Citalopram 10 mg film-coated tablets – patient leaflet, side effects, dosage

1 What Citalopram is and what it is used for

Citalopram belongs to a group of antidepressants known as Selective Serotonin Reuptake Inhibitors (SSRIs).

Citalopram is used for the treatment of:

• Depressive illnesses (major depressive episodes)

• Panic disorders with or without agoraphobia (e.g. strong

  fear of leaving the house, entering shops, or fear of public places)

2 What you need to know before you take Citalopram

Do not take Citalopram:

• If you are allergic (hypersensitive) to Citalopram, other

  SSRI antidepressants or any of the other ingredients of this medicine (see section 6 “Contents of the pack and other information”)

• If you are taking or have recently taken medicines used

  to treat depression called Monoamine Oxidase Inhibitors (MAOIs): e.g moclobemide or you are being treated with the non-selective MAOI linezolid (an antibiotic medicine), unless you are being closely monitored (see “Other medicines and Citalopram” section) .The irreversible MAOI selegiline (used to treat Parkinson`s disease) may be used in combination with Citalopram in doses not exceeding 10mg selegiline per day. Before starting treatment with Citalopram, you may have to wait for up to 14 days after stopping the use of a MAOI. When changing from Citalopram, you may have to wait for at least 7 days before you start taking MAOIs.

• If you are taking the medicine pimozide, used to treat

  mental disorders (see “Other medicines and Citalopram” section)

• If you are born with or have had an episode of abnormal

  heart rhythm (seen at ECG; an examination to evaluate how the heart is functioning)

• If you take medicines for heart rhythm problems or that

  may affect the heart`s rhythm

Warnings and precautions

Talk to your doctor before taking Citalopram if:

• You are older (above 65 years of age)
• You suffer from kidney and liver problems

• You suffer from a panic disorder as you may need to

  start treatment with a low dose

• You are at risk of a decreased salt (sodium) level in the

  blood (hyponatraemia)

• You start to feel restless and cannot sit or stand still

  (akathisia). This is most likely to occur within the first few weeks of treatment. Increasing your dose of Citalopram may make this condition worse

• You have a history of feeling/being elated/over-excited

  which causes unusual behaviour (mania). If you have a manic episode, your treatment with Citalopram should be discontinued

• You have diabetes as the dose of your diabetic medicine

  may need to be adjusted (see “Other medicines and Citalopram” section)

• You have or are at risk of increased pressure in the eye

  (glaucoma) as Citalopram can cause dilation of the pupils (mydriasis)

• You have unstable epilepsy, Citalopram should be

  avoided. If you have controlled epilepsy, you should be carefully monitored. Citalopram should be discontinued if you develop fits (seizures) or there is an increase in the frequency

• You are receiving ECT (Electro-Convulsive Treatment)

• You have a history of bleeding disorders, if you are

  pregnant (see ‘Pregnancy’¹) or are taking anticoagulant medicines (for thinning the blood) (see “Other medicines and Citalopram section”)

• You are taking serotonergic medicines (antidepressants)

  such as sumatriptan or other triptans, tramadol, oxitriptan, and tryptophan (see “Other medicines and Citalopram” section) as on rare occasions, development of serotonin syndrome have occurred. Treatment with Citalopram should be discontinued if symptoms such as agitation, shakiness (tremor), involuntary muscle twitching (myoclonus) and fever (hyperthermia) should occur

• You are taking St. John’s Wort, a herbal remedy used to

  treat depression as it may result in an increase in undesirable effects (see “Other medicines and Citalopram” section).

• You have suspected congenital long qt- syndrome or

  suffer from low blood levels of potassium or magnesium (hypokalaemia/hypomagnesaemia).

• You suffer from or have a history of heart problems or

  have recently had a heart attack. If signs of irregular heartbeat (cardiac arrhythmia) occur during treatment with Citalopram, treatment should be withdrawn and an ECG should be performed

• Medicines like Citalopram (so called SSRIs/SNRIs) may

  cause symptoms of sexual dysfunction (see section 4). In some cases, these symptoms have continued after stopping treatment.

Thoughts of suicide and worsening of your depression or anxiety disorder

If you are depressed and/or have anxiety disorders you can sometimes have thoughts of harming or killing yourself. These may be increased when first starting

antidepressants, since these medicines all take time to work, usually about two weeks but sometimes longer. You may be more likely to think like this:

• If you have previously had thoughts about killing or harming yourself.
• If you are an adult. Information from clinical trials has shown an increased risk of suicidal behaviour in young adults aged less than 25 years old with psychiatric conditions who were treated with an antidepressant. If you have thoughts of harming or killing yourself at any time, contact your doctor or go to a hospital straight away.

You may find it helpful to tell a relative or close friend that you are depressed or have an anxiety disorder, and ask them to read this leaflet. You might ask them to tell you if they think your depression or anxiety disorder is getting worse, or if they are worried about changes in your behaviour.

Use in children and adolescents under the age of 18 years:

Citalopram should not be used in the treatment of children and adolescents under the age of 18 years. Patients under the age of 18 years have an increased risk of suicide-related behaviours (suicide attempt and suicidal thoughts) and hostility (predominantly aggression, oppositional behaviour and anger) when treated with antidepressants. If your doctor has prescribed Citalopram for a patient under 18 and you want to discuss this, please go back to your doctor. You should inform your doctor if any of the symptoms listed above develop or worsen when patients under 18 are taking Citalopram. Studies of people under 18 taking Citalopram have not shown for certain whether or not the medicine affects growth, or development of the brain or body.

Other medicines and Citalopram

Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines, including those obtained without a prescription. This includes herbal medicines.

Medicines which must not be taken with Citalopram

• Monoamine Oxidase Inhibitors (MAOIs), medicines used to treat depression e.g. moclobemide, selegiline, linezolid (see “Do not take” section)
• Buspirone, used to treat anxiety disorders

Do not take Citalopram if you take medicines that may affect the heart’s rhythm such as:

• Class IA and III antiarrhythmics
• Anti-psychotics, medicines used to treat mental health problems (phenothiazine derivatives, pimozide, haloperidol)
• Tricyclic antidepressants such as clomipramine, nortriptyline, imipramine, desipramine
• Certain anti-microbioal agents (sparfloxacin, moxifloxacin, erythromycin IV, pentamidine, anti-malarial treatment - particularly halofantrine)
• Certain anti-histamines, medicines used to treat allergic conditions (astemizole, mizolastine)

Other medicines which should not be taken with Citalopram

• Sumatriptan and other triptans (used to treat headaches and migraines)
• Tramadol (used to treat severe pain)
• Oxitriptan, tryptophan (used to treat depression)
• Herbal products containing St. John’s Wort (hypericum perforatum)

Medicines which may influence the effect of or be influenced by Citalopram

• Metoprolol, flecainide and propafenone (to treat heart problems)
• Medicines that decrease blood levels of potassium or magnesium
• Butyrophenones, phenothiazines such as chlorpromazine, thioxanthenes, risperidone and thioridazine (used to treat mental and emotional conditions)
• Mefloquin (used to treat malaria)
• Bupropion (used to help you stop smoking)
• Lithium, a medicine used to treat mood disorders

• Cimetidine, omeprazole, esomeprazole, lansoprazole

  (used to treat indigestion, stomach ulcers and heartburn)

• SSRI antidepressants (fluvoxamine)
• Medicines for thinning your blood such as warfarin

• Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)

  (aspirin)

• Dipyridamol (used to treat thrombosis)
• Ticlopidine (used to reduce the risk of stroke)
• Medicines used to treat diabetes, as the dose may need to be adjusted

Taking Citalopram with food and drink and alcohol

• You are advised not to drink alcohol whilst taking

  Citalopram.

• These tablets may be taken with or without food but should be taken with a glass of water.

Pregnancy, breast-feeding and fertility

If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor for advice before taking this medicine.

Pregnancy

Do not take Citalopram if you are pregnant or think you may be pregnant, unless you and your doctor have discussed the risks and benefits involved. You should not stop treatment with Citalopram abruptly during pregnancy. Contact your doctor if you wish to pause or stop the treatment.

Make sure your midwife and/or doctor know you are on Citalopram. When taken during pregnancy, particularly in the last 3 months of pregnancy, medicines like Citalopram may increase the risk of a serious condition in babies, called Persistent Pulmonary Hypertension of the Newborn (PPHN), making the baby breathe faster and appear bluish. These symptoms usually begin during the first 24 hours after the baby is born. If this happens to your baby you should contact your midwife and/or doctor immediately.

If you take Citalopram, particularly during the last 3 months of pregnancy, your newborn child may experience serious side effects such as breathing difficulties, bluish skin/lips (cyanosis), irregular breathing with breathing pauses (apnoea), temperature fluctuations, fits (seizures), lack energy (lethargy), sleeping difficulties, difficulty in feeding, being sick (vomiting), low level of sugar in the blood (hypoglycaemia), stiff or floppy muscles, abnormally increased reflexes, shaking (tremor), extreme nervousness or nervous shaking, irritability, lacking energy (lethargy), constant crying and drowsiness (somnolence). If your baby has any of these symptoms when it is born, contact your midwife/and or doctor immediately.

If you take Citalopram near the end of your pregnancy there may be an increased risk of heavy vaginal bleeding shortly after birth, especially if you have a history of bleeding disorders. Your doctor or midwife should be aware that you are taking Citalopram so they can advise you.

Breast-feeding

Citalopram passes into breast milk in small amounts and there is a risk of an effect on the baby. If treatment with Citalopram is considered necessary, discontinuation of breast-feeding should be considered

Fertility

Citalopram has been shown to reduce the quality of sperm in animal studies. Theoretically, this could affect fertility, but impact on human fertility has not been observed as yet.

Driving and using machines

Citalopram has minor to moderate influence on the ability to drive and use machines as it can reduce the ability to make judgements and react to emergencies. If this occurs, you should not drive or use machines. .

Citalopram contains lactose

If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicine.

PATIENT INFORMATION LEAFLET

Citalopram 10mg Film−Coated Tablets

Each film−coated tablet contains 10mg of Citalopram (as Citalopram hydrobromide)

175 mm

Black C

Pharmcode: 710

3 How to take Citalopram

Always take Citalopram exactly as your doctor has told you. You should check with your doctor or pharmacist if you are not sure.

• It may take 2-4 weeks before you notice an

  improvement.

• Treatment should continue until you have been free of

  symptoms for 4-6 months.

• When the treatment with Citalopram is to cease, the

  dose should be reduced gradually over a period of at least 1-2 weeks.

• These tablets are to be taken orally as a single dose

  either in the morning or the evening

• Swallow with a glass of water
• These tablets may be taken with or without food

Adults:

Depression:

The recommended dose is 20mg per day. This may be increased up to a maximum of 40mg per day.

Panic disorder:

• The starting dose is 10mg per day for the first week

  before increasing the dose to 20mg per day. The dose may be increased to a maximum of 40mg per day.

• Full therapeutic response may take up to 3 months to

  develop.

Older people (above 65 years of age)

• The starting dose should be decreased to half of the

  recommended dose, e.g. 10-20mg per day.

• The maximum recommended dose for older people is

  20mg per day.

Children and adolescents under the age of 18 years:

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

Patients with liver problems:

The usual dose is 10mg once daily. Patients with liver complaints should not receive more than 20mg per day.

Patients with kidney problems:

Dose adjustment is not necessary if you have mild to moderate kidney problems. The use of Citalopram is not recommended if you suffer from severe kidney problems,

If you take more Citalopram than you should

If you accidentally take too many tablets, contact your doctor or nearest hospital emergency department immediately for advice. Remember to take this leaflet or any remaining tablets with you.

Symptoms of overdose include: irregular heartbeat, changes in heart rhythm (faster or slower heartbeat [tachycardia/bradycardia]), feeling sick (nausea), being sick (vomiting), sweating, drowsiness (somnolence), unconsciousness (stupor), shakiness (tremor), fits (convulsions), changes in blood pressure (may be increased [hypertension] or decreased [hypotension]), serotonin syndrome, agitation, dizziness, enlarged eye pupils (mydriasis), bluish skin (cyanosis), breathing too quickly (hyperventilation), heart attack (cardiac arrest), coma.

If you forget to take Citalopram

Take it as soon as you remember, unless it is nearly time for your next dose. If you miss a dose, do not take a double dose to make up for a forgotten dose.

If you stop taking Citalopram

It is important that you keep taking Citalopram for as long as your doctor has told you to.

Abrupt discontinuation should be avoided. When you stop treatment with Citalopram the dose should be gradually reduced over a period of at least one to two weeks in order to reduce the risk of withdrawal reactions. If side effects should occur following a decrease in the dose or upon discontinuation of treatment, then resuming the previously prescribed dose may be considered. Subsequently, your doctor may continue decreasing the dose, but at a more gradual rate.

Withdrawal symptoms are common, particularly if treatment is stopped suddenly e.g. feeling dizzy, tingling or numbness in the hands or feet (paraesthesia), finding it difficult to sleep (insomnia) or having intense dreams, agitation, anxiety, feeling (nausea) or being sick (vomiting), shaking (tremor), confusion, sweating, headache, diarrhoea, feeling your heartbeat (palpitations), feeling emotional, irritability, visual disturbances. Most people find that any effects are mild to moderate and go away within two weeks. Some people find they are more severe and last longer (2-3 months or more).

If you have any further questions on the use of this medicine, ask your doctor or pharmacist.

4 Possible side effects

Like all medicines, Citalopram can cause side effects, although not everybody gets them.

Stop taking and seek medical advice immediately if you develop the following symptoms:

• If you have thoughts of harming or killing yourself at any

  time, contact your doctor or go to a hospital straight away. (See section 2 “Thoughts of suicide and worsening of your depression or anxiety disorder”)

• Allergic reactions: swelling of the face, throat or tongue,

  difficulty breathing, dizziness (anaphylaxis)

• Swelling of the deeper layers of the skin caused by a

  build-up of fluid (angioedema)

• Swelling of parts of the body (oedema)

• A group of symptoms together e.g. abnormally high body

  temperature, rigidity, muscle spasms, confusion, irritability, agitation (serotonin syndrome)

• Irregular heartbeat (could be symptom of life-threatening

  condition Torsades de Pointes)

• Bloody vomit and/or black stools due to bleeding from

  the stomach, gums or bottom (gastrointestinal haemorrhage)

Tell your doctor immediately if you develop:

• Feeling elated (euphoria) or emotionally “high” (mania)

• Nausea (feeling sick), muscle weakness, confusion,

  tiredness and muscle twitching due to abnormally low levels of salt (sodium) in blood (hyponatraemia)

• A reduction in blood platelets, which increases risk of

  bleeding or bruising (thrombocytopenia)

• Fits (convulsions)

Very common side effects (may affect more than 1 in 10 people)

• Feeling your heartbeat (palpitations)
• Increased sweating

• Sleeping disorders, drowsiness (somnolence), lethargy

  (urge to sleep), difficulty sleeping (insomnia)

• Eyes unable to focus properly
• General weakness (asthenia)
• Dry mouth
• Feeling sick (nausea)
• Constipation
• Headache

Common side effects (may affect up to 1 in 10 people)

• Decreased appetite, weight loss
• Agitation, anxiety, nervousness
• Diarrhoea
• Being sick (vomiting)

• Gastric discomfort (e.g. indigestion, heartburn), stomach

  pain, wind (flatulence)

• Faster heartbeat (tachycardia)
• Low or high blood pressure (hypotension, hypertension)

• Dizziness and possibly fainting (possibly only when you

  stand up) due to low blood pressure (orthostatic hypotension)

• Fever (pyrexia)
• Shakiness (tremor)
• Tingling or numbness in the hands or feet (paraesthesia)
• Tiredness (fatigue), abnormal dreams

• Dizziness

  • Migraine
  • Ringing in the ears (tinnitus)
  • Visual disturbances

  • Runny nose (rhinitis), swelling of the lining of the sinuses

    (sinusitis)

  • Yawning
  • Difficulties urinating (micturition disorder)
  • Severe itching (pruritus), rash
  • Muscle pain (myalgia), joint pain (arthralgia)

  • Ejaculation problems, inability to maintain an erection

    (impotence)

  • Menstrual pain (dysmenorrhoea)
  • Orgasm difficulties (female)
  • Reduced libido
  • Confusion
  • Indifference (apathy)
  • Concentration disturbances, memory loss (amnesia)
  • Increased salivation
  • Excessive secretion of urine (polyuria)

Uncommon side effects (may affect up to 1 in 100 people)

• Seeing or hearing things that are not real (hallucinations)
• Fainting
• Cramps
• Movement disorders (medicine-induced)
• Enlarged pupils (mydriasis), which may lead to glaucoma
• Slower heartbeat (bradycardia)
• Coughing
• Difficulties urinating, possibly urinary retention.
• Skin rashes with the formation of wheals (urticaria)
• Hair loss (alopecia)
• Increased sensitivity of the skin to light (photosensitivity)
• Skin rash caused by small blood vessels bleeding into the skin (purpura)
• Unusually heavy menstrual bleeding (menorrhagia)
• Aggression
• Feeling detached from yourself (depersonalisation)
• Increased libido
• Increased weight, increased appetite
• Feeling unwell (malaise)

Rare side effects (may affect up to 1 in 1000 people)

• Anti-Diuretic Hormone (ADH) is produced by the brain and is stored in and released by the pituitary gland. ADH controls how your body releases and conserves water. SIADH occurs when ADH is produced somewhere other than the brain, which makes it difficult for your body to get rid of excess water. This causes a build-up of fluids as well as abnormally low sodium levels

• Loss of consciousness and violent muscle contractions

  (grand mal seizure)

• Involuntary movements or movement disorders

  (dyskinesia)

• Taste disturbances
• Severe bleeding (haemorrhage)
• Extreme restlessness accompanied by an increase in muscle spasms, tremors and twitching (psychomotor restlessness/akathisia)
• Inflammation of the liver (hepatitis)

Very rare side effects (may affect up to 1 in 10,000 people)

• Abnormal production of breast milk in men and women

  (galactorrhoea)

Other side effects (frequency not known)

• Weakness, reduced muscle power, quivering and abnormal heart rhythm due to low potassium levels in the blood (hypokalaemia)
• Nose bleeds (epistaxis)
• Bruising (ecchymosis)
• Irregular, heavy menstrual bleeding (metrorrhagia)
• Persistent, painful erection (priapism)
• Panic attacks
• Teeth grinding (bruxism)
• Restlessness
• Movement disorders
• An increased risk of bone fractures has been observed in patients (particularly aged 50 years and older) taking this type of medicine
• Changes in certain laboratory test results, such as liver counts
• Heavy vaginal bleeding shortly after birth (postpartum haemorrhage), see Pregnancy¹ in section 2 for more information.
• Increase in hormone called prolactin in blood.

Reporting of side effects

If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the internet at www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store. By reporting side effects you can help provide more information on the safety of this medicine.

5 How to store Citalopram

• Keep this medicine out of the sight and reach of children.
• Do not use this medicine after the expiry date which is stated on the carton/blister/container after EXP. The expiry date refers to the last day of that month.
• Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help to protect the environment.

6 Contents of the pack and other information

What Citalopram contains:

Each film−coated tablet contains 10mg Citalopram (as Citalopram Hydrobromide).

The other ingredients are: microcrystalline cellulose, glycerol 85%, magnesium stearate, maize starch, lactose monohydrate, copovidone, sodium starch glycollate (type A), macrogol 6000, hypromellose, talc and titanium dioxide (colouring agent E 171).

What Citalopram looks like and contents of the pack:

Citalopram 10mg are white, round, film−coated tablets without a score line.

Citalopram is available in:

Citalopram 10mg are available in blister packs of 10, 14, 20, 28, 30, 50, 56, 60, 98 or 100 tablets.

Not all pack sizes or pack types may be marketed.

Product Licence Number:

PL 51718/0007

Marketing Authorisation Holder and Manufacturer:

Clydesdale Pharma Ltd.,

Unit 3-5 Campbell Court,

Campbell Road,

Tadley,

RG26 5EG,

United Kingdom.

This leaflet was revised in September 2025.

Blind or partially sighted? Is this leaflet hard to see or read?

Call 020 3904 4452 to obtain the leaflet in a format suitable for you.

NCPR 008 R01

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14.08.2025

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NEW 01 CITALOPRAM TABLETS 10MG-LEAFLET

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