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Patients who are hypersensitive to citalopram hydrobromide or to any ingredient in the formulation or component of the container. For a complete listing, see Description.
Monoamine Oxidase Inhibitors: Cases of serious reactions have been reported in patients receiving selective serotonin reuptake inhibitors (SSRIs) in combination with a monoamine oxidase inhibitor (MAOI) or the reversible MAOI (RIMA), moclobemide, and in patients who have recently discontinued an SSRI and have been started on a MAOI (see Interactions). With the co-administration of an SSRI with MAOI, there have been reports of serious, sometimes fatal reactions including hyperthermia, rigidity, myoclonus, autonomic instability with possible fluctuations of vital signs, and mental status changes, including extreme agitation progressing to delirium and coma. Some cases presented with features resembling serotonin syndrome.
Therefore, citalopram should not be used in combination with a MAOI or within 14 days of discontinuing treatment with a MAOI, (including linezolid, an antibiotic which is a reversible non-selective MAO inhibitor and methylene blue, which is a MAOI). Similarly, at least 14 days should elapse after discontinuing citalopram treatment before starting a MAOI.
Pimozide: Citalopram should not be used in combination with the antipsychotic drug pimozide, as results from a controlled study indicate that concomitant use is associated with an increased risk of QTc prolongation compared to pimozide alone. This apparent pharmacodynamic interaction occurred in the absence of a clinically significant pharmacokinetic interaction; the mechanism is unknown (see Interactions).
QT Prolongation: pms-CITALOPRAM (citalopram hydrobromide) is contraindicated in patients with known QT interval prolongation or with congenital long QT syndrome. (See Dosage & Administration; Overdosage; Cardiovascular: QT Prolongation and Torsades de Pointes under Precautions; Post-Market Adverse Drug Reactions under Adverse Reactions; Interactions.)
