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Drug Interactions between citalopram and oritavancin

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Major

citalopram oritavancin

Applies to: citalopram and oritavancin

Consumer information for this interaction is not currently available.

ADJUST DOSE: Coadministration with CYP450 2C19 inhibitors may increase the plasma concentrations of citalopram, which is partially metabolized by the isoenzyme. In 12 healthy subjects who had received citalopram 40 mg once a day for 21 days, administration of cimetidine 400 mg twice a day for 8 days increased the steady-state citalopram peak serum concentration (Cmax) and systemic exposure (AUC) by 39% and 43%, respectively. In addition to inhibiting CYP450 2C19, cimetidine is also an inhibitor of CYP450 2D6 and 3A4, both of which participates in the metabolism of citalopram. The extent to which sole inhibitors of CYP450 2C19 may inhibit citalopram metabolism is unknown. Clinically, high plasma levels of citalopram may increase the risk of QT interval prolongation and torsade de pointes arrhythmia. In a randomized, double-blind, crossover, escalating multiple-dose study consisting of 119 healthy subjects, the maximum mean increase in corrected QT interval from placebo was 8.5 msec for citalopram 20 mg and 18.5 msec for citalopram 60 mg. Based on the established exposure-response relationship, prolongation of the corrected QT interval was estimated to be 12.6 ms for citalopram 40 mg. Cases of QT interval prolongation and torsade de pointes have been reported during postmarketing use. In general, the risk of ventricular arrhythmia in association with QT prolongation is largely unpredictable, but may be increased by certain underlying risk factors such as congenital long QT syndrome, cardiac disease, and electrolyte disturbances (e.g., hypokalemia, hypomagnesemia).

MANAGEMENT: Given the risk of dose-dependent QT prolongation, citalopram dosage should not exceed 20 mg/day when prescribed in combination with CYP450 2C19 inhibitors such as cimetidine, esomeprazole, etravirine, felbamate, fluconazole, lansoprazole, letrozole, modafinil, omeprazole, oxcarbazepine, ticlopidine, and voriconazole. Alternatives should be considered when possible, and hypokalemia or hypomagnesemia should be corrected prior to initiation of citalopram treatment and periodically monitored. Patients should be advised to seek medical attention if they experience symptoms that could indicate the occurrence of torsade de pointes such as dizziness, palpitations, irregular heartbeat, shortness of breath, or syncope.

Drug and food interactions

Moderate

citalopram food

Applies to: citalopram

Alcohol can increase the nervous system side effects of citalopram such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with citalopram. Do not use more than the recommended dose of citalopram, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you. Talk to your doctor or pharmacist if you have any questions or concerns.

Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.


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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.