Before taking citalopram

Before taking citalopram make sure your doctor or pharmacist knows:

• If you are under 18 years of age.
• If you are pregnant, trying for a baby or breast-feeding.
• If you have heart, liver or kidney problems.
• If you have epilepsy.
• If you have diabetes.
• If you have glaucoma (increased pressure in your eye).
• If you have a bleeding disorder.
• If you have ever had abnormally 'high' moods.
• If you are being treated with electroconvulsive therapy (ECT).
• If you have ever had an allergic reaction to this or to any other medicine.
• If you have taken an antidepressant known as a monoamine-oxidase inhibitor (MAOI) within the previous two weeks.
• If you are taking any other medicines, including those available to buy without a prescription, herbal and complementary medicines.

How to take citalopram

• Before starting this treatment, read the manufacturer's printed information leaflet from inside the pack.
• Take citalopram exactly as your doctor has told you. You will be told how many tablets or drops to take each day, and this information will also be on the label of the pack you have been supplied with.
• If you have been given Cipramil® oral drops: count the correct number of drops into water or a drink of orange or apple juice. Stir it briefly and then drink it straightaway.
• Try to take citalopram at the same time each day to avoid missing any of your doses.
• It is not important whether you take citalopram before, during or after food.
• If you do forget to take a dose, take it as soon as you remember. If you do not remember until the following day, skip the missed dose. Do not take two doses together to make up for a forgotten dose.

Getting the most from your treatment

• You may feel that citalopram is not working for you straightaway. It can take a week or two after starting this treatment before the effect begins to build up, and 4-6 weeks before you feel the full benefit. Do not stop taking it after a week or so, feeling it is not helping.
• Try to keep your regular appointments with your doctor. This is so your doctor can check on your progress.
• It is sensible to avoid drinking alcohol while you are being treated with citalopram. Taking citalopram and alcohol increases the chance that you may experience side-effects.
• If you have diabetes you may need to check your blood glucose more frequently, as citalopram may affect the levels of sugar in your blood. Your doctor will be able to advise you about this.
• Citalopram may cause your skin to become more sensitive to sunlight than usual. Avoid strong sunlight and sunbeds until you know how your skin reacts.
• If you buy any medicines, check with a pharmacist that they are safe to take with citalopram.
• There are several types of antidepressants and they differ in their possible side-effects. If you find that citalopram does not suit you then let your doctor know, as another may be found that will.
• Do not stop taking citalopram unless your doctor tells you to do so. Stopping treatment suddenly can cause problems and your doctor will probably want you to reduce your dose gradually if this is necessary.
• While you feel depressed or are taking citalopram, you may have thoughts about harming yourself or ending your life. It is very important that you tell your doctor about this if it happens.
• If you are taking citalopram for depression, you should expect that a normal course will last for around six months after your symptoms have eased. If you are taking citalopram for a panic disorder, your course may last for several months or until you are free from symptoms.

Can citalopram cause problems?

Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. These usually improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following side-effects continue or become troublesome.

• Any swelling of the mouth or face.
• Any shortness of breath or difficulty swallowing.
• An itchy rash.

If you experience any other symptoms that you think may be due to this medicine, speak with your doctor or pharmacist.

How to store citalopram

• Keep all medicines out of the reach and sight of children.
• Store in a cool, dry place, away from direct heat and light.
• You can use citalopram drops for 16 weeks after first opening the bottle. Do not use the drops after this time.

Important information about all medicines

References

• Manufacturer's PIL, Cipramil® Tablets, Lundbeck Limited, electronic Medicines Compendium. Dated March 2011.
• Manufacturer's PIL, Cipramil® Drops, Lundbeck Limited, electronic Medicines Compendium. Dated March 2011.
• British National Formulary; 62nd Edition (Sep 2011) British Medical Association and Royal Pharmaceutical Society of Great Britain, London (link to current BNF)