, have taken too much Citalopram, contact a healthcare professional, hospital emergency department regional, poison control centre or Health Canada’s toll-free number, 1-844 POISON-X (1-844-764-7669) immediately, even if there are no signs or symptoms.

Missed dose:

If you forget a dose, take the next dose as planned. Do not take a double dose to make up for a forgotten dose.

Possible side effects from using Citalopram:

These are not all the possible side effects you may have when taking Citalopram. If you experience any side effects not listed here, tell your healthcare professional.

Side effects may include:

• Fatigue
• Dry mouth
• Increased sweating
• Tremor (shakiness)
• Nausea
• Diarrhea
• Somnolence (sleepiness)
• Ejaculation disorder

Serious side effects and what to do about them

If you have a troublesome symptom or side effect that is not listed here or becomes bad enough to interfere with your daily activities, tell your healthcare professional.

Reporting Side Effects

You can report any suspected side effects associated with the use of health products to Health Canada by:

• Visiting the Web page on Adverse Reaction Reporting (canada.ca/drug-device-reporting) for information on how to report online, by mail or by fax; or
• Calling toll-free at 1-866-234-2345.

NOTE: Contact your healthcare professional if you need information about how to manage your side effects. The Canada Vigilance Program does not provide medical advice.

Storage:

Keep Citalopram out of reach and sight of children. Store Citalopram at room temperature,

15-30°C, in a dry place.

If you want more information about Citalopram:

• Talk to your healthcare professional
• Find the full Product Monograph that is prepared for healthcare professionals and includes the Patient Medication Information by visiting the Health Canada Drug Product Database website (https://www.canada.ca/en/health-canada/services/drugs-health-products/drug-products/drug-product-database.html); or by calling 1-866-399-9091.

JAMP Pharma Corporation

1310 rue Nobel

Boucherville, Québec

J4B 5H3 Canada

Date of Authorization: 2026-04-01