Perrigo Citalopram

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Perrigo Citalopram

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Treatment option: Depression, Neurosis

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Overview of Perrigo Citalopram

Quick Facts

Property Description
Active ingredient Citalopram hydrobromide
Form Oral tablet (e.g., film-coated)
Pharmacological class Selective Serotonin Reuptake Inhibitor (SSRI)
Common use Mood stabilization and emotional health
Origin Synthetic

What is the Medicinal Identity of Perrigo Citalopram?

Perrigo Citalopram is a generic drug containing the active ingredient Citalopram hydrobromide, which is classified as an antidepressant and a Selective Serotonin Reuptake Inhibitor (SSRI). The Citalopram molecule is a synthetic compound—a racemic bicyclic phthalane derivative—supplied as a single-entity product for oral administration. The medication is typically manufactured as an oral tablet, formulated within a solid matrix of inactive ingredients. As a generic drug, it provides the therapeutically equivalent Citalopram component, which is absorbed systemically to achieve its intended effect in the central nervous system.

How is Perrigo Citalopram Classified by Action and Purpose?

The drug’s designation as an SSRI dictates its core function: the highly selective inhibition of neuronal serotonin reuptake within the central nervous system (CNS). This mechanism blocks the reabsorption of the monoamine neurotransmitter serotonin back into the nerve cells, consequently increasing the availability of active serotonin in the synapses. This potentiation of serotonergic activity is the foundational principle for the drug's general antidepressant properties. This action serves the broad purpose of helping to stabilize emotional states and promote improved feelings of well-being for individuals experiencing persistent low mood.

Regulatory References

  1. Citalopram: MedlinePlus Drug Information
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What side effects are possible with Perrigo Citalopram?

Citalopram, a selective serotonin reuptake inhibitor (SSRI), has associated side effects ranging from common to rare and serious. It is crucial to be aware of these risks and to maintain communication with a healthcare provider.

Common Side Effects

Common side effects, which often decrease over time, may include nausea, sleepiness or insomnia, dry mouth (xerostomia), increased sweating (diaphoresis), and sexual side effects such as decreased libido or ejaculation difficulties in males.


Serious Warnings and Precautions

Risk of Suicidal Thoughts and Behavior

Antidepressants, including Citalopram, may increase the risk of suicidal thoughts and actions in children, adolescents, and young adults (up to age 24), particularly during the initial months of treatment or following a dose change. All patients should be closely monitored for unusual behavioral changes, worsening depression, or suicidality.

Heart Rhythm Changes

Citalopram can cause dose-dependent QT interval prolongation, an abnormal change in the heart's electrical activity that can lead to a potentially fatal irregular heart rhythm, Torsade de Pointes. The maximum recommended dosage for most adults is 40 mg per day. The maximum is often restricted to 20 mg per day for patients over 60, those with hepatic impairment, or those taking certain interacting medications. Patients with a history of heart failure, bradycardia, or low levels of potassium or magnesium are at higher risk. Seek immediate medical attention if you experience a fast, pounding, or irregular heartbeat, or if you faint.

Serotonin Syndrome

Citalopram can lead to Serotonin Syndrome when taken alone, but the risk is significantly higher when combined with other serotonergic drugs (e.g., MAOIs, triptans, or St. John's wort). Symptoms can be life-threatening and may include agitation, hallucinations, fever, muscle rigidity, and rapid heart rate. Consult a doctor immediately if these symptoms appear.

Other Serious Risks

Other reported serious effects include an increased risk of bleeding or bruising, especially when taken with NSAIDs or blood thinners; episodes of extreme elevated mood (mania) in patients with undiagnosed bipolar disorder; seizures; and hyponatremia (low sodium levels), often seen in older adults.

Do not stop taking Citalopram suddenly without consulting your healthcare provider, as this can cause withdrawal symptoms.

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Overdose and Emergency Response

Overdose and When to Seek Help

Official regulatory information emphasizes that Citalopram overdose can range in severity from mild to potentially fatal and requires immediate medical attention. Overdose symptoms may manifest when the drug is taken alone or in combination with other substances, including alcohol, which can significantly increase risk.


Documented Overdose Manifestations

Symptoms frequently reported following an overdose include dizziness, sweating, nausea, vomiting, tremor, somnolence, and sinus tachycardia (abnormally fast heart rate).

Severe Clinical Manifestations

More serious, though less frequent, effects involve the Central Nervous System (CNS) and Cardiovascular system. These can include:

  • Seizures (convulsions)
  • Coma
  • Hyperventilation
  • Serious ECG changes, notably QTc prolongation, which can lead to life-threatening abnormal heart rhythms such as ventricular arrhythmia and, in very rare instances, Torsade de Pointes.

Emergency Medical Response

The official guidance mandates that you call a Poison Control Center or get emergency medical treatment right away for any suspected overdose. Immediate medical treatment is required even if symptoms appear mild.

Seek immediate care if you or someone else experiences an irregular heartbeat, shortness of breath, dizziness, or fainting. These symptoms may signal severe cardiovascular complications. The risk of cardiac complications is noted to be higher in patients with pre-existing heart conditions or electrolyte imbalances.

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Therapeutic Uses of Perrigo Citalopram

Perrigo Citalopram is commonly used as a therapeutic agent to address major mood disturbances and associated symptoms, applied in contexts where additional symptomatic support is needed to help support emotional and mental balance.

Its primary therapeutic domains include Major Depressive Disorder (MDD), and it is considered relevant for managing symptoms associated with Panic Disorder, Generalized Anxiety Disorder (GAD), and Obsessive-Compulsive Disorder (OCD).

The medication helps address symptom clusters that may become intense or disruptive, such as persistent low mood, excessive worry, and vegetative symptoms like significant fatigue and problems with concentration. By supporting these elements of function, the medicine contributes to improved day-to-day comfort during symptomatic periods.

This supportive relief is considered relevant in helping patients cope more steadily with difficult emotional and physiological episodes.

Quick Fact: Relief for Key Symptom Domains
Emotional Focus Persistent low mood, sadness, irritability
Functional Focus Loss of interest, fatigue, poor concentration
Anxiety Focus Excessive worry, panic attacks

Regulatory References

  1. NIH MedlinePlus Drug Information
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Eligibility and Restrictions for Use

Who can and cannot use Perrigo Citalopram?

This medication is officially contraindicated (must not be used) in several patient populations due to the risk of serious adverse effects, primarily involving the heart and drug interactions.

Eligibility Severity Classification Population/Condition
Contraindicated Patients with known hypersensitivity to Citalopram or its ingredients.
Contraindicated Patients currently taking a Monoamine Oxidase Inhibitor (MAOI), or within 14 days of stopping an MAOI.
Contraindicated Patients taking Pimozide or with a known prolonged QT interval (an electrical heart rhythm problem).
Contraindicated Patients with congenital Long QT syndrome or uncompensated heart failure.
Age-Related Eligibility Regulatory Status (Adults/Seniors)
Adults (18–60 years) Eligible for standard use, absent contraindications.
Older Adults (Age ge 60 years) Restricted Use; maximum recommended dose is lowered to 20 mg per day.
Children/Adolescents Not Approved; safety and efficacy are not established for use in individuals under 18.

Restricted Use also applies to patients with hepatic impairment (maximum daily dose of 20 mg) and those who are CYP2C19 poor metabolizers. For pregnancy, use is generally not recommended unless the clinical benefit outweighs the risks. Use is not recommended during breastfeeding as the drug is excreted in human milk.

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What should I know about interactions with other medicines?

Interactions with other medicines and products

Official regulatory information documents several important interaction patterns for citalopram, which are classified based on pharmacokinetic (metabolic) and pharmacodynamic (additive effect) mechanisms.

Contraindicated Combinations

The most severe interaction restriction is the absolute prohibition of co-administration with Monoamine Oxidase Inhibitors (MAOIs), including the antibiotic Linezolid and Intravenous Methylene Blue, due to the high risk of Serotonin Syndrome. The co-use of citalopram with Pimozide is also contraindicated because of the additive risk of QT interval prolongation.

Pharmacokinetic and Pharmacodynamic Interactions

Interaction Type Interacting Substance/Class Official Regulatory Statement
Exposure Modification CYP2C19 & CYP3A4 Inhibitors (e.g., Omeprazole) Expected to reduce citalopram clearance, resulting in significantly increased plasma concentrations (AUC and Cmax).
Serotonergic Overload Other Serotonergic Agents (e.g., Triptans, Tramadol) Increases the risk of Serotonin Syndrome due to cumulative effects.
Bleeding Risk Agents Affecting Hemostasis (e.g., NSAIDs, Warfarin) Increases the documented risk of bleeding.
Substance Interaction Alcohol May result in additive CNS depressant effects.

Timing and Population Notes

A mandatory washout period of at least 7 to 14 days must be observed when switching between citalopram and an MAOI. Furthermore, individuals classified as CYP2C19 poor metabolizers exhibit significantly increased drug exposure, which is an important consideration in this specific population.

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Mechanism of Action

Perrigo Citalopram works by modifying neurotransmitter signaling and initiating subsequent long-term neurobiological adaptations.


Modulation of Serotonergic Reuptake

This mechanistic domain focuses on the drug's direct molecular interaction with the presynaptic neuron's serotonin transporter (SERT) protein. The compound selectively inhibits the reabsorption (reuptake) of the neurotransmitter serotonin (5-HT) from the synaptic cleft back into the cell. This action increases the concentration and availability of free serotonin in the synaptic space, thereby enhancing serotonergic receptor engagement within the central nervous system.


Initiation of Neurobiological Adaptation

This domain covers the chronic and downstream effects that emerge following sustained serotonin reuptake inhibition. Prolonged elevation of synaptic serotonin levels can lead to a sequence of molecular adjustments, including the desensitization or downregulation of certain postsynaptic serotonin receptors and alterations in gene expression. These cascading effects are relevant in pathways that regulate neuroplasticity, ultimately influencing the functional state of targeted neural circuits through molecular and cellular adaptations over time.

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Dosage and Administration Information

How to Use Perrigo Citalopram

This section describes the administration and dosing guidelines for Citalopram.


Administration Guidelines

Perrigo Citalopram is supplied primarily as an oral tablet and is administered once daily by mouth. The tablets may be taken either in the morning or the evening and are consumed with or without food, typically accompanied by fluid. For consistency, the medicine should be taken at approximately the same time each day.

Property Administration Detail
Route of Administration Oral
Dosing Frequency Once daily
Intake Condition With or without food; taken with fluid
Duration Principle Used as part of a long-term treatment plan (e.g., minimum six months for maintenance)

Standard Dosage and Adjustments

Dosing parameters for treatment follow specific clinical standards. The typical initial dose for the general adult population is 20 mg taken once per day. The maximum recommended dose for most adults is 40 mg once daily. Doses above this maximum are not recommended.

Specific dosage limits apply to certain groups:

  • Older Adults (Age 65+): The maximum recommended dose is restricted to 20 mg once daily.
  • Hepatic Impairment: The maximum recommended dose is also 20 mg once daily, often initiating with a 10 mg daily dose.

Procedural Instructions

Treatment is not to be stopped abruptly. If therapy is to be discontinued, the dosage is gradually reduced over a period of at least one to two weeks. If a dose is missed, the next scheduled dose should be taken at the regular time; missed doses are not to be doubled.

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Recent Clinical Evidence

Evidence for use in Major Depressive Disorder (MDD)

The core evidence for Citalopram centers on randomized, placebo-controlled trials (RCTs) examining acute symptom change in adults with MDD. Systematic reviews show patterns where the observed symptom score changes and response rates are often different compared to studies involving an inactive placebo. Reviews of studies often described patterns related to changes in symptom severity scores and response rates when contrasted with placebo. However, the evidence base contains inconclusive information regarding the consistent achievement of the most stringent outcome: remission (virtual absence of symptoms).


Long-Term Studies and Prevention of Recurrence

Multi-phase clinical trials explore whether extended use is associated with maintaining outcomes and avoiding a return of symptoms. Studies monitored outcomes where the time to recurrence was observed to be greater in the Citalopram group when compared to the placebo group in the maintenance phases of the trials. Long-term effects are not fully established beyond the specific duration explored in regulatory-focused trials, and specific long-term functional outcomes remain to be fully characterized.


Evidence in Specific Research Cohorts

Research examined Citalopram in older adults, children, and adolescents, as well as cohorts with associated anxiety-related conditions. Studies in older adults described measured outcomes comparable to those observed with other evaluated treatments. Findings for children and adolescents were mixed; some trials described patterns related to changes, while others observed no distinct patterns. The evidence for anxiety conditions is limited, primarily deriving from specialized cohorts.


Limitations and Gaps

A primary limitation is that evidence quality varies across studies, with concerns noted about the reporting of methodology in some original trials. Data show patterns related to findings that often originated from industry-sponsored trials, which necessitates caution regarding potential bias in outcome reporting. Comparative evidence is lacking for many potential head-to-head comparisons.

Key Studies & References

  1. Citalopram for major depressive disorder in adults: a systematic review and meta-analysis of published placebo-controlled trials
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Frequently Asked Questions (FAQ)

Common questions about Perrigo Citalopram (FAQ)


Q: How long does it usually take to feel the full effects of Perrigo Citalopram?

Studies and official information indicate that the full therapeutic benefit of citalopram may take several weeks to notice. Clinical trials for this type of medication typically track symptom changes over four to six weeks. The full benefit is achieved with continued treatment, as indicated by prescribing information.


Q: What are the most common side effects people report when starting Perrigo Citalopram?

According to official product information, common side effects often reported when starting citalopram include nausea, sleepiness or insomnia (difficulty sleeping), dry mouth, and increased sweating. Official product information suggests these effects often lessen in severity over time as the body adjusts.


Q: Will Perrigo Citalopram cause weight gain or weight loss?

Regulatory documents state that citalopram may cause changes in weight, meaning both weight gain and weight loss have been reported in clinical trials. Concerns about weight changes are best discussed with a healthcare provider.


Q: Does Perrigo Citalopram affect sleep (insomnia or drowsiness)?

Yes, sleep disturbances are a common effect. Official product information lists both sleepiness (somnolence) and insomnia (difficulty falling or staying asleep) as commonly reported side effects. How the drug affects sleep can vary from person to person.


Q: Are there any vitamins or supplements that interact badly with Perrigo Citalopram?

Yes, official warnings exist for some supplements. Specifically, supplements known to increase serotonin, such as St. John’s Wort, may increase the risk of a serious condition called Serotonin Syndrome and should be avoided. Major drug labels do not detail specific interactions for most common vitamins.


Q: What happens if you miss a dose of Perrigo Citalopram?

If a dose is forgotten, official guidance states to take the missed dose as soon as it is recalled, unless the time for the next scheduled dose is imminent. Regulatory instructions state that a patient should never double the dose to make up for a missed one.


Q: Can Perrigo Citalopram be used by teenagers or only adults?

Citalopram is generally not approved for use in younger populations. Official regulatory documents indicate that the safety and effectiveness have not been established in patients under 18 years of age.


Q: Can taking Perrigo Citalopram cause stomach issues like nausea or diarrhea?

Yes, gastrointestinal issues are frequently reported. Nausea is listed as a very common side effect of citalopram. Diarrhea is also reported as an adverse reaction in clinical trials.


Q: Can Perrigo Citalopram cause headaches?

Headache is a commonly reported adverse reaction in clinical studies. According to official adverse reaction data, this is one of the more common effects experienced by patients taking citalopram.


Q: What's the difference between Perrigo Citalopram and Lexapro (escitalopram)?

Citalopram is a racemic mixture, meaning the drug contains two forms of the molecule. Escitalopram (Lexapro) is a similar SSRI, but it only contains the one form that is considered the most therapeutically active (known as the S-enantiomer). Both drugs function to increase serotonin in the brain.


Q: Is Perrigo Citalopram safe to use during pregnancy?

Regulatory guidance states that use during pregnancy is not generally recommended unless the potential clinical benefit outweighs the potential risks to the developing fetus. The decision to use this drug requires careful consideration of the risks and benefits by a medical professional.


Q: Why do some people experience vivid dreams or nightmares on Perrigo Citalopram?

Official adverse reaction data includes abnormal dreams, which can manifest as vivid dreams or nightmares. This is a reported effect associated with how the drug influences brain chemistry and sleep cycles.


Q: Does Perrigo Citalopram have a sedative effect?

The listing of sleepiness (somnolence) as a common side effect in official product information suggests a potential for a sedating effect in some patients.


Q: Can you take ibuprofen or Tylenol (acetaminophen) with Perrigo Citalopram?

Official warnings exist for ibuprofen (an NSAID), as taking it with citalopram may increase the risk of bleeding. Conversely, the use of acetaminophen (Tylenol) is not specifically associated with a major interaction warning in the key regulatory documents.


Q: Can Perrigo Citalopram affect driving or operating machinery?

Official patient safety information states that as psychoactive drugs can impair motor skills, caution is required when operating hazardous machinery, such as automobiles, until the patient knows how the medication affects them.


Q: Why do doctors often prescribe Perrigo Citalopram?

Citalopram is officially indicated and approved for the treatment of Major Depressive Disorder (MDD) in adults. It belongs to the class of Selective Serotonin Reuptake Inhibitors (SSRIs), which are a common therapeutic option for this condition.


Q: What is the half-life of Perrigo Citalopram?

Pharmacokinetic data from regulatory sources show that the mean terminal elimination half-life of citalopram is approximately 35 hours. This refers to the time it takes for half of the drug to be cleared from the bloodstream.


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How should Perrigo Citalopram be stored and disposed of?

How to Store and Dispose of Perrigo Citalopram?

This section explains the official regulatory requirements for the storage and disposal of Citalopram hydrobromide tablets, as defined by government health authorities.

Official Storage Requirements

Requirement Specifics
Temperature Store at controlled room temperature (20 C to 25 C), away from excess heat.
Environment Keep away from excess moisture; do not store the product in the bathroom.
Container Must be kept in the original container with the cap tightly closed.
Child Safety Mandatory to store the medicine strictly out of the sight and reach of children and pets.

Official Disposal Rules

Expired or unused Perrigo Citalopram must not be thrown away into household trash or wastewater unless specifically instructed by a local authority. Disposal must follow official procedures, such as drug take-back programs or consultation with a pharmacist, to protect the environment and prevent contamination.

Attention! Always consult to a doctor or pharmacist before using pills or medicines.

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