Generic Celexa ( Citalopram )

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Celexa is a selective serotonin reuptake inhibitor (SSRI) used to treat depression in adults. It works by increasing the amount of serotonin in the brain, which helps improve mood and emotional balance.
The usual starting dose is 20 mg once daily, taken at the same time each day. Your doctor may adjust the dose based on how you respond. The maximum recommended dose is 40 mg per day for most adults, though lower doses are often used for older adults or people with liver problems.
The administration form is film-coated tablets containing 10 mg, 20 mg, and 40 mg of citalopram hydrobromide. The 20 mg tablet is white, oval, and scored, marked with "C" and "N" on either side of the score.
Celexa does not work overnight. You may start to feel a little better within a few weeks, but the full benefit usually takes several weeks of steady dosing. Do not stop taking it just because you do not feel an effect right away.
Alcohol should be avoided during treatment. It adds to the drowsiness and dizziness that citalopram can cause, and it can make depression worse.
The most common side effects are nausea, dry mouth, insomnia, and increased sweating. Sexual side effects, such as decreased libido or difficulty reaching orgasm, are also common but often not discussed.
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Common Use Celexa

Citalopram is a selective serotonin reuptake inhibitor. It works by blocking the reuptake of serotonin at nerve endings, which increases its availability in the spaces between nerve cells. This is thought to improve mood and emotional balance. Health Canada has approved Celexa for the symptomatic relief of depressive illness in adults. The relapse rate was significantly lower in Celexa-treated patients than in placebo-treated patients in two placebo-controlled studies conducted over a 24-week period in patients who responded to 6 or 8 weeks of acute treatment. Citalopram is not approved for use in patients under 18 years of age.

Basic Celexa Information

• INN (International Nonproprietary Name): Citalopram hydrobromide
• Brand names available in Canada: Celexa® (Lundbeck Canada Inc.); generics include Apo-Citalopram (Apotex Inc.), Teva-Citalopram (Teva Canada Limited), Sandoz Citalopram (Sandoz Canada Inc.), MINT-Citalopram (Mint Pharmaceuticals Inc.), ACT Citalopram (Teva Canada Limited), AG-Citalopram (Angita Pharma Inc.), and others.
• ATC Code: N06AB04
• Forms and dosages: Film-coated tablets – 10 mg, 20 mg, and 40 mg of citalopram hydrobromide (as base). The 10 mg tablet is manufactured only by generic companies in some markets.
• Manufacturers in Canada: Lundbeck Canada Inc. holds the DINs for Celexa 10 mg (02239606), 20 mg (02239607), and 40 mg (02239608). Generic citalopram is manufactured by Apotex Inc., Teva Canada Limited, Sandoz Canada Inc., Mint Pharmaceuticals Inc., Angita Pharma Inc., and others.
• Registration status in Canada: Approved by Health Canada. Celexa 10 mg (DIN 02239606), 20 mg (DIN 02239607), and 40 mg (DIN 02239608) are currently marketed. Multiple generic citalopram products are also approved under various DINs, including 02387956 (Citalopram, marketed since 2024-02-27) and 02355280 (Septa-Citalopram).
• OTC / Rx classification: Prescription only (Rx) – not legally sold over-the-counter in Canadian pharmacies

Dosage & Direction

Take Celexa exactly as your doctor prescribes. The usual recommended starting dose is 20 mg once daily. Your doctor may increase the dose as appropriate, based on how well it is working and whether you are experiencing side effects. The maximum recommended dose is 40 mg daily. For older adults and people with liver problems, a lower starting dose of 10 mg daily is often used. Celexa should be taken once daily either in the morning or evening, but at the same time every day. Swallow the tablet whole with water and it may be taken with food or on an empty stomach. Continue to take the medication regularly, even if you do not feel as though it is working. It may take several weeks to see a noticeable improvement in your mood. If you miss a dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. Do not stop taking Celexa suddenly without talking to your doctor. Stopping abruptly can cause withdrawal effects such as agitation, anxiety, difficulty concentrating, nausea, and vomiting. If it becomes necessary to stop taking citalopram, ask your doctor to advise you on how best to gradually reduce the dose to avoid withdrawal effects.

Precautions

Celexa carries a boxed warning about an increased risk of suicidal thoughts and behaviours in pediatric and young adult patients taking antidepressants. Close monitoring is required, especially during the first few weeks of treatment or after dose changes. If you or someone you care for notices worsening mood, new or increased thoughts of self-harm, or unusual behaviour changes, get help immediately. Celexa can cause serotonin syndrome, a potentially life-threatening condition caused by too much serotonin in the body. The risk is higher when citalopram is taken with other serotonergic drugs, including MAO inhibitors, other SSRIs, SNRIs, triptans, tramadol, and St. John's wort. Symptoms include agitation, confusion, rapid heartbeat, muscle rigidity, and sweating. Stop the medication and seek emergency care if these occur. Celexa can cause QT prolongation, a change in heart rhythm that can lead to serious arrhythmias. Health Canada issued a safety warning about this risk in 2021. Use with caution if you have heart disease or take other drugs that affect heart rhythm. The medication can cause angle-closure glaucoma in patients with untreated anatomically narrow angles. Tell your doctor if you have a history of glaucoma. Celexa can cause hyponatremia (low sodium in the blood), especially in older adults and people taking diuretics. Symptoms include headache, difficulty concentrating, memory problems, confusion, and weakness. Celexa can increase the risk of bleeding, especially when taken with aspirin, NSAIDs, warfarin, or other anticoagulants. Tell your doctor if you take any of these medications. The medication can cause drowsiness and dizziness. Do not drive or operate heavy machinery until you know how it affects you. Celexa is not recommended during pregnancy unless the benefit clearly outweighs the risk. It passes into breast milk, so breastfeeding is not recommended without medical advice. Women who could become pregnant should discuss the risks and benefits with their doctor. Celexa should not be used in patients under 18 years of age. Older adults may be more sensitive to the side effects of Celexa and may need lower doses. Tell your doctor if you have liver or kidney problems, as dose adjustments may be needed. Bone fractures have been reported with this class of medication.

Contraindications

Do not take Celexa if you have had an allergic reaction to citalopram or any of the inactive ingredients in the tablet. Celexa is contraindicated in patients taking monoamine oxidase inhibitors (MAOIs), including phenelzine, tranylcypromine, moclobemide, and selegiline. Do not start an MAOI within 14 days of stopping Celexa, and do not start Celexa within 14 days of stopping an MAOI. This combination can cause a life-threatening condition called serotonin syndrome. Celexa is contraindicated in patients taking pimozide, an antipsychotic medication, because the combination can cause serious heart rhythm problems. Do not take Celexa if you have been diagnosed with congenital long QT syndrome. Celexa should not be used during pregnancy or breastfeeding unless specifically directed by a doctor. The safety and effectiveness of Celexa in children and adolescents under 18 years of age have not been established. If you are unsure whether any of these apply to you, check with your doctor or pharmacist.

Possible Side Effects

More than 1 in 10 people experience nausea, dry mouth, insomnia, and increased sweating. Other common side effects include drowsiness, fatigue, dizziness, diarrhea, constipation, and decreased appetite. Sexual side effects such as decreased libido, erectile dysfunction, and difficulty reaching orgasm are common but often not discussed. These effects may fade as your body adjusts, but if they persist or bother you, tell your doctor. Serious side effects require immediate medical attention. Serotonin syndrome presents with agitation, confusion, rapid heartbeat, muscle rigidity, and sweating. QT prolongation can cause palpitations, fainting, or sudden collapse. Hyponatremia can cause headache, confusion, and weakness. Angle-closure glaucoma presents with sudden eye pain, blurred vision, and redness. Increased bleeding risk can cause easy bruising or unusual bleeding. Severe allergic reactions, including rash, hives, swelling of the face or throat, and difficulty breathing, need emergency care. If you develop any of these serious effects, stop the medication and seek medical help right away. Antidepressants, including Celexa, may increase suicidal thoughts or behaviour, especially in young people. If you notice worsening mood or new thoughts of self-harm, contact your doctor immediately. Discontinuation syndrome can occur if the medication is stopped suddenly, causing dizziness, agitation or anxiety, difficulty concentrating, strange dreams, nausea, or vomiting.

Drug Interaction

Celexa interacts with several medications. MAO inhibitors are strictly contraindicated and must not be used with Celexa. Pimozide is also contraindicated because the combination can cause serious heart rhythm problems. Other serotonergic drugs, including other SSRIs, SNRIs, tricyclic antidepressants, triptans, fentanyl, tramadol, and St. John's wort, can increase the risk of serotonin syndrome. Drugs that affect bleeding, such as aspirin, NSAIDs, warfarin, and other anticoagulants, can increase the risk of bleeding when taken with Celexa. Celexa is a weak inhibitor of CYP2D6, so it can increase the levels of drugs metabolized by this enzyme, including certain antidepressants, antipsychotics, beta-blockers, and opioids. If you take one of these, your doctor may need to adjust the dose. Drugs that prolong the QT interval, such as certain antiarrhythmics, antipsychotics, and antibiotics, may increase the risk of dangerous heart rhythms when taken with Celexa. Celexa can also interact with diuretics, increasing the risk of hyponatremia. Tell your doctor and pharmacist about every medication you take, including over-the-counter products, vitamins, and herbal supplements.

Missed Dose

If you miss a dose of Celexa, skip the missed dose and continue with your regular dosing schedule. Do not take two doses at once to make up for a missed one. If you miss several doses in a row, contact your doctor before restarting. Missing doses can cause your symptoms to return, so try to take the medication at the same time each day.

Overdose

Overdose with Celexa can cause drowsiness, nausea, vomiting, fast heart rate, and tremor. In severe cases, it can cause serotonin syndrome, seizures, and changes in heart rhythm. There is no specific antidote. Treatment is supportive and may include activated charcoal if the overdose was recent, intravenous fluids, and monitoring of vital signs. Contact a poison control centre or go to an emergency department immediately if you or someone else has taken too much. Do not try to manage an overdose at home.

Storage

Store Celexa tablets at room temperature between 15 and 30 degrees Celsius (59 and 86 degrees Fahrenheit). Keep the container tightly closed and protect it from light and moisture. Do not store in the bathroom or near a sink. Keep out of reach of children and pets. Do not use after the expiry date on the label. Dispose of unused medication according to local guidelines. Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Disclaimer

We provide only general information about medications which does not cover all directions, possible drug integrations, or precautions. Information at the site cannot be used for self-treatment and self-diagnosis. Any specific instructions for a particular patient should be agreed with your health care adviser or doctor in charge of the case. We disclaim reliability of this information and mistakes it could contain. We are not responsible for any direct, indirect, special or other indirect damage as a result of any use of the information on this site and also for consequences of self-treatment.

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