Citalopram 20mg Film-Coated Tablets

Document: leaflet MAH GENERIC_PL 17907-0090 change

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PACKAGE LEAFLET: INFORMATION FOR THE USER

CITALOPRAM10MG FILM-COATED TABLETS CITALOPRAM 20MG FILM-COATED TABLETS CITALOPRAM 40MG FILM-COATED TABLETS

Important things you need to know about Citalopram

Please read all of the leaflet. It Includes a lot of additional information

about this medicine.

• Citalopram treats depression. Like all medicines it can have unwanted effects. It is therefore important that you and your doctor weigh up the benefits of treatment against the possible unwanted effects, before starting treatment.

• Citalopram is not for use in children and adolescents under 18.

See section 2, Children and adolescents under 18, inside this leaflet

• Citalopram won’t work straight away. Some people taking antidepressants feel worse before feeling better. Your doctor should ask to see you again a couple of weeks after you first start treatment. Tell your doctor if you haven’t started feeling better. See section 3, inside this leaflet

• Some people who are depressed or anxious think of harming or killing themselves. If you start to feel worse, or think of harming or killing yourself, see your doctor or go to a hospital straight away. See section 2 ‘ Thoughts of suicide or worsening of depression or anxiety disorder’ inside this leaflet.

• Don’t stop taking Citalopram without talking to your doctor. If you stop taking Citalopram suddenly or miss a dose, you may get withdrawal effects. See section 3, ‘Effects when treatment with Citalopram tablets is stopped', inside this leaflet.

• If you feel restless and feel like you can’t sit or stand still, tell your doctor. Increasing the dose of Citalopram may make these feelings worse. See section 4, inside this leaflet.

• Taking some other medicines with Citalopram can cause problems. You may need to talk to your doctor. See section 2, ‘Other medicines and Citalopram tablets’ inside this leaflet.

• If you are pregnant or planning to get pregnant, talk to your doctor. See ‘Pregnancy and breast-feeding' inside this leaflet.

Read all of this leaflet carefully before you start taking this

medicine because it contains important information for you.

• Keep this leaflet. You may need to read it again.

• If you have any further queries, ask your doctor or pharmacist.

• This medicine has been prescribed for you only. Do not pass it on to others. It may harm them, even if their signs of illness are the same as yours.

• If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet.

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 for

The active ingredient citalopram, is a Selective Serotonin Reuptake Inhibitor (SSRI) and belongs to a group of medicines known as antidepressants. These medicines help to correct certain chemical imbalances in the brain that are causing the symptoms of your illness. This medicine 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 these tablets:

• if you are allergic (hypersensitive) to citalopram or to any of the other ingredients of this medicine (see section 6). Consult your doctor if you think you might be.

• if you are also taking a medicine containing pimozide. Talk to your doctor.

• 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 you must allow 1 week before taking anyMAOI.

• 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 affect the heart’s rhythm (see other medicines and citalopram tablets, below).

Warnings and precautions

Please tell your doctor if you have any medical problems, especially if you have:

• Liver disease, Kidney disease.

• Diabetes (you may need an adjustment of your antidiabetic therapy).

• Epilepsy or a history of seizures or fits.

• A bleeding disorder or have ever suffered from bleeding in the stomach or intestine.

• Mania or panic disorder

• Low blood levels of sodium

• ECT (electroconvulsive therapy)

• Problems with your eyes, such as certain kinds of glaucoma.

• 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.

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.

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 suicide and worsening of your depression or anxiety disorder

If you are depressed and/or have anxiety disorders you can sometimes have thoughts of harming or killing yourself. These may be increased when first starting antidepressants, since these medicines all take time to work, usually about two weeks but sometimes longer.

You may be more likely to think like this:

• If you have previously had thoughts about killing or harming yourself.

• If you are a young adult. Information from clinical trials has shown an increased risk of suicidal behaviour in adults aged less than 25 years with psychiatric conditions who were treated with an antidepressant.

If you have thoughts of harming or killing yourself at any time, contact your doctor or go to a hospital straight away.

You may find it helpful to tell a relative or close friend that you are depressed or have an anxiety disorder, and ask them to read this leaflet. You might ask them to tell you if they think your depression or anxiety is getting worse, or if they are worried about changes in your behaviour. Use in children and adolescents under 18 years of age Citalopram 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 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. 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 tablets Please tell your doctor or pharmacist if you are taking or have taken any other medicines (including those purchased without prescription) during the last 14 days. This includes other medicines for depression (see Do not take these tablets above).

• The herbal remedy St John’s wort (Hypericum perforatum). This should not be taken at the same time as citalopram.

• Monoamine oxidase inhibitors (MAOIs). These should not be taken at the same time as citalopram (see Do not take these tablets above).

Tell your doctor if you are taking any of the following medicines:

• Linezolid (an antibiotic).

• Sumatriptan (used to treat migraine) or tramadol (a pain killer). If you feel unwell when using these medicines with citalopram you should see your doctor.

• 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 (see Do not take these tablets above).

• Imipramine and desipramine (used to treat depression).

• Medicines containing selegiline (used to treat Parkinson's disease)

• Cimetidine (used to treat stomach ulcers).

• 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 the heart's rhythm, e.g. such as Class IA and III antiarrhythmics, antipsychotics (e.g. fentiazine 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.

Citalopram tablets with food, drink and alcohol Citalopram tablets can be taken with or without food (see section 3). 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

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. When taken during pregnancy, particularly in the last 3 months of pregnancy, medicines like citalopram 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 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 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. |

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Artwork Same Size Size : 470 x 130 mm

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Revision : IBRNNA/O

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 tablets contain Lactose

• If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicinal product.

3. How to take Citalopram Tablets

• It is important to take your tablets as instructed by your doctor.

• The label will tell you how many to take and how often. If it does not, or you are not sure, ask your doctor or pharmacist.

• Citalopram tablets are 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.

The usual doses are as follows:

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 your 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 (< 18 years)

Citalopram tablets should not be given to children or adolescents. For further information, please see section 2.

Patients with special risks

Patients with liver problems should not receive more than 20 mg per day.

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 nearest hospital emergency department immediately. Do this even if there are no signs of discomfort or poisoning. Take the Citalopram tablets 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, changes in heart rhythm

• Seizures

• 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 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.

Effects when treatment with Citalopram tablets is stopped

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 is usually reduced gradually over a couple of weeks.

If you have any further questions on the use of this product, ask your doctor or pharmacist.

| 4. Possible Side Effects |

Like all medicines, Citalopram tablets can have side effects and some people may experience unwanted effects (side effects) whilst taking citalopram. 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 this medicine and seek medical advice immediately if you have any of the following allergic reactions:

• 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 heart beat, 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, difficulties in sleeping

• 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

• Decreased sex drive

• Anxiety, nervousness, confusion

• Abnormal dreams

• Tremor

• Tingling or numbness in the hands or feet

• Ringing in the ears (tinnitus)

• Yawning

• Diarrhoea, constipation, vomiting

• Itching, prickling of the skin

• Pain in muscles and joints

• For men, problems with ejaculation and erection

• For females, failing to reach an orgasm

• Tiredness

• Loss of weight

Uncommon: may affect up to 1 in every 100 people

• Bruising easily

• Increased appetite, increased weight

• Aggression

• Reduced emotions, indifference

• Hallucinations, mania

• Fainting

• Large pupils (the dark centre of the eye)

• Fast and slow heart beat

• Nettle rash

• Loss of hair

• Sensitivity to sunlight

• Difficulties urinating or vaginal bleeding

• Swelling of the arms or legs

Rare: may affect up to 1 in every 1000 people

• Convulsions

• Involuntary movements

• Taste disturbances

• Bleeding

• Hepatitis

Not known: frequency cannot be estimated from the available data

• Thoughts of harming or killing themselves

• An increase in bleeding or bruising caused by a decrease in blood platelets

• Rash (hypersensitivity)

• Low potassium levels in the blood (hypokalaemia), which can cause muscle weakness, twitching or abnormal heart rhythms

• Panic attack or restlessness

• Grinding teeth

• Unusual muscle movements or stiffness

• Involuntary movements of the muscles (akathisia)

• Low blood pressure

• Bleeding disorders including skin and mucosal bleeding (ecchymosis)

• Sudden swelling of skin or mucosa, nose bleed

• In men, painful erections

• Flow of breast milk in men or in women who are not breast-feeding (galactorrhoea)

• Abnormal liver function tests

• An increased risk of bone fractures has been observed in patients taking this type of medicines.

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, 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: www.mhra.gov.uk/yellowcard. By reporting side effects 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.

• Do not store above 25°C. Store in the original package in order to

protect the tablets from light and moisture.

• There is an expiry date on the carton, label or blister foil. Do not use the medicine after this date.

• 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

• The active substance is citalopram (as hydrobromide).

Each Citalopram film-coated tablets contain 10 mg, 20 mg, or 40 mg citalopram.

• The other ingredients are maize starch, lactose monohydrate, microcrystalline cellulose, croscarmellose sodium, magnesium stearate, hypromellose, purified talc, macrogol and the white colour E 171 (titanium dioxide).

What Citalopram Tablets look like and contents of the pack

• The 10mg tablets are white to off white, round, plain, film-coated.

• The 20mg tablets are white to off white, oval, biconvex, film-coated with BL embossed on one side, & '20' on the other.

• The 40mg tablets are white to off white, oval, biconvex, film-coated with BL embossed on one side, & ‘40’ on the other.

• They are available in - Blister: Pack sizes of 14,28,56 or 84 tablets, Containers: Pack size of 1000 tablets.

• Not all pack sizes may be marketed.

Marketing Authorization Holder and Manufacturer:

Name and address: Bristol Laboratories Ltd,

Unit 3, Canalside, Northbridge Road, Berkhamsted, Hertfordshire,

HP41EG, United Kingdom Telephone: 0044 (0)1442 200922

Fax: 0044 (0)1442 873717

Email: info@bristol-labs.co.uk

Citalopram 10mg Film-coated Tablets; PL 17907/0089 Citalopram 20mg Film-coated Tablets; PL 17907/0090 ₃

Citalopram 40mg Film-coated Tablets; PL 17907/0091 t

This leaflet was last revised in February 2015 -

To request a copy of this leaflet in Braille, large print or audio format, please contact the licence holder at the address (or telephone, fax, email) above. wzwh-isdo

PACKAGE LEAFLET: INFORMATION FOR THE USER_

CITALOPRAM10MG FILM-COATED TABLETS CITALOPRAM 20MG FILM-COATED TABLETS CITALOPRAM 40MG FILM-COATED TABLETS

Important things you need to know about Citalopram

Please read all of the leaflet. It Includes a lot of additional information

about this medicine.

• Citalopram is not for use in children and adolescents under 18.

See section 2, Children and adolescents under 18, inside this leaflet

• If you feel restless and feel like you can’t sit or stand still, tell your doctor. Increasing the dose of Citalopram may make these feelings worse. See section 4, inside this leaflet.

• Taking some other medicines with Citalopram can cause problems. You may need to talk to your doctor. See section 2, ‘Other medicines and Citalopram tablets’ inside this leaflet.

• If you are pregnant or planning to get pregnant, talk to your doctor. See ‘Pregnancy and breast-feeding' inside this leaflet.

Read all of this leaflet carefully before you start taking this

medicine because it contains important information for you.

• Keep this leaflet. You may need to read it again.

• If you have any further queries, ask your doctor or pharmacist.

• This medicine has been prescribed for you only. Do not pass it on to others. It may harm them, even if their signs of illness are the same as yours.

• If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet.

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 for

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 these tablets:

• if you are allergic (hypersensitive) to citalopram or to any of the other ingredients of this medicine (see section 6). Consult your doctor if you think you might be.

• if you are also taking a medicine containing pimozide. Talk to your doctor.

• 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 affect the heart’s rhythm (see other medicines and citalopram tablets, below).

Warnings and precautions

Please tell your doctor if you have any medical problems, especially if you have:

• Liver disease, Kidney disease.

• Diabetes (you may need an adjustment of your antidiabetic therapy).

• Epilepsy or a history of seizures or fits.

• A bleeding disorder or have ever suffered from bleeding in the stomach or intestine.

• Mania or panic disorder

• Low blood levels of sodium

• ECT (electroconvulsive therapy)

• Problems with your eyes, such as certain kinds of glaucoma.

• 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.

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.

Special information relating to your disease

Thoughts of suicide and worsening of your depression or anxiety disorder

You may be more likely to think like this:

• If you have previously had thoughts about killing or harming yourself.

If you have thoughts of harming or killing yourself at any time, contact your doctor or go to a hospital straight away.

taking citalopram. 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.

• The herbal remedy St John’s wort (Hypericum perforatum). This should not be taken at the same time as citalopram.

• Monoamine oxidase inhibitors (MAOIs). These should not be taken at the same time as citalopram (see Do not take these tablets above).

Tell your doctor if you are taking any of the following medicines:

• Linezolid (an antibiotic).

• Sumatriptan (used to treat migraine) or tramadol (a pain killer). If you feel unwell when using these medicines with citalopram you should see your doctor.

• 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 (see Do not take these tablets above).

• Imipramine and desipramine (used to treat depression).

• Medicines containing selegiline (used to treat Parkinson's disease)

• Cimetidine (used to treat stomach ulcers).

• Mefloquine (used to treat malaria).

• Bupropion (used to treat depression).

• 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).

Pregnancy

Fertility

Citalopram has been shown to reduce the quality of sperm in animal studies. Theoretically, this could affect fertility, but impact on _shuman fertility has not been observed as yet. 1

Artwork Same Size H Black

Size : 470 x 140 mm

Kaypee Design (kaypeedesign@gmail.com) 20 04 15

Ph. Code 1358

Revision : IBRNN9/0