Can You Take Citalopram with Omeprazole?
Last reviewed: · Source: US FDA drug label database
Omeprazole raises citalopram blood levels, which increases the risk of QT heart-rhythm changes — the citalopram dose may need capping at 20mg.
Is it safe to take Citalopram with Omeprazole?
Omeprazole inhibits CYP2C19, the main enzyme that clears citalopram. This can roughly double citalopram levels in some people. Citalopram already carries a dose-dependent warning about QT interval prolongation (a heart rhythm change), so the combination effectively pushes a standard dose towards the higher-risk range. Prescribers often cap citalopram at 20mg daily when it must be combined with omeprazole, or switch the PPI.
How do Citalopram and Omeprazole interact?
Citalopram is metabolised primarily by CYP2C19 (with CYP3A4/2D6 contributions). Omeprazole and esomeprazole are CYP2C19 inhibitors, increasing citalopram AUC by ~30-120% depending on metaboliser status. Citalopram causes dose-dependent QTc prolongation; the FDA caps dosing at 40mg (20mg with 2C19 inhibitors or in poor metabolisers).
Data sourced from the US Food and Drug Administration (FDA) drug label database: FDA citalopram Drug Safety Communication — QT prolongation and CYP2C19 inhibitors.
Who should be careful?
People on citalopram doses above 20mg, anyone with existing heart rhythm problems, low potassium or magnesium, or those on other QT-prolonging drugs (e.g. clarithromycin, some antipsychotics).
What if I've already taken Citalopram and Omeprazole?
Don't stop either drug suddenly. Mention the combination to your GP or pharmacist — they may reduce citalopram to 20mg, switch to pantoprazole/lansoprazole, or arrange an ECG if you have palpitations, fainting, or other heart symptoms.
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Frequently Asked Questions
Can I take omeprazole with citalopram?
They can be combined with care, but omeprazole raises citalopram levels. Doses above 20mg citalopram usually need review or a PPI switch.
What is QT prolongation?
A delay in the heart's electrical recharging between beats, visible on an ECG. Severe prolongation can trigger dangerous rhythms. Risk rises with higher citalopram levels.
Which heartburn treatment doesn't affect citalopram?
Pantoprazole and lansoprazole have far less CYP2C19 inhibition. Antacids and Gaviscon don't interact at all.
What symptoms should worry me on this combination?
Palpitations, blackouts, fainting, or severe dizziness warrant prompt medical review and possibly an ECG.