How Effective Is Citalopram for Insomnia?

Citalopram hydrobromide tablets, the indication is depressive mental disorder (endogenous and non-endogenous depression).

Citalopram hydrobromide tablets, the indication is depressive mental disorder (endogenous and non-endogenous depression).

Drug Name

Citalopram hydrobromide tablets

Drug type

Prescription drugs, medicines for medical workers' injuries

Use classification

Selective serotonin reuptake inhibitors

Caution for Citalopram Hydrobromide Tablets

Results of short-term clinical trials of suicidal tendency and antidepressants for depression (MDD) and other mental disorders show that antidepressants increase suicide perceptions and commit suicide in children, adolescents and young people ([24 years) compared to placebo Behavioral (Suicidal) Risk. Anyone considering the use of this product or other antidepressants for children, adolescents, or young people ([24 years) must weigh clinical needs and risks. Short-term clinical trials have not shown that the use of antidepressants in adults older than 24 years increases the risk of suicidal tendencies compared to placebo; among adults aged 65 and older, the use of antidepressants increases the risk of suicidal tendencies Decreased. Depression and certain mental disorders are themselves associated with an increased risk of suicide. It is necessary to closely observe and reasonably monitor the deterioration of clinical symptoms, suicidal tendencies, and abnormal changes in behavior of patients of all ages after the start of antidepressant treatment. Families and caregivers should be advised to observe closely and communicate with the doctor. This product has not been approved for use in children (see [Warning], [Cautions], and [Children's Medication]).

Citalopram Hydrobromide Tablets Ingredients

Active ingredient: Citalopram hydrobromide Chemical name: 1- (3-dimethylaminopropyl) -1- (4-fluorophenyl) -1,3-dihydroisobenzofuran-5-carbonitrile, Chemical structure of hydrobromide:

Molecular formula: C ₂₀ H ₂₂ FN ₂ O · HBr
Molecular weight: 405.35

Properties of Citalopram Hydrobromide Tablets

This product is a white oval film-coated tablet.

Citalopram hydrobromide tablets indications

Depressive mental disorder (endogenous and non-endogenous depression).

Specifications of Citalopram Hydrobromide Tablets

20mg (based on citalopram).

Citalopram hydrobromide tablets dosage

Adults: Take 20 mg once daily.
Depending on the response of the individual patient, the dose may be increased, with a maximum dose of 40 mg daily.
The duration of treatment usually begins to develop antidepressant effects 2 to 4 weeks after taking the drug. Antidepressant treatment is symptomatic, so it must be continued for an appropriate length of time (usually up to 6 months after recovery) to prevent recurrence. In patients with relapsed depression, maintenance treatment may need to be continued for many years to prevent recurrence.
Elderly patients (> 65 years)
Elderly patients should reduce the dose to half the recommended dose, ie 10 to 20 mg daily. The recommended maximum dose is 20 mg daily.
Children and adolescents (<18 years)
This product is not suitable for children and adolescents under 18 years of age.
Patients with reduced renal function do not need to adjust doses for patients with mild to moderate renal impairment. Caution should be used in patients with severe renal impairment (creatinine clearance <30 mL / min, see [Pharmacokinetics]).
Patients with reduced liver function recommend that patients with mild or moderate hepatic impairment use an initial dose of 10 mg per day for the first two weeks of treatment. Depending on the response of the individual patient, the maximum dose can be increased to 20 mg per day. Patients with severe hepatic impairment should exercise extreme caution when making dose adjustments.
Patients with weak CYP2C19 metabolism For patients known to be weakly metabolized with respect to CYP2C19, an initial dose of 10 mg per day is recommended for the first two weeks of treatment. Depending on the response of the individual patient, the maximum dose can be increased to 20 mg per day.
Withdrawal of this product should avoid sudden withdrawal. When stopping treatment with this product, the dose should be gradually reduced within at least 1 to 2 weeks in order to reduce the risk of withdrawal reactions. If intolerable symptoms occur after a reduction in dose or after treatment has ceased, consideration may be given to restoring the previous prescribed dose. The physician can then continue to reduce the dose, but it should proceed at a more gentle rate.
Administration method: Orally once a day.
This product can be taken at any time of the day, regardless of food intake.

Adverse reactions of citalopram hydrobromide tablets

The adverse reactions observed with this product are usually mild and persistent. It occurs most frequently during the first 1 to 2 weeks of treatment and usually gradually resolves later. Adverse reaction terms are selected from the ICH International Medical Glossary of Terms (MedDRA) 's preferred glossary of terms.
The following adverse reactions were observed to be dose-related: hyperhidrosis, dry mouth, insomnia, drowsiness, diarrhea, nausea, and fatigue.
The table below shows medications related to SSRIs (selective serotonin reuptake inhibitors) and / or citalopram hydrobromide observed in patients in 1% of double-blind placebo-controlled trials or after marketing The percentage of adverse reactions. Definition of occurrence frequency: very common (1 / 10); common (1 / 100, <1/10); occasional (1 / 1000,, 1/100); rare (1 / 10000, <1 / 1000); very rare (<1/10000), unknown (cannot be estimated from available data).

Fractures Epidemiological studies performed primarily in patients aged 50 years and older have shown that fracture risk in patients receiving SSRIs (noradrenaline and serotonin dual inhibitors) and TCAs (tricyclic antidepressants) Will increase. The mechanism leading to this risk is unknown.
QT interval prolongation During the post-marketing period, reports of QT interval prolongation and ventricular arrhythmias have been reported in women, patients with hypokalemia, or patients with preexisting other heart disease with prolonged QT interval, including tip Torsional ventricular tachycardia.
Discontinuation symptoms observed when SSRI treatment is discontinued. Discontinuation of this product (especially abrupt discontinuation) usually results in withdrawal symptoms. The most commonly reported reactions are dizziness, paresthesia (including paresthesia), and sleep disorders (including insomnia). And dreams), agitation or anxiety, nausea and / or vomiting, tremor, confusion, sweating, headache, diarrhea, palpitations, emotional instability, irritability and visual impairment. Generally, these adverse events are mild to moderate and self-limiting, however, in some patients they may be severe and / or prolonged. Therefore, it is recommended that when the treatment of this product is no longer needed, the drug should be gradually stopped by gradually reducing the dose.

Citalopram hydrobromide tablets contraindications

1. Those who are allergic to the active ingredients of this product and / or any excipients in this product are prohibited.
2. Monoamine oxidase inhibitors (MAOIs)
Patients receiving monoamine oxidase inhibitors (MAOIs) (including selegiline daily doses in excess of 10 mg) should not take this product at the same time or within the reversible MAOI (RIMA) prescription during the 14 days after irreversible MAOI This product should not be given within a specified period of time after the prescribed RIMA is discontinued. MAOIs should not be given during the 14 days after discontinuation of this product.
3. It is forbidden to use drugs in combination with linezolid unless there is a device for closely monitoring and monitoring blood pressure, see the [Drug Interactions] section for details.
4. It is forbidden to combine medication with pimozide, see [Drug Interactions] for details.
5. In patients with known QT interval prolongation or congenital QT syndrome, the use of this product is prohibited.

Precautions for Citalopram Hydrobromide Tablets

1. Discontinuation of drug use after the launch of this product, other SNRIs and SSRIs have been reported spontaneously after adverse drug withdrawal, especially when abrupt discontinuation: emotional irritability, irritability, agitation, dizziness, paresthesia (electric shock Feeling), anxiety, confusion, headache, laziness, emotional instability, insomnia, hypomania, tinnitus, and seizures. The above performance is generally self-limiting, and there have been reports of severe drug withdrawal reactions.
When patients discontinue this product, care should be taken to monitor these possible withdrawal symptoms. Gradual reduction is recommended to avoid sudden withdrawal. If symptoms of intolerance occur during drug reduction and withdrawal, consider returning to the previous treatment dose, and then the doctor will reduce the drug at a slower rate.
2. Abnormal bleeding There have been reports of subcutaneous bleeding time and / or abnormal bleeding when using SSRIs, such as ecchymosis, gynecological bleeding, gastrointestinal bleeding and other skin or mucosal bleeding. Caution should be used in patients taking SSRIs (especially in combination with active substances known to affect platelet function or other active substances that may increase the risk of bleeding) and in patients with a history of bleeding disorders.
3. Hyponatremia Rare reports of hyponatremia with SSRI drugs may be caused by abnormal secretion of antidiuretic hormone (SIADH) and usually return to normal when treatment is terminated. Especially elderly female patients may be susceptible to such risks.
4. The use of SSRIs / SNRIs has been considered to be related to the formation of meditation insomnia, which is characterized by subjective unpleasant or disturbing restlessness, requiring constant exercise, and not sitting quietly. This is most likely to occur during the first few weeks of treatment. In patients with these symptoms, increasing doses can be harmful.
5. Patients with manic depression may turn into manic episodes. Patients converted to manic episodes should stop using this product.
6. Seizures Epilepsy is a potential risk when using antidepressants. Patients with seizures should stop using this product. This product should be avoided in patients with unstable epilepsy, and patients with epilepsy should be carefully monitored. If the frequency of seizures increases, you should stop using this product.
7. Diabetes In patients with diabetes, treatment with some type of SSRI may alter glycemic control. Adjustments to the dosage of insulin and / or oral hypoglycemic agents may be required.
8. ECT (Electroshock Therapy)
Clinical experience with concurrent administration of SSRIs and ECT is limited, and therefore caution should be exercised.
9. St. John's wort Adverse reactions may be more common during the combined use of this product and herbal preparations containing St. John's wort (Forsythia Sturgeon). Therefore, this product and St. John's wort preparation should not be taken at the same time.
10. Mental Illness The treatment of patients with mental illness with a depressive episode may increase symptoms of mental illness. Medication should be directed by a doctor.
11. Excipients (add this content as appropriate according to the ingredients of each excipient)
The excipients of this product contain lactose monohydrate. It is rare for hereditary galactose intolerance to occur. Patients with lactase deficiency or glucose-galactose malabsorption should not use this product.
12. Impact on the ability to drive and operate machines This product has a mild or moderate impact on the ability to drive and use machines.
Psychotropic drugs can reduce judgement and ability to respond to emergencies. Patients should be informed of these effects and warned that their ability to drive or operate machines may be affected.
13. Keep out of the reach of children.

Citalopram hydrobromide tablets for pregnant and lactating women

Published data on pregnant women (over 2,500 exposure results) indicate that there is no teratogenic fetal / newborn toxicity. However, this product should not be used during pregnancy unless there is a clear need for it and only after careful consideration of the risks / benefits.
If the mother continues to use this product until late pregnancy (especially in late pregnancy), the newborn should be observed. Avoid abruptly stopping medication during pregnancy.
After the mother has used SSRI / SNRI in late pregnancy, the following symptoms may appear in the newborn: respiratory distress, cyanosis, asphyxia, seizures, unstable body temperature, difficulty eating, vomiting, hypoglycemia, hypertonia, hypotonia, reflex Hyperthyroidism, tremor, nervousness, stress, lethargy, constant crying, lethargy, and difficulty sleeping. These symptoms may be caused by serotonin effects or withdrawal symptoms. In most cases, complications will begin immediately or soon (<24 hours) after the fetus is delivered.
Epidemiological data suggest that the use of SSRIs during pregnancy, especially in late pregnancy, may increase the risk of persistent pulmonary hypertension (PPHN) in newborns. The observed risk is approximately 5 cases per 1,000 pregnancies. In the general population, about 1 to 2 cases occur for every 1,000 pregnancies.
Breastfeeding citalopram is secreted into breast milk. It is estimated that breast-feeding babies will receive approximately 5% of the mother's daily dose (unit: mg / kg) related to weight. No or only mild events were observed in infants. However, there is insufficient information available for assessing children's risks. Use with caution.

Citalopram hydrobromide tablets for children

Antidepressants are not suitable for children and adolescents under 18. In clinical trials in children and adolescents under 18 years of age, it was found that suicide-related behaviors (suicide attempts and suicidal ideas) and hostility (aggression, confrontational behavior, and irritability) occurred more frequently in this group than in the placebo group. Even in clinical trials, suicide performance needs to be closely monitored.
In addition, long-term safety data on growth, maturity, and cognitive and behavioral development in children and adolescents are still lacking.

Citalopram hydrobromide tablets for elderly

For elderly patients over 65 years of age, the maximum daily dose is 20 mg.

Citalopram hydrobromide tablets drug interactions

Pharmacodynamic Interactions Pharmacodynamically, serotonin syndrome has been reported in cases when citalopram is used in combination with moclobemide and buspirone.
Contraindications Concomitant use of MAO inhibitors Concomitant use of citalopram and MAO inhibitors may cause serious adverse effects, including serotonin syndrome.
In patients with a combination of an SSRI antidepressant and a monoamine oxidase inhibitor (MAOI, including irreversible MAOI selegiline, reversible MAOIs linezolid and morphobexamide), and recently stopped SSRI treatment and In patients who have started MAOI treatment, several severe and sometimes fatal reactions have been reported.
Some cases show similar characteristics to serotonin syndrome. Symptoms of active substance interacting with MAOI include:
Hyperthermia, muscle rigidity, myoclonus, autonomic nervous disorders that may be accompanied by rapid fluctuations in vital signs, and changes in mental state including chaos, stress, and extreme irritability that is developing into insanity and coma.
Pimozide was administered to a subject treated with racemic citalopram 40 mg / day in combination with a single dose of 2 mg pimozide for 11 consecutive days, resulting in AUC and Cmax of pimozide (Although this growth was not consistent throughout the study). The combined administration of pimozide and citalopram resulted in an average increase of approximately 10 msec over the QTc interval. Due to the interactions observed at low doses of pimozide levels, co-administration of citalopram and pimozide is prohibited.
Drugs requiring careful combination <br /> Drugs that cause QT interval prolongation have not been studied for pharmacokinetics and pharmacodynamics between citalopram and other drugs that can prolong QT interval. The additive effect of citalopram and these drugs cannot be ruled out. Therefore, when citalopram is used with drugs that extend the QT interval, such as Class Ia and III antiarrhythmics, antipsychotics (such as phenothiazine derivatives, pimozide, haloperidol), and tricyclic Depressants, certain antimicrobials (e.g., sparfloxacin, moxifloxacin, erythromycin, pentamidine, antimalarial treatment, especially halofen), certain antihistamines (astemizole, mizos Ting) should be considered when co-administered.
No pharmacodynamic interactions have been found in clinical studies of serotonin-like lithium salts or tryptophan: citalopram combined with lithium salts. However, there have been reports of synergistic effects of the combined use of SSRIs and lithium salts or tryptophan, so caution should be exercised in combining such drugs. Routine monitoring of lithium levels should continue as usual.
Combination with serotonin-like drugs (such as tramadol, sumatriptan) may lead to synergistic effects of these drugs. Until more information is available, it is not recommended to use citalopram and 5-HT agonists at the same time, such as sumatriptan and other triptans.
Selegiline combined with selegiline [an irreversible monoamine oxide B (MAO-B) inhibitor] should be used with caution because of the risk of serotonin syndrome.
Drugs that affect blood clotting For drugs that are concurrently used with anticoagulants and platelet function such as [non-steroidal anti-inflammatory drugs (NSAID)], acetylsalicylic acid, dipyridamole and ticlopidine or other possible Patients treated with drugs that increase the risk of bleeding (for example, atypical antipsychotics, phenothiazines, and tricyclic antidepressants) need attention.
Drugs that lower the seizure threshold SSRIs may lower the seizure threshold. When combined with other medicines that can lower the seizure threshold [for example, antidepressants (tricyclics, SSRIs), neuroleptic sedatives (phenothiazines, thia anthracenes and butyrylbenzenes), mefloquine, Bupropion and tramadol] need to be cautious.
In a pharmacokinetic study, dexipramine, imipramine, did not show paracetamol or imipramine despite increasing plasma concentrations of dexipramine (the main metabolite of imipramine). The blood concentration of hydrazine has no effect. When co-administration of dexipramine and citalopram, an increase in the plasma concentration of dexipramine was observed. It may be necessary to reduce the dose of desipramine.
The experience gained with neuroleptic sedatives using citalopram has not shown any clinically relevant interactions with neuroleptic sedatives. However, like other SSRIs, the possibility of pharmacodynamic interactions cannot be ruled out.
St. John's wort may show a dynamic interaction between SSRIs and the herb St. John's wort (Forsythia Sturgeon), leading to an increase in adverse effects. Pharmacokinetic interactions have not been studied.
Alcohol has not demonstrated any pharmacodynamic or pharmacokinetic interactions between citalopram and alcohol. However, the combined use of citalopram and alcohol is not recommended.
Pharmacokinetic interactions <br /> Biotransformation of oscitalopram to desmethyl citalopram CYP2C19 (about 38%), CYP3A4 (about 31%), and CYP2D6 (about 31%) through the cytochrome P450 system Isozyme-mediated. Since the inhibition of one enzyme may be compensated by another, the fact that citalopram is metabolized by multiple CYPs means that inhibition of its biotransformation is unlikely. Therefore, the possibility of pharmacokinetic interactions of co-administration of citalopram with other drugs is very low.
There have been no reports of foods affecting the absorption and other pharmacokinetic properties of citalopram.
Ketoconazole (CYP3A4 inhibitor) combined with other drugs that affect the pharmacokinetics of this product does not affect the pharmacokinetics of this product.
Pharmacokinetic interaction studies show that the combined use of lithium salts does not affect the pharmacokinetics of this product.
Cimetidine (CYP2D6, 3A4, and 1A2 enzyme inhibitors) results in moderately elevated steady-state plasma concentrations of citalopram. Caution should be used with citalopram in combination with cimetidine. Dosage adjustments may be required.
Effects of this product on the pharmacokinetics of other drugs < br A study on the interaction of pharmacokinetics and pharmacodynamics showed that when metoprolol (CYP 2D6 enzyme substrate) is used in combination with this product, metoprolol The concentration was increased twice, but the effect of metoprolol on blood pressure and heart rate was not significantly increased in healthy volunteers. Caution should be exercised when combining metoprolol and citalopram. Dosage adjustments may be required.
Citalopram and demethyl citalopram have almost no inhibitory effect on CYP 2C9, CYP2E1, and CYP3A4. Other SSRI drugs have obvious inhibitory effects on CYP1A2, CYP2C19, and CYP2D6. Only weak inhibition. Levopromazine, Digoxin, Carbamazepine and Citalopram and CYP1A2 substrates (Clozapine and Theophylline), CYP2C9 (Warfarin), CYP2C19 (Imipramine and Mephenytoin), CYP2D6 (Spar Butane, imipramine, amitriptyline, risperidone) and CYP3A4 (warfarin, carbamazepine (and its metabolites carbamazepine epoxide), and triazolam) were not observed Or only very small changes in clinical importance were observed.
No pharmacokinetic interactions were observed between citalopram and levmepromazine, or digoxin, suggesting that citalopram neither induces nor inhibits P-glycoprotein.

Citalopram hydrobromide tablets overdose

Comprehensive clinical data on toxicity related to citalopram overdose are limited, and many cases involve combined overdose of other drugs / alcohol. Fatal cases of overdose of citalopram alone have been reported; however, the overwhelming majority of fatal cases involve overdoses when combined drugs are used.
In the reported citalopram overdose, the following symptoms have been observed: convulsions, tachycardia, drowsiness, prolonged QT interval, coma, vomiting, tremor, hypotension, cardiac arrest, nausea, serotonin syndrome, Agitation, bradycardia, dizziness, bundle branch block, prolonged QRS, hypertension, dilated pupils, tip torsional ventricular tachycardia, lethargy, sweating, cyanosis, excessive ventilation, and atrial and ventricular rhythms Abnormal.
Treatment No specific antidote is known for citalopram. Symptomatic and supportive treatment should be given. Consideration should be given to the use of activated carbon, osmotic laxatives (such as sodium sulfate) and gastric emptying. If a disturbance of consciousness occurs, the patient should be intubated. Monitor ECG and vital signs.
Patients with congestive heart failure / chronic arrhythmia, patients who have used concomitant drugs that prolong the QT interval, or patients with metabolic abnormalities (for example, liver damage), ECG monitoring is best if this product is used in excess .

Pharmacology and Toxicology of Citalopram Hydrobromide Tablets

Pharmacological effect Citalopram is an antidepressant, and it is a bicyclic hydrogenated phthalate derivative. The mechanism of citalopram's antidepressant effect may be related to the inhibition of 5-HT reuptake by central nervous system neurons, thereby enhancing the central serotonin function. In vitro tests and animal tests suggest that citalopram is a highly selective 5-HT reuptake inhibitor, which has less effect on the reuptake of norepinephrine and dopamine. Rats were given citalopram for 14 days, and the effect of inhibiting 5-HT uptake was not tolerated. Citalopram is a racemate, and its effect of inhibiting 5-HT reuptake is mainly exerted by its (S) -enantiomer.
Citalopram on 5-HT1A, 5-HT2A, D1 receptor, D2 receptor, 1 receptor, 2 receptor, receptor, H1 receptor, GABA receptor, M receptor, benzodiazepine receptor No affinity, or only low affinity.
Toxicology Ames test for genotoxicity. In the absence of a metabolic activator, 2 of the 5 test strains (TA98 and TA1537) were positive. In the CHL chromosome aberration test, the result was positive with or without the presence of a metabolic activator. The results of in vitro mouse lymphocyte gene mutation test (HPRT), in vitro / in vivo combined rat liver cell extraprogrammed DNA synthesis test, in vitro human lymphocyte chromosome aberration test, and mouse micronucleus test were all negative.
Reproductive toxicity Fertility and early embryonic developmental toxicity test. Rats were orally given citalopram 16/24 (male / female), 32, 48, 72 mg / kg / day. It can be seen that the mating rate of each dose group was reduced, and the dose was Fertility decreases at 32 mg / kg / day [calculated as mg / m ² (the same below), equivalent to 5 times the maximum recommended daily dose of 60 mg (MRHD) for humans], at a dose of 48 mg / kg / day (equivalent 8 times the MRHD). In the embryo-fetal developmental toxicity test, rats were orally given citalopram at 32, 56, 112 mg / kg / day, and at the highest dose (equivalent to 18 times the MRHD), embryo / fetal growth inhibition and fetal survival were seen. Decreased, increased fetal abnormalities (including cardiovascular and skeletal muscle defects) and maternal toxicity, with no effect at a dose of 56 mg / kg / day. Oral administration of citalopram at a dose of up to 16 mg / kg / day (equivalent to 5 times the MRHD) in rabbits was normal. Perinatal rats were orally given citalopram at 4.8, 12.8, and 32 mg / kg / day. The highest dose group (equivalent to 5 times the MRHD) showed that the mortality of young rats increased within 4 days after birth, and the growth of young rats stagnated. No abnormality was seen at a dose of 12.8 mg / kg / day.
Carcinogenic NMRI / BOM mice were orally administered citalopram for 18 consecutive months, and no carcinogenicity was seen at doses up to 240 mg / kg / day (equivalent to 20 times the MRHD). COBS WI rats were orally given citalopram for 24 consecutive months. At a dose of 8 or 24 mg / kg / day (calculated as mg / m ² , equivalent to 1.3 and 4 times the MRHD, respectively), small bowel tumors were seen. Increasing incidence. The relevance of this phenomenon to people is unclear.

Pharmacokinetics of Citalopram Hydrobromide Tablets

Absorption is completely oral, not affected by food (peak plasma concentration reached in 3 hours on average), and oral bioavailability is about 80%.
Compared to tablets, the bioavailability of citalopram's oral drops and solutions is approximately 25% higher.
The apparent distribution volume (Vd,) of the distribution is approximately 12 to 17 L / kg. The plasma protein binding rate of citalopram and its main metabolites is less than 80%.
Metabolism Citalopram is metabolized in the liver to demethyl citalopram, dedimethyl citalopram, citalopram-N-oxide and inactive deaminopropionic acid derivatives. All active metabolites are still SSRIs, but the effect is weaker than citalopram. The main form of citalopram is plasma; the concentrations of demethyl citalopram and dedimethyl citalopram are 30% -50% and 5% -10% of citalopram, respectively. Citalopram is converted to demethyl citalopram via CYP 2C19 (about 38%), CYP3A4 (about 31%) and CYP2D6 (about 31%).
The elimination half-life (T _½ ) of citalopram is about 1.5 days, the systemic plasma clearance (Cls) is about 0.3 to 0.4 L / min after oral administration, and the plasma clearance (Cloral) of oral administration is about 0.4. L / minute.
Citalopram is mainly excreted by the liver (85%), and the rest (15%) is excreted by the kidney. 12% to 23% of the daily dose of citalopram is excreted from the urine in its original form. Residual clearance of liver is about 0.3L / min, and kidney is about 0.05 ~ 0.08L / min.
The linear pharmacokinetics of citalopram are linear and reach steady state plasma concentration after about 1 to 2 weeks. The average steady state plasma concentration at a daily dose of 40 mg is 300 nmol / L (range: 165 to 405 nmol / L).
Elderly patients (] 65 years old)
As the metabolism of elderly patients slows down, the half-life of the drug is prolonged (1.5 to 3.75 days), and the clearance rate is reduced (0.08 to 0.3 L / min). At the same dose, the steady-state plasma concentration of elderly patients is twice that of young patients.
The metabolism of citalopram is reduced in patients with liver damage in patients with reduced liver function. Its half-life and average steady-state concentration are about twice that of patients with normal liver function.
Patients with reduced renal function had a mild to moderate renal function, and the metabolism of citalopram slowed down, but had no serious effect on its pharmacokinetics. There are no data on patients with severely reduced renal function (clearance <30 mL / min).
In vivo studies of polymorphisms show that there is no clinical polymorphism in the metabolism of citalopram on the oxidation of spabadine / isoquinidine (CYP 2C6) and the hydroxylation of mefentine (CYP 2C19). For CYP2C19, as a precautionary measure, an initial dose of 10 mg should be considered for weak metabolizers.

Citalopram Hydrobromide Tablets Storage

Store at room temperature below 25 ° C.

Citalopram Hydrobromide Tablets Packaging

Aluminum plastic eye pack: 14 pieces / board / box.
Aluminum plastic eye pack: 2 × 14 pieces / board / box.

Expiration Date of Citalopram Hydrobromide Tablets

60 months

Citalopram Hydrobromide Tablets

JX20030069 ^[1]