How Citalopram care of us.

uses of Citalopram Citalopram is an antidepressant ( selective serotonin reuptake inhibitor-SSRI ) used to treat depression. It works by restoring balance of certain natural substances ( neurotransmitters such as serotonin ) in the brain. Citalopram may improve your feelings of well-being and energy level.

how to use of Citalopram Read Medication Guide provided by your pharmacist before you start using Citalopram and each time we get a refill. If you have any questions, consult your doctor or pharmacist.

Take Citalopram once daily in the morning or evening, with or without food or as directed by your doctor. The dosage is based on your medical condition and response to treatment. If you're using the liquid form of Citalopram, measure dose carefully using a special measuring device/spoon. Don't use a household spoon because you may not get the correct dose.

To reduce your risk of side effects, your doctor may direct you to start taking Citalopram at a low dose and gradually increase your dose. Follow your doctor's instructions carefully. Don't take more or less medication or take it more frequently than prescribed. Your condition will not improve any faster, and your risk of side effects will increase. Use this medication regularly in order to get most benefit from it. To help we remember, use it at same time each day.

It is important to continue taking Citalopram even if you feel well. Don't stop taking Citalopram without consulting your doctor. Some conditions may become worse when the drug is suddenly stopped. Your dose may need to be gradually decreased.

Citalopram may cause dependence, especially if it has been used regularly for an extended time or if it has been used in high doses. In such cases, withdrawal reactions ( e. g. , nervousness, headache, numbness, tingling, trouble sleeping, nightmares ) may occur while use Citalopram if you suddenly stop this drug. To prevent withdrawal when stopping extended/regular treatment with this drug, gradually reduce the dosage as directed. Consult your doctor or pharmacist for more details, and report any withdrawal reactions immediately.

It may take 1 to 2 weeks to feel a benefit from Citalopram and 4 weeks to feel full benefit of Citalopram. Tell your doctor if your condition persists or worsens.

other used of Citalopram This section contains uses of Citalopram that are not listed in the approved professional labeling for drug but that may be prescribed by your health care professional. Use Citalopram for a condition that's listed in this section only if it has been so prescribed by your health care professional.

Citalopram is also used to treat other mental conditions ( obsessive-compulsive disorder, panic disorder ) .

side effects of Citalopram See also Warning section.

Nausea, dry mouth, trouble sleeping, loss of appetite, weakness, tiredness, drowsiness, dizziness, increased sweating, blurred vision, or yawning may occur while use Citalopram. If any of these effects persist or worsen, tell your doctor promptly.

Remember that your doctor has prescribed Citalopram because he or she has judged that benefit to you is greater than the risk of side effects. Many people using Citalopram don't have serious side effects.

Tell your doctor immediately if any of these unlikely but serious side effects occur:

Tell your doctor immediately if any of these rare but very serious side effects occur:

Citalopram may rarely cause a very serious condition called serotonin syndrome. The risk increases when Citalopram is used with certain other drugs such as " triptans " used to treat migraine headaches ( e. g. , sumatriptan, eletriptan ) , certain antidepressants including other SSRIs ( e. g. , fluoxetine, paroxetine ) and SNRIs ( e. g. , venlafaxine ) , lithium, tramadol, tryptophan, or a certain drug to treat obesity ( sibutramine ) . See also Drug Interactions section. Before taking Citalopram, tell your doctor if you take any of these medications. Serotonin syndrome may be more likely when we start or increase dose of any of these medications. Seek immediate medical attention if we develop some of following symptoms:

For males, in very unlikely event we have a painful or prolonged erection lasting 4 or more hours, stop using Citalopram and seek immediate medical attention, or permanent problems could occur.

A very serious allergic reaction to Citalopram is rare. However, seek immediate medical attention if we notice any symptoms of a serious allergic reaction, including:

This is not a complete list of possible side effects. If we notice other effects not listed above, contact your doctor or pharmacist.

precautions of Citalopram Before taking Citalopram, tell your doctor or pharmacist if we are allergic to it; or to esCitalopram; or if we have any other allergies.

Before using Citalopram, tell your doctor or pharmacist your medical history, especially of:

Citalopram may make we dizzy or drowsy. Use caution while driving, using machinery, or doing any other activity that requires alertness. Avoid alcoholic beverages.

Caution is advised when using Citalopram in elderly because they may be more sensitive to its effects. The elderly are more likely to lose too much salt ( hyponatremia ) , especially if they're also taking " water pills " ( diuretics ) with Citalopram.

Citalopram isn't recommended for use during pregnancy. It may harm an unborn baby. Also, babies born to mothers who have used Citalopram during the last 3 months of pregnancy may infrequently develop withdrawal symptoms such as feeding/breathing difficulties, seizures, muscle stiffness, or constant crying. If you notice any of these symptoms in your newborn, tell doctor promptly.

Since untreated depression can be a serious condition, do not stop taking Citalopram unless directed by your doctor. If we are planning pregnancy, become pregnant, or think we may be pregnant, immediately discuss benefits and risks of using Citalopram during pregnancy with your doctor.

Citalopram passes into breast milk and may have undesirable effects on a nursing infant. Breast-feeding isn't recommended while using Citalopram. Consult your doctor before breast-feeding.

interactions of Citalopram Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring we for them. Don't start, stop, or change dosage of any medicine before checking with your doctor or pharmacist first.

Taking certain medications with Citalopram could result in serious ( rarely fatal ) drug interactions. Avoid taking MAO inhibitors ( e. g. , furazolidone, isocarboxazid, linezolid, moclobemide, phenelzine, procarbazine, rasagiline, selegiline, tranylcypromine ) with Citalopram for 2 weeks before treatment, during treatment, or for 2 weeks after your last dose of Citalopram.

Citalopram should not be used with the following medications because very serious interactions may occur while use Citalopram:

If you are currently using any of these medications, tell your doctor or pharmacist before starting Citalopram.

Before using Citalopram, tell your doctor or pharmacist of all prescription and nonprescription/herbal products we may use, especially of:

Aspirin can increase risk of bleeding when used with Citalopram ( see above ) . If your doctor has directed we to take low-dose aspirin for heart attack or stroke prevention ( usually at dosages of 81-325 milligrams a day ) , we should continue taking it unless your doctor instructs we otherwise. Discuss the risks and benefits with your doctor.

Also tell your doctor if we take any other drugs that increase serotonin, such as buspirone, dextromethorphan, lithium, meperidine, propoxyphene, phentermine, other SSRIs ( e. g. , paroxetine ) , SNRIs ( e. g. , duloxetine ) , tryptophan, St. John's wort, drugs used to treat migraines such as " triptans " and dihydroergotamine, street drugs such as MDMA/ " ecstasy, " amphetamine. ( See also Side Effects section. )

Tell your doctor or pharmacist if you also take drugs that cause drowsiness, such as certain antihistamines ( e. g. , diphenhydramine ) , anti-seizure drugs ( e. g. , carbamazepine ) , medicine for sleep or anxiety ( e. g. , lorazepam, zolpidem ) , muscle relaxants, narcotic pain relievers ( e. g. , codeine ) , psychiatric medicines ( e. g. , chlorpromazine, quetiapine, nortriptyline, trazodone ) . Check labels on all your medicines ( e. g. , cough-and-cold products ) because they may contain ingredients that cause drowsiness.

Cimetidine is a nonprescription drug that's commonly used to treat extra stomach acid. Because it may cause undesirable interactions when used with Citalopram, ask your pharmacist about other products to treat stomach acid.

This document doesn't contain all possible interactions. Therefore, before using Citalopram, tell your doctor or pharmacist of all products we use. Keep a list of all your medications with you, and share list with your doctor and pharmacist.

overdose of Citalopram If overdose of Citalopram is suspected, contact your local poison control center or emergency room immediately. US residents can call the US National Poison Hotline at 1-800-222-1222. Canada residents can call a provincial poison control center.

notes of Citalopram Don't share Citalopram with others.

Psychiatric/medical check-ups and possibly lab tests should be done periodically to monitor your progress or check for side effects. Consult your doctor for more details.

missed dose of Citalopram If we miss a dose Citalopram, take it as soon as we remember. If it's near time of next dose, skip missed dose and resume your usual dosing schedule. Don't double dose of Citalopram to catch up.

storage of Citalopram Store Citalopram at room temperature at 77 degrees F ( 25 degrees C ) away from light and moisture. Brief storage between 59-86 degrees F ( 15-30 degrees C ) is permitted. Do not store Citalopram in bathroom. Keep all medicines away from children and pets.

Properly discard Citalopram when it's expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.

warning of Citalopram Antidepressant medications are used to treat a variety of conditions, including depression and other mental/mood disorders. These medications can help prevent suicidal thoughts/attempts and provide other important benefits. However, studies have shown that a small number of people ( especially children/teenagers ) who take antidepressants for any condition may experience worsening depression, other mental/mood symptoms, or suicidal thoughts/attempts. Therefore, it is very important to talk with doctor about risks and benefits of antidepressant medication ( especially for children/teenagers ) , even if treatment is not for a mental/mood condition.

Tell doctor immediately if you notice worsening depression/other psychiatric conditions, unusual behavior changes ( including possible suicidal thoughts/attempts ) , or other mental/mood changes ( including new/worsening anxiety, panic attacks, trouble sleeping, irritability, hostile/angry feelings, impulsive actions, severe restlessness, very rapid speech ) . Be especially watchful for these symptoms when a new antidepressant is started or when dose is changed.

FDA approved Citalopram

New-look National Prescribing Service Pharmacy Review Improves Health By Building Rapport, Australia

Pharmacists say relationships with patients are extended and supported by the National Prescribing Service Limited's ( NPS ) new-look Pharmacy Practice Review counselling and action resource and this is yielding better results for patients.

Designed to better support pharmacist-patient counselling and interaction, new-look materials include tear-off pads with information to give to patients, an action checklist for pharmacists to work through with individual patients and the latest clinical information about best practice.

Launched in 2001 as Pharmacy Practice Audit and now called Pharmacy Practice Review, it retains the self-audit component for pharmacy professionals to help pharmacists keep up with best practices for specific conditions. Participants receive a feedback report that includes individual results, aggregated results of total participating pharmacist group and provides expert commentary on the aggregate results.

Sydney-based pharmacist Irene McMartin said the new approach has prompted her to think about way she counsels patients.

" The focus is on me. It gets me to reflect on how well I did and how I can improve my service and level of care. It reminds me to ask people about their lifestyles, " Ms McMartin said.

" The review kit has been well received. Pharmacists say they're using the materials to form closer relationships with their patients, which is yielding positive results, " NPS Acting CEO, Karen Kaye said.

South Australian-based pharmacist Thelma Tantalos, says the reviews she has done have helped develop her communication skills and encourage more meaningful interactions with her patients.

" I would definitely recommend them to other pharmacists. They help us to optimise our counselling and achieve best results for each of our customers. The review is now easier to follow and easier to apply with each patient, " she said.

David North, a New South Wales-based pharmacist who is completing current Pharmacy Practice Review 'Enhancing patient care in type 2 diabetes' , said it helps him establish priorities when counselling patients and reminds him to also ask lifestyle questions.

" The presentation is much easier; it's more in-depth, it sets out points to encourage adherence to medication and it encourages us [pharmacists] to discuss lifestyle matters such as exercise, " Mr North said. " For instance, if they are playing golf, we ask them, how's your golf going? The review takes a more holistic approach and there have been flow-on effects. Our patients are now volunteering information so we are receiving information about other aspects of their health, such as if they have a weight problem or if they smoke. "

The review package is a part of NPS's broader vision to encourage quality use of medicines by enabling pharmacists and health professionals to deliver best-practice management care. The review uses best practice guidelines to help pharmacists and staff review current practice, consider introducing changes, review and reflect on these changes, and to monitor their progress.

NPS resources also help pharmacists keep up to date and build core competencies that contribute to their continuing professional development.

To take part in new Pharmacy Practice Review go to http: //www. nps. org. au/healthpro, email info@nps. org. au or call 02 8217 8700. When we have completed activity, return your forms to NPS by 25 July 2008 to receive feedback in December 2008, or by 24 October 2008 to receive feedback in February 2009.

National Prescribing Service Limited ( NPS ) is an independent, non-profit organisation for Quality Use of Medicines funded by the Australian Government Department of Health and Ageing.

National Prescribing Service Limited

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