Take citalopram tablets by mouth. Follow the directions on the prescription label. Swallow the tablets with a drink of water. Citalopram can be taken with or without food. Take your doses at regular intervals. Do not take your medicine more often than directed. Do not stop taking except on your prescriber or health care professional's advice.

Are There Possible Side Effects?
Side effects that you should report to your prescriber or health care professional as soon as possible:
Rare or uncommon:

• confusion
• Dizziness or lightheadedness
• Skin rash, itching (hives)
• Fast talking and excited feelings or actions that are out of control
• Suicidal thoughts
• Vomiting

More common:

• Agitation, anxiety, or restlessness, especially in the first week of treatment or when doses are changed

Side effects that usually do not require medical attention (report to your prescriber or health care professional if they continue or are bothersome):

• Blurred vision
• Diarrhea
• Difficulty sleeping
• Drowsiness
• Dry mouth
• Fever
• Frequent urination
• Headache
• Indigestion, nausea
• Increased or decreased appetite
• Increased sweating
• Sexual difficulties (decreased sexual ability or desire)
• Taste alterations
• Tremor (shaking)
• Weight changes

What should my health care professional know before I take citalopram?
They need to know if you have any of these conditions:

• Diabetes
• Heart disease
• Kidney disease
• Liver disease
• Mania
• Receive electroconvulsive therapy
• Seizures (convulsions)
• Suicidal thoughts or a previous suicide attempt
• An unusual or allergic reaction to citalopram, the related drug escitalopram, other medicines, foods, dyes, or preservatives
• Pregnant or trying to become pregnant
• Breast-feeding

What About Interactions With Other Drugs?
Do not take citalopram with any of the following medications:

• Cisapride
• Escitalopram
• Medicines called MAO inhibitors-phenelzine (Nardil), tranylcypromine (Parnate), isocarboxazid (Marplan), selegiline (Eldepryl)

Citalopram may also interact with the following medications:

• Alosetron
• Alprazolam
• Amphetamine
• Aspirin, warfarin, or nonsteroidal antiinflammatory drugs (NSAIDs) such as
• Iuprofen or naproxen
• Buspirone
• Carbamazepine
• Certain diet drugs (dexfenfluramine, fenfluramine, phentermine, sibutramine)
• Clarithromycin
• Cimetidine
• Cyproheptadine
• Dexamethasone
• Dextromethorphan
• Dextroamphetamine
• Diazepam
• Diltiazem
• Erythromycin
• Ethosuximide
• Furazolidone
• Grapefruit juice
• Kava kava
• Ketoconazole
• Linezolid
• Lithium
• Medicines that treat depression or other mood problems
• Medicines that treat HIV infection or AIDS
• Methadone
• Migraine headache medicines (almotriptan, eletriptan, frovatriptan, naratriptan, rizatriptan, sumatriptan, zolmitriptan)
• Medicines for psychosis or severe mood problems
• Modafinil
• Nefazodone
• Nicardipine
• Phenobarbital
• Phenytoin
• Prescription pain relievers (codeine, hydrocodone, meperidine, morphine, tramadol, oxycodone)
• Primidone
• Procarbazine
• Quinine
• Rifabutin
• Rifampin
• St. John's Wort
• Troglitazone
• Tryptophan
• Valerian
• Verapamil

Tell your prescriber or health care professional about all other medicines you are taking, including non-prescription medicines. Also tell your prescriber or health care professional if you are a frequent user of grapefruit juice, drinks with caffeine or alcohol, if you smoke, or if you use illegal drugs. These may affect the way your medicine works. Check with your health care professional before stopping or starting any of your medicines.

What If I Miss A Dose?
If you miss a dose of citalopram, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Follow your prescriber or health care professional's advice on missed doses. Do not take double or extra doses.

What should I watch for while taking citalopram?
Visit your prescriber or health care professional for regular checks on your progress. Continue to take your tablets even if you do not immediately feel better. It can take about 4 weeks before you feel the full effect of citalopram.

Patients and their families should watch out for worsening depression or thoughts of suicide. Also watch out for sudden or severe changes in feelings such as feeling anxious, agitated, panicky, irritable, hostile, aggressive, impulsive, severely restless, overly excited and hyperactive, or not being able to sleep. If this happens, especially at the beginning of antidepressant treatment or after a change in dose, call your health care professional.

If you have been taking citalopram regularly for some time, do not suddenly stop taking it. You must gradually reduce the dose, or your symptoms may get worse. Ask your prescriber or health care professional for advice.

You may get drowsy or dizzy. Do not drive, use machinery, or do anything that needs mental alertness until you know how citalopram affects you. Do not stand or sit up quickly, especially if you are an older patient. This reduces the risk of dizzy or fainting spells. Alcohol may interfere with the effect of citalopram. Avoid alcoholic drinks.

Do not treat yourself for coughs, colds, or allergies without asking your prescriber or health care professional for advice. Some ingredients can increase possible side effects.

Your mouth may get dry. Chewing sugarless gum or sucking hard candy, and drinking plenty of water will help.

If you are going to have surgery, tell your prescriber or health care professional that you are taking citalopram.

How Should It Be Stored?
Keep out of reach of children in a container that small children cannot open.

Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F). Throw away any unused medicine after the expiration date.

NOTE: The above information is intended to supplement, not substitute for, the expertise and judgment of your physician, pharmacist, or other healthcare professional. It should not be construed to indicate that the use of the product is safe, appropriate, or effective for you. Consult your healthcare professional before taking the product.