Citalopram STELLA 20 mg

Rx

Indications:

• Treatment of major depressive episodes.
• Treatment of panic disorder with or without agoraphobia.

Dosage:

Adults

• Major depressive episodes: A single dose of 20 mg daily, depend on response, may be increased to a maximum of 40 mg daily; treatment should continue until the patient has been free of symptoms for 4 – 6 months to give adequate protection against the possibility of a relapse.
• Panic disorder: A single dose of 10 mg for first week before increasing the dose to 20 mg daily, depend on response, may be increased to maximum 40 mg daily; continue treatment for several months.

Older people (> 65 years of age): Half of the recommended dose.

Reduced hepatic function mild – moderate or poor metabolisers regarding CYP2C19: 10 mg daily for the first two weeks, may be increased to a maximum of 20 mg daily.

Stopping treatment: Gradually reduced over a period of at least one to two weeks. If intolerable symptoms occur following a dosage decrease/discontinuation of treatment: resuming the previously prescribed dose; continue decreasing the dose, but at a more gradual rate.

Reduced renal function mild to moderate: Dosage adjustment is not necessary; severe (ClCr < 20 ml/min): Do not use.

Children and adolescents under 18 years of age: Do not use.

Usage:

Taken with or without food, but with fluid, either in the morning or in the evening.

• Known hypersensitivity to any ingredient in the formulation.
• The combination with linezolid unless there are facilities for close observation and monitoring of blood pressure.
• Patients with know QT-interval prolongation or congenital long QT syndrome.
• The co-administration with medicinal products that are known to prolong the QT-interval.
• Citalopram should not be given to patients receiving monoamine oxidase inhibitors (MAOIs)

Very common:

Agitation, nervousness; lethargy, insomnia, tremor, dizziness, headache, somnolence; abnormal accommodations; palpitations; dry mouth, nausea, constipation; increased sweating; asthenia.

Common:

Appetite decreased, weight decreased; libido decreased, abnormal orgasm (female), anxiety, confusional state, apathy, impaired concentration, abnormal dreams, memory loss; paraesthesia, sleeping disorders, migraine, taste disturbance, disturbance in attention; visual disturbance; tinnitus; tachycardia; hypotension, hypertension, orthostatic hypotension; diarrhoea, vomiting, dyspepsia, abdominal pain, flatulence, increased salivation; pruritus, rash; myalgia, arthralgia; polyuria, micturition disorder; impotence, ejaculation disorder, ejaculation failure, dysmenorrhea; fatigue, pyrexia.

• Caution when using Citalopram STELLA 20 mg for patients with diabetes; unstable epilepsy (avoid using); controlled epilepsy; significant bradycardia, recent acute myocardial infarction/uncompensated heart failure; reduced kidney and liver function; angle-closure glaucoma or history of glaucoma; elderly patients; pregnancy (consideration of the benefit/risk); nursing women.
• Electrolyte disturbances should be corrected before treatment with citalopram is started.
• Risk of suicidal/suicide thoughts or clinical worsening.
• Citalopram should be discontinued if there is an increase in seizure frequency; signs of cardiac arrhythmia; enter a manic phase in patients with manic – depressive illness; serotonin syndrome (rare).
• Withdraw symptoms seen on discontinuation of treatment.
• Concurrent administration of citalopram and ECT (electro-convulsive therapy).
• There have been reports of prolonged bleeding time and/or bleeding abnormalities.
• Treatment of psychotic patients with depressive episodes may increase psychotic symptoms.
• Patients with rare hereditary problems of galactose intolerance, total lactase deficiency or glucose-galactose malabsorption should not take this medicine.
• Caution when driving/operating machines.