Citalopram

CLINICAL USE

SSRI antidepressant:Depressive illness Panic disorder

DOSE IN NORMAL RENAL FUNCTION

10–60 mg dailyOral drops: 8–48 mg (4 drops = 8 mg liquid = 10 mg tablet)

PHARMACOKINETICS

Molecular weight :324.4

%Protein binding :<80

%Excreted unchanged in urine : 12

Volume of distribution (L/kg) :12.3

half-life – normal/ESRD (hrs) :36/49.5

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 : Dose as in normal renal function

10 to 20 : Dose as in normal renal function

<10 : Dose as in normal renal function. Use with caution

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD :Unlikely to be dialysed. Dose as in GFR <10 mL/min

HD :Not dialysed. Dose as in GFR <10 mL/min

HDF/high flux :Not dialysed. Dose as in GFR <10 mL/min

CAV/VVHD :Unlikely to be dialysed. Dose as in GFR 10 to 20 mL/min

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugsAnalgesics: increased risk of bleeding with aspirin and NSAIDs; risk of CNS toxicity increased with tramadolAnticoagulants: effect of coumarins possibly enhancedAntidepressants: avoid concomitant use with MAOIs and moclobemide, increased risk of toxicity; avoid concomitant use with St John’s wort; possibly enhanced serotonergic effects with duloxetine; can increase tricyclics antidepressant concentration; increased agitation and nausea with tryptophanAnti-epileptics: convulsive threshold loweredAntimalarials: avoid concomitant use with artemether/lumefantrineAntipsychotics: possibly increased clozapine concentrationAntivirals: concentration possibly increased by ritonavirDopaminergics: use selegiline with caution; increased risk of CNS toxicity with rasagiline5 HT 1 agonist: increased risk of CNS toxicity with sumatriptan; possibly increased risk of serotonergic effects with frovatriptanLinezolid: use with care, possibly increased risk of side effectsLithium: increased risk of CNS effects Sibutramine: increased risk of CNS toxicity (avoid concomitant use)

ADMINISTRATION

Reconstition

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Route

Oral

Rate of Administration

–

Comments

OTHER INFORMATION

Only 1% of drug is removed by haemodialysisThere is reduced clearance of Citalopram in severe renal failure

See how to identify renal failure stages according to GFR calculation

See how to diagnose irreversible renal disease

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