Patient leaflet - Citalopram 20 mg tablets
1. What Citalopram Tablets are and what they are used for How does Citalopram Tablets work?
Citalopram is a Selective Serotonin Reuptake Inhibitor (SSRI) and belongs to a group of medicines known as antidepressants. As with many other kinds of medications and treatments, we don't know for certain how antidepressants work. We do know that they affect the activity of certain chemicals in our brains. These are called neurotransmitters, and pass signals from one brain cell to another. The neurotransmitters most affected by antidepressants are serotonin and noradrenaline. However, research suggests that antidepressants work on the brain in multiple ways that go beyond simple chemical reactions. This research suggests that they:
- influence how the body responds to stress
- improve our negative thinking
- stop or even reverse damage to brain cells
What is Citalopram Tablets used for?
Citalopram Tablets contains citalopram and is used for the treatment of depression and, when you feel better, to help prevent these symptoms recurring. Citalopram is also used for long-term treatment to prevent the occurrence of new episodes of depression if you have recurrent depression.
Citalopram is also beneficial in relieving symptoms if you tend to suffer from panic attacks.
2. What you need to know before you take Citalopram Tablets
Do not take Citalopram Tablets
- if you are allergic to citalopram hydrobromide or to any of the other ingredients of this medicine (listed in section 6). Consult your doctor if you think you might be.
- at the same time as taking medication known as monoamine oxidase inhibitors (MAOIs). MAOIs include medicines such as phenelzine, iproniazid, isocarboxazid, nialamide, tranylcypromine and moclobemide (used for the treatment of depression), selegiline (used in the treatment of Parkinson’s disease) and linezolid (an antibiotic). Even if you have finished taking one of the following MAOIs: phenelzine, iproniazid, isocarboxazid, nialamide or tranylcypromine you will need to wait 2 weeks before you start taking your Citalopram tablets. One day must elapse after you have finished taking moclobemide. After stopping Citalopram tablets you must allow 1 week before taking any MAOI.
- 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 effect the heart's rhythm. (see section "Other medicines and Citalopram" below).
- if you are taking buprenorphine-containing medicinal products. The use of these medicines together with Citalopram can lead to serotonin syndrome, a potentially life threatening condition (see “Other medicines and citalopram”).
Warnings and precautions
Talk to your doctor or pharmacist before taking Citalopram tablets if you have any medical problems, especially if you have
- Liver or kidney disease.
- Diabetes (you may need an adjustment of your antidiabetic therapy).
- Epilepsy or a history of seizures or fits.
History of bleeding disorder or have ever suffered from bleeding in the stomach or intestine, or if you are pregnant (see ‘Pregnancy, breast-feeding and fertility’).
- Mania or panic disorder
- Low blood levels of sodium
- ECT (electroconvulsive therapy)
- Or have previously had eye problems, such as certain kinds of glaucoma (increased pressure in the eye).
- Suffered or suffer from heart problems or have recently had a heart attack.
- A low resting heart-rate and/or you know that you may have salt depletion as a result of prolonged severe diarrhoea and vomiting (being sick) or usage of diuretics (water tablets)
- Experienced a fast or irregular heartbeat, fainting, collapse or dizziness on standing up which may indicate abnormal functioning of the heart rate
Please consult your doctor, even if these statements were applicable to you at any time in the past.
Please note:
Some patients with manic-depressive illness may enter into a manic phase. This is characterized by unusual and rapidly changing ideas, inappropriate happiness and excessive physical activity. If you experience this, contact your doctor. Symptoms such as restlessness or difficulty in sitting or standing still can also occur during the first weeks of the treatment. Tell your doctor immediately if you experience these symptoms. Medicines like Citalopram tablets may cause symptoms of sexual dysfunction (see section 4). Rarely people can experience more persistent sexual side-effects after they have stopped taking SSRIs. The term ‘post SSRI sexual dysfunction’ (PSSD) has been used by some people to describe these symptoms. For these people, PSSD can have a significant and distressing impact on their lives. Research is needed to understand why this happens and how common it is. It is important that people experiencing ongoing sexual side-effects receive appropriate and timely support.
Special information relating to your disease
As with other medicines used to treat depression or related diseases, the improvement is not achieved immediately. After the start of Citalopram treatment it may take several weeks before you experience any improvement. In the beginning of the treatment certain patients may experience increased anxiety, which will disappear during continued treatment. Therefore, it is very important that you follow exactly your doctor’s orders and do not stop the treatment or change the dose without consulting your doctor.
Thoughts of self- harm and suicidal behaviour
This medicine may be associated with thoughts of self-harm and suicidal behaviour in some people.
Tell someone you trust, who can help you in an emergency, that you are taking this medicine and ask that they read this leaflet. Talk to your trusted person, prescriber or go to a hospital straight Very common side effects (may affect more than 1 in 10 people)
- Sleepiness • Difficulty in sleeping
- Headache • Changes in your sleeping pattern
- Loss of body strength, weakness
- Increased sweating • Feeling sick (nausea)
- Dry mouth (a dry mouth increases the risk of tooth decay, so be sure to clean your teeth more often than usual) Common side effects (may affect up to 1 in 10 people)
- Lack of appetite • Agitation
- Decreased sex drive • Anxiety
- Nervousness • Confusion
- Abnormal dreams • Blocked or runny nose (rhinitis)
- Reduced emotions, indifference (apathy)
- Tremor • Loss of weight
- Tingling or numbness in the hands or feet
- Dizziness • Problems concentrating
- Migraine • Loss of memory (amnesia)
- Ringing in the ears (tinnitus)
- Palpitations • Yawning
- Diarrhoea • Vomiting
- Constipation • Stomach pain
- Flatulence (wind) • Increase in saliva (drooling)
- Itching • Pain in muscles and joints
- For men, problems with ejaculation and erection
- For women, failing to reach an orgasm
- Tiredness • Prickling of the skin Uncommon (may affect up to 1 in 100 people)
- Bruising easily • Increased appetite
- Aggression • Hallucinations
- Mania • Fainting
- Large pupils (the dark centre of the eye)
- Fast heart beat • Slow heart beat
- Nettle rash (hives) • Loss of hair
- Rash • Sensitivity to sunlight
- Difficulties urinating • Swelling of the arms or legs
- Heavy menstrual bleeding (menorrhagia)
Rare (may affect up to 1 in 1000 people)
- Increased sex drive • Convulsions
- Involuntary movements • Taste disturbances
- Bleeding • Coughing
- Hepatitis • Feeling unwell (malaise) Some patients have reported (frequency not known)
- Increase in a hormone called prolactin in the blood
Thoughts of harming or killing themselves, see also section 2
“What you need to know before you take Citalopram Tablets”
- An increase in bleeding or bruising caused by a decrease in blood platelets (thrombocytopenia)
- Rash (hypersensitivity) • Abnormal heart rhythm
- Low potassium levels in the blood (hypokalaemia), which can cause muscle weakness, twitching or abnormal heart rhythms
- Panic attack • Grinding teeth
- Restlessness • In men, painful erections
- Unusual muscle movements or stiffness
- Involuntary movements of the muscles (akathisia)
- Low blood pressure • Nosebleed
- Bleeding disorders including skin and mucosal bleeding (ecchymosis)
- Sudden swelling of skin or mucosa
- Flow of breast milk in men or in women who are not breast-feeding (galactorrhoea)
- Abnormal liver function tests
- Irregular menstrual periods (metrorrhagia)
- An increased risk of bone fractures has been observed in patients taking this type of medicines
- Heavy vaginal bleeding shortly after birth (postpartum haemorrhage), see ‘Pregnancy breast-feeding and fertility’ in section 2 for more information
SSRIs can, very rarely, increase the risk of bleeding, including stomach or intestinal bleeding. Let your doctor know if you vomit blood or develop black or blood stained stools.
Also let your doctor know if you continue to have other symptoms associated with your depression. This might include hallucinations, anxiety, mania or confusion.
Any side effects that do occur will usually disappear after a few days. If they are troublesome or persistent, or if you develop any other unusual side effects while taking Citalopram Tablets, please tell your doctor.
Reporting of side effects
If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme at: http://www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store. By reporting side affects you can help provide more information on the safety of this medicine.
- 5. How to store Citalopram Tablets
Keep this medicine out of the sight and reach of children. Store in the original package.
Do not use this medicine after the expiry date which is stated on the carton after “EXP”. The expiry date refers to the last day of that month.
Do not use Citalopram if you notice the visible signs of deterioration.
Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.
- 6. Contents of the pack and other information What Citalopram Tablets contain
Each tablet contains 10 mg, 20 mg or 40 mg of citalopram (as citalopram hydrobromide). The other ingredients are maize starch, lactose monohydrate, croscarmellose sodium, glycerol, copovidone, magnesium stearate, microcrystalline cellulose, hypromellose, macrogol 400 and titanium dioxide (E 171). What Citalopram Tablets look like and contents of the pack Citalopram 10 mg Tablets
Citalopram 10 mg Tablets are round, biconvex, white-coloured, film-coated tablet embossed '10' on one side.
Citalopram 20 mg Tablets
Citalopram 20 mg Tablets are oval, biconvex, scored, white-coloured, film-coated tablet embossed '20' on one side. Citalopram 40 mg Tablets
Citalopram 40 mg Tablets are oval, biconvex, scored, white-coloured, film-coated tablet embossed '40' on one side. Citalopram Tablets are available in a blister pack of 28 tablets.
This leaflet was last revised in October 2026.
To listen to or request a copy of this leaflet in Braille, large print or audio please call, 020 33998960 (UK only)
Please be ready to give the following information:
Product name Reference number Citalopram 10mg Tablets PL 44041/0008 Citalopram 20mg Tablets PL 44041/0009 Citalopram 40mg Tablets PL 44041/0010 Marketing Authorisation Holder and Manufacturer:
NOUMED LIFE SCIENCES LIMITED
Noumed House, Shoppenhangers Road
Maidenhead, Berkshire, SL6 2RB, United Kingdom.
Warning – Thoughts of self- harm and suicidal behaviour – see section 2
L0008-00/02 | L0009-00/02 | L0010-00/02 Breast-feeding
Ask your doctor or pharmacist for advice before taking any medicine.
If you are breast-feeding, ask your doctor for advice. You should not breast-feed your baby when taking Citalopram Tablets because small amounts of the medicine can pass into the breast milk. 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 does not usually affect the ability to carry out normal daily activities. However, if you feel dizzy or sleepy when you start to take this medicine, you should be careful when driving, operating machinery or performing jobs that need you to be alert until these effects wear off.
Citalopram contains Sodium
This medicine contains less than 1 mmol sodium (23 mg) per tablet, that is to say essentially ‘sodium-free’.
Citalopram contains Lactose monohydrate.
Citalopram tablets contain lactose monohydrate. If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking these tablets.
3. How to take Citalopram Tablets How much to take
Always take this medicine exactly as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are not sure.
The recommended dose is:
Adults
Depression: The usual dose is 20 mg per day. This may be increased by your doctor to a maximum of 40 mg per day. Panic Disorder: The starting dose is 10 mg per day for the first week before increasing the dose to 20-30 mg per day. The dose may be increased by doctor to a maximum of 40 mg per day. Elderly patients (above 65 years of age)
The starting dose should be decreased to half of the recommended dose, e.g. 10-20 mg per day. Elderly patients should not usually receive more than 20 mg per day.
Children and adolescents (less than 18 years of age)
Citalopram should not be given to children or adolescents. For further information, please see section 2, What you need to know before you take Citalopram Tablets
Patients with special risks
Patients with liver complaints should not receive more than 20 mg per day.
How and when to take Citalopram Tablets
Citalopram Tablets is taken every day as a single daily dose. Citalopram Tablets can be taken any time of the day with or without food. Swallow the tablets with a drink of water. Do not chew them (they have a bitter taste).
Duration of treatment
Like other medicines for depression and panic disorder these tablets may take a few weeks before you feel any improvement. Continue to take Citalopram Tablets even if it takes some time before you feel any improvement in your condition. The duration of treatment is individual, usually at least 6 months. Continue to take the tablets for as long as your doctor recommends. Do not stop taking them even if you begin to feel better, unless you are told to do so by your doctor. The underlying illness may persist for a long time and if you stop your treatment too soon your symptoms may return.
Patients who have recurrent depression benefit from continued treatment, sometimes for several years, to prevent the occurrence of new depressive episodes.
Never change the dose of the medicine without talking to your doctor first.
If you take more Citalopram Tablets than you should
If you think that you or anyone else may have taken too many citalopram tablets, contact your doctor or hospital emergency department immediately. Do this even if there are no signs of discomfort or poisoning. Take the citalopram box/ container with you if you go to a doctor or hospital. Some of the signs of an overdosage could be life-threatening.
Symptoms of overdosage may include:
- Irregular heart beat • Seizures
- Changes in heart rhythm • Feeling sick (nausea)
- Vomiting • Sweating
- Drowsiness • Unconsciousness
- Fast heart beats • Tremor
- Changes in blood pressure • Breathing too quickly
- Serotonin syndrome (see Section 4)
- Agitation • Dizziness
- Enlarged eye pupils • Bluish skin
If you forget to take Citalopram Tablets
If you forget to take a dose, take the next dose at the usual time. Do not take a double dose.
If you stop taking Citalopram Tablets
Stopping this medicine quickly may cause symptoms such as dizziness, nausea and numbness or tingling in hands or feet, sleep disturbances (vivid dreams, nightmares, inability to sleep), feeling anxious, headaches, feeling or being sick, sweating, feeling restless or agitated, tremor, feeling confused or disorientated, feeling emotional or irritable, diarrhoea (loose stools), visual disturbances, fluttering or pounding heartbeat (palpitations). These are usually non- serious and disappear within a few days. When you have completed your course of treatment, the dose of Citalopram Tablets is usually reduced gradually over a couple of weeks.
If you have any further questions on the use of this medicine, ask your doctor or pharmacist.
4. Possible side effects
Like all medicines, this medicine can cause side effects, although not everybody gets them.
Several of the effects listed below can also be symptoms of your illness and may disappear as you start to get better. Serious side effects
Stop taking Citalopram Tablets and seek medical advice immediately if you have any of the following symptoms:
- Difficulty in breathing.
- Swelling of the face, lips, tongue or throat that causes difficulty in swallowing or breathing.
- Severe itching of the skin (with raised lumps).
- Fast, irregular heartbeat, fainting which could be symptoms of a life-threatening condition known as torsades de pointes. If you notice any of the following symptoms you should contact your doctor immediately as your dose may need to be reduced or stopped:
- You start having fits for the first time or fits that you have suffered from in the past become more frequent.
- Your behaviour changes because you feel elated or over excited.
- You experience high fever, agitation, confusion, trembling or abrupt contractions of muscles. These may be signs of a rare condition called serotonin syndrome.
Tiredness, confusion and twitching of your muscles. These may be signs of a low blood level of sodium.
If you have thoughts of harming or killing yourself at any time, contact your doctor or go to a hospital straight away.
The following side effects are often mild and usually disappear after a few days’ treatment.
away, if after starting this medicine, you have new or worse:
- Feelings of anxiety or irritability
- Feelings of restlessness and agitation
- Extreme increases in activity and difficulty sleeping
- Thoughts of acting on dangerous impulses to harm yourself
- Thoughts about suicide or dying
- Changes in behaviour or mood you, or someone you trust, notices and is worried about
In some people, thoughts of self-harm and suicidal behaviour may be increased when first starting antidepressants. Antidepressants take time to work; and sometimes side effects occur before you or others notice improvements in your mood.
Never stop taking an antidepressant suddenly without first talking to a healthcare professional. Stopping an antidepressant medicine suddenly can cause other symptoms related to withdrawal to occur.
Information from clinical trials has shown the highest risk of thoughts of self-harm and suicidal behaviour, is in adults aged less than 25 years who were treated with an antidepressant, but the risk applies to people of all ages treated with these medicines. Call NHS 111 who can offer you support, until you can be with someone who can help you in person.
Use in children and adolescents under 18 years of age
Citalopram Tablets should normally not be used for children and adolescents under 18 years. Also, you should know that patients under 18 have an increased risk of side-effects such as suicide attempt, suicidal thoughts and hostility (predominantly aggression, oppositional behaviour and anger) when they take this class of medicines.
Despite this, your doctor may prescribe citalopram for patients under 18 because he/she decides that this is in their best interests. If your doctor has prescribed Citalopram Tablets 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 Tablets. Also, the long-term safety effects concerning growth, maturation and cognitive and behavioural development of Citalopram Tablets in this age group have not yet been demonstrated.
Other medicines and Citalopram
Medicines may affect the action of other medicines and this can sometimes cause serious adverse reactions. Please tell your doctor or pharmacist if you are taking, have taken or might take any other medicines.
This includes other medicines for depression (see Do not take Citalopram Tablets above).
The herbal remedy St John’s wort (Hypericum perforatum).
This should not be taken at the same time as Citalopram Tablets.
Monoamine oxidase inhibitors (MAOIs). These should not be
taken at the same time as Citalopram Tablets (see Do not take Citalopram Tablets above).
Tell your doctor if you are taking any of the following medicines:
- Linezolid (an antibiotic).
Sumatriptan (used to treat migraine) or tramadol and
buprenorphine and similar medicines (strong pain killers). Taking these medicines together with Citalopram can lead to serotonin syndrome, a potentially life-threatening condition. The syndrome may be associated with symptoms such as involuntary, rhythmic contractions of muscles, including the muscles that control movement of the eye, agitation, hallucinations, coma, excessive sweating, tremor, exaggeration of reflexes, increased muscle tension, body temperature above 38°C. Contact your doctor when experiencing such symptoms.
Lithium (used to prevent and treat mania) and tryptophan (an
anti-depressant)
Pimozide (a neuroleptic). This should not be taken at the same
time as Citalopram Tablets (see Do not take Citalopram Tablets above).
- Imipramine and desipramine (used to treat depression).
Medicines containing selegiline (used to treat Parkinson’s
disease)
Cimetidine, lansoprazole and omeprazole (used to treat
stomach ulcers), fluconazole (used to treat fungal infections), fluvoxamine (antidepressant) and ticlopidine (used to reduce the risk of stroke). These may cause increased blood levels of citalopram.
- Mefloquine (used to treat malaria).
- Bupropion (used to treat depression).
Medicines known to affect the blood platelets (e.g.
anticoagulant drugs used to treat or prevent blood clots; aspirin and non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and diclofenac used as painkillers and some antipsychotic drugs and tricyclic antidepressants).
Metoprolol, a beta blocker used to treat migraine, some heart
conditions and high blood pressure. The effects of either drug could be increased, decreased or altered.
- Neuroleptics (used in the treatment of schizophrenia). Do not take Citalopram if you take medicines for heart rhythm problems or medicines that may affect heart's rhythm, e.g. such as class IA and III antiarrhythmics, antipsychotics (e.g. phenothiazine derivatives, pimozide, haloperidol), tricyclic antidepressants, certain antimicrobial agents (e.g. sparfloxacin, moxifloxacin, erythromycin IV, pentamidine, anti-malarial treatment particularly halofantrine), certain antihistamines (astemizole, mizolastine). If you have any further questions about this you should speak to your doctor.
Taking Citalopram Tablets with food and drink
Citalopram can be taken with or without food (see section 3 “How to take Citalopram Tablets”).
As with all antidepressants, it is sensible to avoid drinking alcohol whilst receiving treatment although Citalopram has not been shown to increase the effects of alcohol.
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 or pharmacist for advice before taking this medicine.
Pregnancy
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.
Ask your doctor or pharmacist for advice before taking any medicine. If you are pregnant, think you might be pregnant, or are trying to become pregnant, tell your doctor. Do not take Citalopram Tablets if you are pregnant unless you and your doctor have discussed the risks and benefits involved.
Make sure your midwife and/or doctor know you are on Citalopram Tablets. When taken during pregnancy, particularly in the last 3 months of pregnancy, medicines like Citalopram Tablets 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. Also, if you take Citalopram Tablets during the last 3 months of your pregnancy and until the date of birth you should be aware that the following effects may be seen in your newborn: fits, being too hot or cold, feeding difficulties, vomiting, low blood sugar, stiff or floppy muscles, overactive reflexes, tremor, jitteriness, irritability, lethargy, constant crying, sleepiness or sleeping difficulties. If your newborn baby gets any of these symptoms please contact your midwife and/or doctor immediately.
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 does not usually affect the ability to carry out normal daily activities. However, if you feel dizzy or sleepy when you start to take this medicine, you should be careful when driving, operating machinery or performing jobs that need you to be alert until these effects wear off.
Citalopram contains Sodium
This medicine contains less than 1 mmol sodium (23 mg) per tablet, that is to say essentially ‘sodium-free’.
Citalopram contains Lactose monohydrate
Citalopram tablets contain lactose monohydrate. If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking these tablets.
- 3. How to take Citalopram Tablets How much to take
Always take this medicine exactly as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are not sure.
The recommended dose is:
Adults
Depression: The usual dose is 20 mg per day. This may be increased by your doctor to a maximum of 40 mg per day. Panic Disorder: The starting dose is 10 mg per day for the first week before increasing the dose to 20-30 mg per day. The dose may be increased by doctor to a maximum of 40 mg per day. Elderly patients (above 65 years of age)
The starting dose should be decreased to half of the recommended dose, e.g. 10-20 mg per day. Elderly patients should not usually receive more than 20 mg per day.
Children and adolescents (less than 18 years of age)
Citalopram should not be given to children or adolescents. For further information, please see section 2, What you need to know before you take Citalopram Tablets
Patients with special risks
Patients with liver complaints should not receive more than 20 mg per day.
How and when to take Citalopram Tablets
Citalopram Tablets is taken every day as a single daily dose. Citalopram Tablets can be taken any time of the day with or without food. Swallow the tablets with a drink of water. Do not chew them (they have a bitter taste).
Duration of treatment
Like other medicines for depression and panic disorder these tablets may take a few weeks before you feel any improvement. Continue to take Citalopram Tablets even if it takes some time before you feel any improvement in your condition. The duration of treatment is individual, usually at least 6 months. Continue to take the tablets for as long as your doctor recommends. Do not stop taking them even if you begin to feel better, unless you are told to do so by your doctor. The underlying illness may persist for a long time and if you stop your treatment too soon your symptoms may return.
Patients who have recurrent depression benefit from continued treatment, sometimes for several years, to prevent the occurrence of new depressive episodes.
Never change the dose of the medicine without talking to your doctor first.
If you take more Citalopram Tablets than you should
If you think that you or anyone else may have taken too many citalopram tablets, contact your doctor or hospital emergency department immediately. Do this even if there are no signs of discomfort or poisoning. Take the citalopram box/ container with you if you go to a doctor or hospital. Some of the signs of an overdosage could be life-threatening.
Symptoms of overdosage may include:
- Irregular heart beat • Seizures
- Changes in heart rhythm • Feeling sick (nausea)
- Vomiting • Sweating
- Drowsiness • Unconsciousness
- Fast heart beats • Tremor
- Changes in blood pressure
- Serotonin syndrome (see Section 4)
- Agitation • Dizziness
- Enlarged eye pupils • Bluish skin
- Breathing too quickly
If you forget to take Citalopram Tablets
If you forget to take a dose, take the next dose at the usual time. Do not take a double dose.
If you stop taking Citalopram Tablets
Stopping this medicine quickly may cause symptoms such as dizziness, nausea and numbness or tingling in hands or feet, sleep disturbances (vivid dreams, nightmares, inability to sleep), feeling anxious, headaches, feeling or being sick, sweating, feeling restless or agitated, tremor, feeling confused or disorientated, feeling emotional or irritable, diarrhoea (loose stools), visual disturbances, fluttering or pounding heartbeat (palpitations). These are usually non- serious and disappear within a few days. When you have completed your course of treatment, the dose of Citalopram Tablets is usually reduced gradually over a couple of weeks.
If you have any further questions on the use of this medicine, ask your doctor or pharmacist.
- 4. Possible side effects
Like all medicines, this medicine can cause side effects, although not everybody gets them.
Several of the effects listed below can also be symptoms of your illness and may disappear as you start to get better. Serious side effects
Stop taking Citalopram Tablets and seek medical advice immediately if you have any of the following symptoms:
- Difficulty in breathing.
Swelling of the face, lips, tongue or throat that causes
difficulty in swallowing or breathing.
- Severe itching of the skin (with raised lumps).
Fast, irregular heartbeat, fainting which could be symptoms of
a life-threatening condition known as torsades de pointes. If you notice any of the following symptoms you should contact your doctor immediately as your dose may need to be reduced or stopped:
You start having fits for the first time or fits that you have
suffered from in the past become more frequent.
Your behaviour changes because you feel elated or over
excited.
You experience high fever, agitation, confusion, trembling or
abrupt contractions of muscles. These may be signs of a rare condition called serotonin syndrome.
Tiredness, confusion and twitching of your muscles. These
may be signs of a low blood level of sodium.
If you have thoughts of harming or killing yourself at any time, contact your doctor or go to a hospital straight away.
The following side effects are often mild and usually disappear after a few days’ treatment.
Very common side effects (may affect more than 1 in 10 people)
- Sleepiness • Difficulty in sleeping
- Headache • Changes in your sleeping pattern
- Loss of body strength, weakness
- Increased sweating
Dry mouth (a dry mouth increases the risk of tooth decay, so be
sure to clean your teeth more often than usual)
- Feeling sick (nausea)
Common side effects (may affect up to 1 in 10 people)
- Lack of appetite • Agitation
- • • • • •
I
Feelings of anxiety or irritability
Feelings of restlessness and agitation
Extreme increases in activity and difficulty sleeping Thoughts of acting on dangerous impulses to harm yourself Thoughts about suicide or dying
Changes in behaviour or mood you, or someone you trust, notices and is worried about
n some people, thoughts of self-harm and suicidal behaviour may
b
e increased when first starting antidepressants. Antidepressants
t
ake time to work; and sometimes side effects occur before you or
o
thers notice improvements in your mood.
Never stop taking an antidepressant suddenly without first talking
t
o a healthcare professional. Stopping an antidepressant medicine
s
uddenly can cause other symptoms related to withdrawal to
o I
ccur.
nformation from clinical trials has shown the highest risk of
t
houghts of self-harm and suicidal behaviour, is in adults aged less
t
han 25 years who were treated with an antidepressant, but the risk
a
pplies to people of all ages treated with these medicines. Call NHS 111 who can offer you support, until you can be with
s
omeone who can help you in person.
Use in children and adolescents under 18 years of age
Citalopram Tablets should normally not be used for children and
a
dolescents under 18 years. Also, you should know that patients
u
nder 18 have an increased risk of side-effects such as suicide
a
ttempt, suicidal thoughts and hostility (predominantly
a
ggression, oppositional behaviour and anger) when they take this
c
lass of medicines.
Despite this, your doctor may prescribe citalopram for patients
u
nder 18 because he/she decides that this is in their best interests.
I
f your doctor has prescribed Citalopram Tablets for a patient
u
nder 18 and you want to discuss this, please go back to your
d
octor. You should inform your doctor if any of the symptoms
l
isted above develop or worsen when patients under 18 are taking
Citalopram Tablets. Also, the long-term safety effects concerning
g
rowth, maturation and cognitive and behavioural development of
Citalopram Tablets in this age group have not yet been
d
emonstrated.
Other medicines and Citalopram
Medicines may affect the action of other medicines and this can
s
ometimes cause serious adverse reactions. Please tell your doctor
o
r pharmacist if you are taking, have taken or might take any other
medicines.
This includes other medicines for depression (see Do not take
Citalopram Tablets above).
The herbal remedy St John’s wort (Hypericum perforatum).
•
This should not be taken at the same time as Citalopram
Tablets.
Monoamine oxidase inhibitors (MAOIs). These should not be
•
taken at the same time as Citalopram Tablets (see Do not take
Citalopram Tablets above).
Tell your doctor if you are taking any of the following medicines: Linezolid (an antibiotic).
Sumatriptan (used to treat migraine) or tramadol and
•
buprenorphine and similar medicines (strong pain killers).
Taking these medicines together with Citalopram can lead to
serotonin syndrome, a potentially life-threatening condition.
The syndrome may be associated with symptoms such as
involuntary, rhythmic contractions of muscles, including the
muscles that control movement of the eye, agitation,
hallucinations, coma, excessive sweating, tremor,
exaggeration of reflexes, increased muscle tension, body
temperature above 38°C. Contact your doctor when
experiencing such symptoms.
Lithium (used to prevent and treat mania) and tryptophan (an
•
anti-depressant)
Pimozide (a neuroleptic). This should not be taken at the same
•
time as Citalopram Tablets (see Do not take Citalopram
Tablets above).
Imipramine and desipramine (used to treat depression). Medicines containing selegiline (used to treat Parkinson’s
•
disease)
Cimetidine, lansoprazole and omeprazole (used to treat
•
stomach ulcers), fluconazole (used to treat fungal infections),
fluvoxamine (antidepressant) and ticlopidine (used to reduce
the risk of stroke). These may cause increased blood levels of
citalopram.
Mefloquine (used to treat malaria).
Bupropion (used to treat depression).
Medicines known to affect the blood platelets (e.g.
• •
anticoagulant drugs used to treat or prevent blood clots;
aspirin and non-steroidal anti-inflammatory drugs (NSAIDs)
such as ibuprofen and diclofenac used as painkillers and some
antipsychotic drugs and tricyclic antidepressants). Metoprolol, a beta blocker used to treat migraine, some heart
•
conditions and high blood pressure. The effects of either drug
could be increased, decreased or altered.
Neuroleptics (used in the treatment of schizophrenia). Do not take Citalopram if you take medicines for heart rhythm
•
p
roblems or medicines that may affect heart's rhythm, e.g. such as
c
lass IA and III antiarrhythmics, antipsychotics (e.g.
p
henothiazine derivatives, pimozide, haloperidol), tricyclic
a
ntidepressants, certain antimicrobial agents (e.g. sparfloxacin,
moxifloxacin, erythromycin IV, pentamidine, anti-malarial
t
reatment particularly halofantrine), certain antihistamines
(
astemizole, mizolastine). If you have any further questions about
t
his you should speak to your doctor.
Taking Citalopram Tablets with food and drink
Citalopram can be taken with or without food (see section 3 “How
t
o take Citalopram Tablets”).
As with all antidepressants, it is sensible to avoid drinking alcohol
whilst receiving treatment although Citalopram has not been
s
I
hown to increase the effects of alcohol.
Pregnancy, breast-feeding and fertility
f you are pregnant or breast-feeding, think you may be pregnant
o
r are planning to have a baby, ask your doctor or pharmacist for
a P I
dvice before taking this medicine.
regnancy
f you take Citalopram near the end of your pregnancy there may
b
e an increased risk of heavy vaginal bleeding shortly after birth,
e
specially if you have a history of bleeding disorders. Your doctor
o
r midwife should be aware that you are taking Citalopram so
t
hey can advise you.
Ask your doctor or pharmacist for advice before taking any
medicine. If you are pregnant, think you might be pregnant, or are
t
rying to become pregnant, tell your doctor. Do not take
Citalopram Tablets if you are pregnant unless you and your doctor
h
ave discussed the risks and benefits involved.
Make sure your midwife and/or doctor know you are on
Citalopram Tablets. When taken during pregnancy, particularly in
t
he last 3 months of pregnancy, medicines like Citalopram Tablets
may increase the risk of a serious condition in babies, called
p
ersistent pulmonary hypertension of the newborn (PPHN),
making the baby breathe faster and appear bluish. These
s
ymptoms usually begin during the first 24 hours after the baby is
b
orn. If this happens to your baby you should contact your
midwife and/or doctor immediately. Also, if you take Citalopram
Tablets during the last 3 months of your pregnancy and until the
d
ate of birth you should be aware that the following effects may
b
e seen in your newborn: fits, being too hot or cold, feeding
d
ifficulties, vomiting, low blood sugar, stiff or floppy muscles,
o
veractive reflexes, tremor, jitteriness, irritability, lethargy,
c
onstant crying, sleepiness or sleeping difficulties. If your
n
ewborn baby gets any of these symptoms please contact your
midwife and/or doctor immediately.
Breast-feeding
Ask your doctor or pharmacist for advice before taking any
medicine.
f you are breast-feeding, ask your doctor for advice. You should
I
n
ot breast-feed your baby when taking Citalopram Tablets
b
ecause small amounts of the medicine can pass into the breast
milk.
PACKAGE LEAFLET:
INFORMATION FOR THE USER
Citalopram 10 mg, 20 mg
& 40 mg Tablets
(citalopram hydrobromide)
Read all of this leaflet carefully before you start taking th medicine because it contains important information for you.
- Keep this leaflet. You may need to read it again.
If you have any further questions, ask your doctor
pharmacist.
This medicine has been prescribed for you only. Do not pass
on to others. It may harm them, even if their signs of illness a the same as yours.
If you get any side effects, talk to your doctor or pharmacis
This includes any side effects not listed in this leaflet. Se section 4.
What is in this leaflet
- 1. What Citalopram Tablets are and what they are used for
- 2. What you need to know before you take Citalopram Tablets
- 3. How to take Citalopram Tablets
- 4. Possible side effects
- 5. How to store Citalopram Tablets
- 6. Contents of the pack and other information
- 1.
What Citalopram Tablets are and what they are used
is
or
it re
t. e
for
How does Citalopram Tablets work?
Citalopram is a Selective Serotonin Reuptake Inhibitor (SSR and belongs to a group of medicines known as antidepressants. As with many other kinds of medications and treatments, we don know for certain how antidepressants work. We do know that the affect the activity of certain chemicals in our brains. These a called neurotransmitters, and pass signals from one brain cell another. The neurotransmitters most affected by antidepressan are serotonin and noradrenaline. However, research suggests th antidepressants work on the brain in multiple ways that go beyon simple chemical reactions. This research suggests that they:
- influence how the body responds to stress
- improve our negative thinking
- stop or even reverse damage to brain cells
What is Citalopram Tablets used for?
Citalopram Tablets contains citalopram and is used for th
I)
't y re to ts at d
e
t
reatment of depression and, when you feel better, to help preve
nt
t
hese symptoms recurring. Citalopram is also used for long-ter
m
t
reatment to prevent the occurrence of new episodes of depressio
n
i
f you have recurrent depression.
Citalopram is also beneficial in relieving symptoms if you tend suffer from panic attacks.
- 2. What you need to know before you take Citalopra Tablets
Do not take Citalopram Tablets
if you are allergic to citalopram hydrobromide or to any of th
other ingredients of this medicine (listed in section 6). Consu your doctor if you think you might be.
at the same time as taking medication known as monoamin
oxidase inhibitors (MAOIs). MAOIs include medicines suc as phenelzine, iproniazid, isocarboxazid, nialamid tranylcypromine and moclobemide (used for the treatment depression), selegiline (used in the treatment of Parkinson disease) and linezolid (an antibiotic). Even if you hav finished taking one of the following MAOIs: phenelzin iproniazid, isocarboxazid, nialamide or tranylcypromine yo will need to wait 2 weeks before you start taking yo Citalopram tablets. One day must elapse after you hav finished taking moclobemide. After stopping Citalopra tablets you must allow 1 week before taking any MAOI.
if you are born with or have had an episode of abnormal hea
rhythm (seen at ECG; an examination to evaluate how th heart is functioning).
if you take medicines for heart rhythm problems or that ma
effect the heart's rhythm. (see section "Other medicines an Citalopram" below).
if you are taking buprenorphine-containing medicin
products. The use of these medicines together with Citalopra can lead to serotonin syndrome, a potentially life threatenin condition (see “Other medicines and citalopram”). Warnings and precautions
Talk to your doctor or pharmacist before taking Citalopram table
to
m
e lt
e h e, of ’s e e, u ur e m
rt e
y d
al m g
ts
i
f you have any medical problems, especially if you have
- Liver or kidney disease.
Diabetes (you may need an adjustment of your antidiabet
therapy).
- Epilepsy or a history of seizures or fits.
History of bleeding disorder or have ever suffered fro
bleeding in the stomach or intestine, or if you are pregnant (se ‘Pregnancy, breast-feeding and fertility’).
- Mania or panic disorder
- Low blood levels of sodium
- ECT (electroconvulsive therapy)
Or have previously had eye problems, such as certain kinds
glaucoma (increased pressure in the eye).
Suffered or suffer from heart problems or have recently had
heart attack.
A low resting heart-rate and/or you know that you may hav
salt depletion as a result of prolonged severe diarrhoea an vomiting (being sick) or usage of diuretics (water tablets)
Experienced a fast or irregular heartbeat, fainting, collapse
dizziness on standing up which may indicate abnorm functioning of the heart rate
Please consult your doctor, even if these statements we applicable to you at any time in the past.
Please note:
Some patients with manic-depressive illness may enter into manic phase. This is characterized by unusual and rapid changing ideas, inappropriate happiness and excessive physic activity. If you experience this, contact your doctor. Symptoms such as restlessness or difficulty in sitting or standin still can also occur during the first weeks of the treatment. Te your doctor immediately if you experience these symptoms. Medicines like Citalopram tablets may cause symptoms of sexu dysfunction (see section 4). Rarely people can experience mo persistent sexual side-effects after they have stopped takin SSRIs. The term ‘post SSRI sexual dysfunction’ (PSSD) has bee used by some people to describe these symptoms. For the people, PSSD can have a significant and distressing impact o
ic
m e
of
a
e d
or al
re
a ly al
g ll
al re g n se n
t
heir lives. Research is needed to understand why this happe and how common it is. It is important that people experiencin ongoing sexual side-effects receive appropriate and time support.
Special information relating to your disease
As with other medicines used to treat depression or relate diseases, the improvement is not achieved immediately. After th start of Citalopram treatment it may take several weeks before yo experience any improvement. In the beginning of the treatme certain patients may experience increased anxiety, which wi disappear during continued treatment. Therefore, it is ver
ns g ly
d e u nt ll y
i
mportant that you follow exactly your doctor’s orders and do n stop the treatment or change the dose without consulting yo doctor.
Thoughts of self- harm and suicidal behaviour
This medicine may be associated with thoughts of self-harm an suicidal behaviour in some people.
Tell someone you trust, who can help you in an emergency, th you are taking this medicine and ask that they read this leaflet. Talk to your trusted person, prescriber or go to a hospital straig away, if after starting this medicine, you have new or worse:
ot ur
d
at
ht
- Decreased sex drive • Anxiety
- Nervousness • Confusion
- Abnormal dreams • Tremor
- Reduced emotions, indifference (apathy)
- Tingling or numbness in the hands or feet
- Dizziness • Problems concentrating
- Migraine • Loss of memory (amnesia)
- Ringing in the ears (tinnitus)
- Palpitations • Yawning
- Blocked or runny nose (rhinitis)
- Diarrhoea • Vomiting
- Constipation • Stomach pain
- Flatulence (wind) • Increase in saliva (drooling)
- Itching • Pain in muscles and joints
- For men, problems with ejaculation and erection
- For women, failing to reach an orgasm
- Tiredness • Prickling of the skin
- Loss of weight
Uncommon (may affect up to 1 in 100 people)
- Bruising easily • Increased appetite
- Aggression • Hallucinations
- Mania • Fainting
- Large pupils (the dark centre of the eye)
- Fast heart beat • Slow heart beat
- Nettle rash (hives) • Loss of hair
- Rash • Sensitivity to sunlight
- Difficulties urinating
- Heavy menstrual bleeding (menorrhagia)
- Swelling of the arms or legs
- Increased weight
Rare (may affect up to 1 in 1000 people)
- Increased sex drive • Convulsions
- Involuntary movements • Taste disturbances
- Bleeding • Coughing
- Hepatitis • Feeling unwell (malaise) Some patients have reported (frequency not known)
- Increase in a hormone called prolactin in the blood
Thoughts of harming or killing themselves, see also section 2
“What you need to know before you take Citalopram Tablets”
- An increase in bleeding or bruising caused by a decrease in blood platelets (thrombocytopenia)
- Rash (hypersensitivity)
- Low potassium levels in the blood (hypokalaemia), which can cause muscle weakness, twitching or abnormal heart rhythms
- Panic attack • Grinding teeth
- Restlessness
- Unusual muscle movements or stiffness
- Involuntary movements of the muscles (akathisia)
- Low blood pressure • Nosebleed
Bleeding disorders including skin and mucosal bleeding
(ecchymosis)
- Sudden swelling of skin or mucosa
- In men, painful erections
- Flow of breast milk in men or in women who are not breast-feeding (galactorrhoea)
- Abnormal liver function tests
- Irregular menstrual periods (metrorrhagia)
- An increased risk of bone fractures has been observed in patients taking this type of medicines
- Abnormal heart rhythm
- Heavy vaginal bleeding shortly after birth (postpartum haemorrhage), see ‘Pregnancy breast-feeding and fertility’ in section 2 for more information
SSRIs can, very rarely, increase the risk of bleeding, including stomach or intestinal bleeding. Let your doctor know if you vomit blood or develop black or blood stained stools.
Also let your doctor know if you continue to have other symptoms associated with your depression. This might include hallucinations, anxiety, mania or confusion.
Any side effects that do occur will usually disappear after a few days. If they are troublesome or persistent, or if you develop any other unusual side effects while taking Citalopram Tablets, please tell your doctor.
Reporting of side effects
If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme at: http://www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store. By reporting side affects you can help provide more information on the safety of this medicine.
5. How to store Citalopram Tablets
Keep this medicine out of the sight and reach of children. Store in the original package.
Do not use this medicine after the expiry date which is stated on the carton after “EXP”. The expiry date refers to the last day of that month.
Do not use Citalopram if you notice the visible signs of deterioration.
Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.
6. Contents of the pack and other information What Citalopram Tablets contain
Each tablet contains 10 mg, 20 mg or 40 mg of citalopram (as citalopram hydrobromide). The other ingredients are maize starch, lactose monohydrate, croscarmellose sodium, glycerol, copovidone, magnesium stearate, microcrystalline cellulose, hypromellose, macrogol 400 and titanium dioxide (E 171). What Citalopram Tablets look like and contents of the pack
Citalopram 10 mg Tablets
Citalopram 10 mg Tablets are round, biconvex, white-coloured, film-coated tablet embossed '10' on one side.
Citalopram 20 mg Tablets
Citalopram 20 mg Tablets are oval, biconvex, scored, white-coloured, film-coated tablet embossed '20' on one side. Citalopram 40 mg Tablets
Citalopram 40 mg Tablets are oval, biconvex, scored, white-coloured, film-coated tablet embossed '40' on one side. Citalopram Tablets are available in a blister pack of 28 tablets. This leaflet was last revised in October 2026.
To listen to or request a copy of this leaflet in Braille, large print or audio please call, 020 33998960 (UK only)
Please be ready to give the following information:
Product name Reference number Citalopram 10mg Tablets PL 44041/0008 Citalopram 20mg Tablets PL 44041/0009 Citalopram 40mg Tablets PL 44041/0010 Marketing Authorisation Holder and Manufacturer:
NOUMED LIFE SCIENCES LIMITED
Noumed House, Shoppenhangers Road
Maidenhead, Berkshire, SL6 2RB, United Kingdom.
L0008-01/02 | L0009-01/02 | L0010-01/02
Warning – Thoughts of self- harm and suicidal behaviour–see section 2