Citalopram

(sye TAL oh pram)

What key warnings do I need to know about before giving this drug to my child?

• Children and teens who take this drug may be at a greater risk of having thoughts or actions of suicide. Adults may also be at risk. The risk may be greater in people who have had these thoughts or actions in the past. Watch people who take this drug closely. Call the doctor right away if signs like low mood (depression), nervousness, restlessness, grouchiness, panic attacks, or changes in mood or actions are new or worse. Call the doctor right away if any thoughts or actions of suicide occur.
• A very bad and sometimes deadly health problem called serotonin syndrome may happen. The risk may be greater if your child takes this drug with certain other drugs. Call your child's doctor right away if your child has dizziness, a very bad headache, agitation, hallucinations, fever, a fast heartbeat, a heartbeat that does not feel normal, flushing, seizures, shakiness, is sweating a lot, a change in balance, a change in thinking clearly and with logic, a very bad upset stomach and throwing up, or very bad loose stools.
• Sometimes drugs are not safe when your child takes them with other drugs. Taking them together can cause bad side effects. This is one of those drugs. Be sure to talk to your child’s doctor about all the drugs your child takes.
• This drug comes with an extra patient fact sheet called a Medication Guide. Read it with care. Read it again each time this drug is refilled.

Is it safe for my child to take this drug?

• Not if your child has an allergy to citalopram or any other part of this drug.
• Be sure to let the doctor know if your child has any allergies or side effects to drugs, foods, or dyes. Make sure to tell about the allergy and what signs your child had. This includes telling about rash; hives; itching; shortness of breath; wheezing; cough; swelling of face, lips, tongue, or throat; or any other signs.

Why does my child need this drug?

• It is used to treat low mood (depression).
• It is used to treat obsessive-compulsive problems.

How is this drug given?

• To gain the most benefit, do not miss giving your child doses.
• Give this drug with or without food. Give with food if it causes an upset stomach.
• There is a liquid (solution) if your child cannot swallow pills.
• Children who have feeding tubes may also use the liquid. Flush the feeding tube before and after this drug is given.
• Measure liquid doses carefully. Use the measuring device that comes with this drug. If there is none, get an oral syringe, a dropper, a spoon, or a cup (only for older children) from your pharmacist.

How long does this drug take to work?

• Your child may start feeling better a few weeks after starting this drug.
• It may take 6 weeks to see the full effect.

What do I do if my child misses a dose?

• Give a missed dose as soon as you think about it.
• If it is close to the time for your child's next dose, skip the missed dose and go back to your child's normal time.
• Do not give 2 doses or extra doses.
• Do not change the dose or stop your child's drug. Talk with your child's doctor.

What safety measures do I need to take when my child is using this drug?

• Make sure you have the right drug for your child.
• If your child has been taking this drug for many weeks, talk with your child's doctor before stopping. You may want to slowly stop this drug.
• Check all drugs your child is taking with your child's doctor. This drug may not mix well with some other drugs.
• Keep a list of all your child's drugs (prescription, natural products, vitamins, OTC) with you. Give this list to your child's doctor.
• Avoid giving your child other drugs and natural products that may slow your child's actions.
• If your child has bleeding problems, talk with the doctor.
• If your child has kidney disease, talk with the doctor.
• If your child has liver disease, talk with the doctor.
• If your child has seizures, talk with the doctor.
• If your child has thoughts of taking his/her own life, talk with the doctor.
• If your child has a weak heart, talk with the doctor.
• This drug may cause your child to be less alert. Have your child avoid tasks or actions that call for alertness. These include playing (for example, riding a bicycle, rollerblading, sports) or using items that call for your child to have focus or coordination (for example, scissors, lawnmower, electric scooters, or toy cars). Your child's actions will be closely watched until you see how this drug affects him/her. School work may be hard for your child to focus on and get done.
• Talk with the doctor before giving your child products that have aspirin, ibuprofen or like products, blood thinners (warfarin, ticlopidine, clopidogrel), garlic, ginseng, ginkgo, or vitamin E.
• Your child may get sunburned more easily. Avoid lots of sun, sunlamps, and tanning beds. Use sunscreen and dress your child in clothing and eyewear that protects him/her from the sun.

What are some side effects of this drug?

• Feeling lightheaded, sleepy, having blurred eyesight, or a change in thinking clearly. Have your child avoid tasks or actions that call for him/her to be alert or have clear eyesight until you see how this drug works.
• Headache.
• Nervous and excitable.
• Upset stomach or throwing up. Many small meals and good mouth care may help. Older children may suck hard, sugar-free candy.
• Not able to sleep. Giving this drug in the morning may help.
• Dry mouth. Good mouth care may help. Older children may suck hard, sugar-free candy. Have your child see a dentist often.

When do I need to call my child's doctor?

• If any of this news causes you to be worried, any of the unwanted side effects happen, or if your child is not better after taking this drug.
• If you think there has been an overdose, call 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center (http://www.aapcc.org), or emergency room (ER) right away.http://www.aapcc.org), or emergency room (ER) right away.
• If your child shows signs of a very bad reaction, call your child's doctor or the ER right away. These include wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; swelling of face, lips, tongue, or throat; or if your child is not acting normal.
• If your child is planning to harm him/herself. If the want to harm him/herself gets worse.
• If your child has a change in thinking clearly and with logic.
• If your child has trouble breathing.
• If your child has a fast heartbeat.
• If your child has very bad dizziness or passing out.
• If your child has a change in balance.
• If your child is agitated, twitching, sweating, or has muscle stiffness.
• If your child has a very bad upset stomach or is throwing up.
• If your child is feeling very nervous and excitable.
• If your child has any bruising or bleeding.
• If your child gets a rash.
• If your child’s health problem does not get better or if you believe your child’s health problem is worse.

How do I store and/or throw out this drug?

• Store at room temperature.
• Store in a dry place. Do not store in a bathroom.

General drug facts

• If your child has a very bad allergy, he/she needs to wear an allergy ID at all times.
• You may get this drug by drug order only. If there are refills, call your pharmacy. If your child does not have refills left, you may need to call your child's doctor.
• Get rid of this drug when your child no longer needs it or if the drug is outdated.
• If you have any questions about this drug, please talk with your doctor, pharmacist, or other health care provider.
• In Canada, take any unused drugs to the pharmacy. Also, visit http://www.hc-sc.gc.ca/hl-vs/iyh-vsv/med/disposal-defaire-eng.php#th to learn about the right way to get rid of unused drugs.http://www.hc-sc.gc.ca/hl-vs/iyh-vsv/med/disposal-defaire-eng.php#th to learn about the right way to get rid of unused drugs.
• Do not share your child's drug with others and do not give anyone else's drug to your child.
• Keep all drugs out of the reach of children and pets.
• Keep a list of all your child's drugs (prescription, natural products, vitamins, OTC) with you. Give this list to your child's doctor.
• These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.
• Talk with the doctor before giving your child any new drug, including OTC, natural products, or vitamins.
• If you do not use a drug the right way, it may not be safe. Follow what your child’s doctor tells you.

This information should not be used to decide whether or not to take this medicine or any other medicine. Only your healthcare provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your healthcare provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.

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