Information For Patients Physicians are advised to discuss the following issues with patients for whom they prescribe Celexa. Patients should be cautioned about the risk of serotonin syndrome with the concomitant use of Celexa and triptans, tramadol or other serotonergic agents.
Patients should be advised that taking Celexa can cause mild pupillary dilation, which in susceptible individuals, can lead to an episode of angle closure glaucoma. Pre-existing glaucoma is almost always open-angle glaucoma because angle closure glaucoma, when diagnosed, can be treated definitively with iridectomy. Open-angle glaucoma is not a risk factor for angle closure glaucoma. Patients may wish to be examined to determine whether they are susceptible to angle closure, and have a prophylactic procedure e.
Although in controlled studies Celexa has not been shown to impair psychomotor performance, any psychoactive drug may impair judgment, thinking, or motor skills, so patients should be cautioned about operating hazardous machinery, including automobiles, until they are reasonably certain that Celexa therapy does not affect their ability to engage in such activities. Patients should be told that, although Celexa has not been shown in experiments with normal subjects to increase the mental and motor skill impairments caused by alcohol, the concomitant use of Celexa and alcohol in depressed patients is not advised.
Patients should be advised to inform their physician if they are taking, or plan to take, any prescription or over-the-counter drugs, as there is a potential for interactions. Patients should be cautioned about the concomitant use of Celexa and NSAIDs, aspirin, warfarin, or other drugs that affect coagulation since combined use of psychotropic drugs that interfere with serotonin reuptake and these agents has been associated with an increased risk of bleeding.
Patients should be advised to notify their physician if they become pregnant or intend to become pregnant during therapy. Patients should be advised to notify their physician if they are breastfeeding an infant. While patients may notice improvement with Celexa therapy in 1 to 4 weeks, they should be advised to continue therapy as directed. Prescribers or other health professionals should inform patients, their families, and their caregivers about the benefits and risks associated with treatment with Celexa and should counsel them in its appropriate use.
The prescriber or health professional should instruct patients, their families, and their caregivers to read the Medication Guide and should assist them in understanding its contents. Patients should be given the opportunity to discuss the contents of the Medication Guide and to obtain answers to any questions they may have.
The complete text of the Medication Guide is reprinted at the end of this document. Patients should be advised of the following issues and asked to alert their prescriber if these occur while taking Celexa. Clinical Worsening And Suicide Risk Patients, their families, and their caregivers should be encouraged to be alert to the emergence of anxiety, agitation, panic attacks , insomnia, irritability, hostility, aggressiveness, impulsivity, akathisia psychomotor restlessness , hypomania, mania, other unusual changes in behavior, worsening of depression, and suicidal ideation, especially early during antidepressant treatment and when the dose is adjusted up or down.
Families and caregivers of patients should be advised to look for the emergence of such symptoms on a dayto-day basis, since changes may be abrupt. Such symptoms should be reported to the patient's prescriber or health professional, especially if they are severe, abrupt in onset, or were not part of the patient's presenting symptoms. Although trough citalopram plasma levels were unaffected, given the enzyme-inducing properties of carbamazepine, the possibility that carbamazepine might increase the clearance of citalopram should be considered if the two drugs are coadministered.
However, coadministration of citalopram 40 mg and ketoconazole mg , a potent inhibitor of CYP3A4, did not significantly affect the pharmacokinetics of citalopram. Because citalopram is metabolized by multiple enzyme systems, inhibition of a single enzyme may not appreciably decrease citalopram clearance.
Increased metoprolol plasma levels have been associated with decreased cardioselectivity. Coadministration of Citalopram HBr Tablets and metoprolol had no clinically significant effects on blood pressure or heart rate.
The clinical significance of the desipramine change is unknown. A no-effect dose for this finding was not established. The relevance of these findings to humans is unknown. Mutagenesis Citalopram was mutagenic in the in vitro bacterial reverse mutation assay Ames test in 2 of 5 bacterial strains Salmonella TA98 and TA in the absence of metabolic activation.
It was clastogenic in the in vitro Chinese hamster lung cell assay for chromosomal aberrations in the presence and absence of metabolic activation. It was not clastogenic in the in vitro chromosomal aberration assay in human lymphocytes or in two in vivo mouse micronucleus assays. This dose was also associated with maternal toxicity clinical signs, decreased body weight gain.
Thus, teratogenic effects were observed at a maternally toxic dose in the rat and were not observed in the rabbit. When female rats were treated with citalopram 4.
The no-effect dose of A no-effect dose was not determined in that study. There are no adequate and well-controlled studies in pregnant women; therefore, citalopram should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Nonteratogenic Effects Neonates exposed to Citalopram HBr Tablets and other SSRls or SNRls, late in the third trimester, have developed complications requiring prolonged hospitalization, respiratory support, and tube feeding.
Such complications can arise immediately upon delivery. Reported clinical findings have included respiratory distress, cyanosis, apnea, seizures, temperature instability, feeding difficulty, vomiting, hypoglycemia, hypotonia, hypertonia, hyperreflexia, tremor, jitteriness, irritability, and constant crying. These features are consistent with either a direct toxic effect of SSRls and SNRls or, possibly, a drug discontinuation syndrome.
PPHN occurs in 1- 2 per live births in the general population and is associated with substantial neonatal morbidity and mortality. In a retrospective, case-control study of women whose infants were born with PPHN and women whose infants were born healthy, the risk for developing PPHN was approximately six-fold higher for infants exposed to SSRIs after the 20th week of gestation compared to infants who had not been exposed to antidepressants during pregnancy.
Muestre la caja de los comprimidos. En caso de olvido de una dosis, espere a la siguiente. Pero no tome una dosis doble para compensar la dosis olvidada. Si interrumpe el tratamiento con Citalopram Ranbaxygen: Citalopram siempre debe interrumpirse de manera gradual durante un periodo de semanas.
Posibles efectos adversos Citalopram ranbaxygen 20 mg comprimidos recubiertos con pelicula Al igual que todos los medicamentos, Citalopram Ranbaxygen puede producir efectos adversos, aunque no todas las personas los sufran. Pase dos semanas asi, de tal forma que hubo un dia que tuve que volver a tomar los anti-ansioliticos para enganar al cuerpo y que me quitara el malestar, no toleraba el ruido, ni a la gente, era horrible! Pase de tomar una pastilla de 0. Hace un mes comence el mismo proceso con el Citalopram: Ahora voy por la media pastilla es decir solo 10 mg Lo importante es que sepas que lo que te pasa no es nada grave, es solo la reaccion de tu cuerpo a algo de lo que estaba acostumbrado y se esta liberando Carbamazepina usado para el tratamiento de la epilepsia.
Siga fielmente sus instrucciones. Los comprimidos deben tomarse con un poco de agua, y no deben masticarse. Recuerde tomar su medicamento. Lea todo el prospecto detenidamente antes de empezar a usar el medicamento.
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