Does Citalopram Interact With Flecainide? (3+ Tips)

By Dr Drielli Vital-Fujii (PhD)

Page last updated: 02/01/2024 | Next review date: 02/01/2026

Author bio

Dr Drielli Vital-Fujii, PhD, is a Pharmacist with expertise in Drug Design and Development, Enzymes, Molecular Modelling, and Photodynamic Therapy. She writes and reviews content on these topics.

Dr Drielli Vital-Fujii’s Highlights:

Postdoctoral fellow at the Department of Biochemistry at the University of São Paulo, emphasizing therapy of neglected diseases using light.

PhD in Pharmaceutical Sciences focusing on drug design and development at the Faculty of Pharmaceutical Sciences of the University of São Paulo.

Six months as an international researcher at the Center for Discovery and Innovation in Parasitic Diseases (University of California San Diego)

Master’s degree in Pharmaceutical Sciences focusing on drug design and development at the Faculty of Pharmaceutical Sciences of the University of São Paulo.

Bachelor of Pharmacy at the University of Mogi das Cruzes – São Paulo / Brazil

Professional Experience:

2012 – 2018 Project manager at University of São Paulo – Pharmacy Department

Dr Drielli Vital-Fujii has worked with computational studies, synthesis, biological evaluation, design, and development of new inhibitor candidates for Chagas Disease and Leishmaniasis.

2017 – 2017 International research fellow at University of California San Diego Skaggs School of Pharmacy and Pharmaceutical Sciences – Center for Discovery and Innovation in Parasitic Diseases.

She used Virtual Screening (VS) and High-Throughput Screening (HTS) Integration in the Discovery of new drugs against neglected tropical diseases (NTDs).

2018 – 2019 Faculdades Oswaldo Cruz

Dr Drielli Vital-Fujii was a professor in the Faculty of Pharmacy, teaching the subjects of Pharmaceutical Chemistry and Drug Development.

2019 – 2021 Researcher in Biochemistry University of São Paulo – Biochemistry Department

She applied Photodynamic Therapy in Leishmaniasis Treatment, mentored undergraduate students in scientific activities, and wrote, executed, translated, and reported scientific projects with funding agencies.

2023-2023 UniPiaget – University Center.

Dr Drielli Vital-Fujii was a Biology, Nutrition, Physiotherapy, and Pharmacy professor.

Education:

2018 -2021 Postdoctoral at the Department of Biochemistry at the University of São Paulo

2013 -2018 PhD of Science: Drugs and Medicines at Department of Pharmacy at University of São Paulo

2012 -2013 M.Sc. of Sciences: Drugs and Medicines at the Department of Pharmacy at the University of São Paulo

2005-2008 Bachelor of Pharmacy at the University of Mogi das Cruzes

The leading publications of Dr Drielli Vital-Fujii are:

Vital-Fujii, D.G, Baptista, M.S. (2021). Progress in the photodynamic therapy treatment of Leishmaniasis. Brazilian Journal of Medical and Biological Research, 54, 1-11.

Gatti, F. M., Gomes, R.A., da Fonseca, A.L., Lima, E.J.C., Vital-Fujii, D.G., Taranto, A.G., Varotti, F.P., Trossini, G.H.G. (2020). Antiplasmodial activity of sulfonylhydrazones: in vitro and in silico approaches. Future medicinal chemistry, 13, 233-250.

Silva, E.J., Bezerra-Souza, A., Passero, L.F., Laurenti, M.D., Ferreira, G.M., Fujii, D.G.V., et al. (2018). Synthesis, leishmanicidal activity, structural descriptors and structure-activity relationship of quinoline derivatives. Future medicinal chemistry, 10, 2069-2085.

Leite, F.H.A., Froes, T.Q., da Silva, S.G., de Souza, E.I.M., Vital-Fuji,i D.G., Trossini, G.H.G., et al. (2017). An integrated approach towards the discovery of novel non-nucleoside Leishmania major pteridine reductase 1 inhibitors. European Journal of Medicinal Chemistry, 132, 322-332.

Vital, D.G., Damasceno, F.S., Rapado, L.N., Silber, A.M., Vilella, F.S., Ferreira, R.S., et al. (2017). Application of bioisosterism in design of the semicarbazone derivatives as cruzain inhibitors: a theoretical and experimental study. Journal of Biomolecular Structure and Dynamics, 35, 1244–1259.

Mello, J. F.R., Gomes, R.A., Vital-Fujii, D.G., Ferreira, G.M., Trossini, G.H.G. (2017). Fragment-based drug discovery as alternative strategy to the drug development for neglected diseases. Chemical Biology & Drug Design, 90, 1067-1078.

Pantaleao, S.Q., Fujii, D.G.V., Maltarollo, V.G., da C. Silva, D., Trossini, G.H.G., Weber, K.C., et al. (2017). The Role of QSAR and Virtual Screening Studies in Type 2 Diabetes Drug Discovery. Medicinal Chemistry, 13, 706-720.

Vital, D., Arribas, M., Trossini, G. (2014). Molecular Modeling and Docking Application to Evaluate Cruzain Inhibitory Activity by Chalcones and Hydrazides. Letters in Drug Design and Discovery, 11, 249-255.

Blau, L., Menegon, R.F., Trossini, G.H.G., Molino, J.V.D., Vital, D.G., Cicarelli, R.M.B., et al. (2013). Design, synthesis and biological evaluation of new aryl thiosemicarbazone as antichagasic candidates. European Journal of Medicinal Chemistry, 67, 142-151.

You can view some of Dr Drielli’s work below and links to her professional profile.

Orcid: https://orcid.org/0000-0001-9270-0466

Research Gate: https://www.researchgate.net/profile/Drielli-Gomes-Vital-Fujii

Scopus: https://www.scopus.com/authid/detail.uri?authorId=55829534000

Google Scholar: https://scholar.google.com/citations?user=F9U50AEAAAAJ&hl=pt-BR

Linkedin: linkedin.com/in/driellivital

Escavador: https://www.escavador.com/sobre/6101380/drielli-gomes-vital

CDIPD: https://cdipd.org/index.php/about-us/visiting-scientists

Dr Drielli Vital-Fujii (PhD)

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In this article, we are going to discuss whether there are any drug interactions between citalopram and flecainide or not, what research suggests and what side effects can occur while taking both medications together.

Does citalopram interact with Flecainide?

Yes, citalopram can interact with flecainide, potentially leading to serious side effects.

Flecainide belongs to a class of medications known as antiarrhythmics, which are used to regulate and normalize the heart’s electrical activity. This medication is used to treat certain heart rhythm disorders, particularly those associated with irregular or rapid heartbeats. It works by slowing down electrical signals in the heart, which can help maintain a steady and regular heartbeat. (1)

On the other hand, citalopram is an antidepressant that belongs to a class of drugs known as selective serotonin reuptake inhibitors (SSRIs). It is primarily used to treat mood disorders, such as depression and anxiety by elevating the levels of serotonin in the brain, which elevates mood. (2)

However, if citalopram and flecainide are prescribed together, you should be mindful of the potential risks associated with this combination.

What are the potential interactions between citalopram and flecainide?

Citalopram and flecainide are two different medications that can have potential interactions. Here are some considerations regarding their interactions:

QT Prolongation: Both citalopram and flecainide can individually increase the risk of prolonging the QT interval on an electrocardiogram (ECG). Both drugs can individually affect the rhythm of your heart, which could lead to problems. (5)
Serotonin Syndrome: Although the risk is relatively low, combining citalopram and flecainide can increase the risk of developing serotonin syndrome (accumulation of serotonin in the brain), which is characterized by symptoms like agitation, confusion, rapid heart rate, fever and muscle rigidity. (4)

What does research suggest?

According to research, citalopram and flecainide can increase the risk of potential side effects in individuals. If not promptly treated, individuals may experience a gradual worsening of their condition and can become severely ill. Serotonin syndrome, when left untreated, can have life-threatening consequences. (4,5)

However, with appropriate treatment, symptoms typically improve within less than 24 hours. It’s important to note that even with treatment, there is a possibility of lasting damage to the organs.

What are the signs and symptoms of toxicity from citalopram-flecainide interaction?

The signs and symptoms of toxicity from citalopram-flecainide interaction may include: (3)

Irregular Heart Rhythm: Arrhythmias and irregular heartbeats are significant concerns. You may experience a rapid or slow heartbeat.
Agitation: Excessive restlessness or nervousness.
Confusion: Difficulty thinking clearly or focusing.
High blood pressure: You may experience elevated blood pressure levels.
Dilated pupils: Pupils become larger than normal.
Gastrointestinal symptoms: Nausea, vomiting or diarrhoea may occur.
Headache: Severe headaches. (3)
Hallucinations: Sensing things that are not there.
Shivering or chills: Uncontrolled shivering and chills or feeling extremely cold.
Muscle rigidity: Stiff or trembling muscles.
Coma ( in severe cases): A state of unconsciousness.

Who is more at risk from citalopram-flecainide-induced toxicity?

The risk of developing toxicity, such as serotonin syndrome, from the combination of citalopram and flecainide, is determined by the individual’s medical history, medication doses, and how these drugs interact in the body.

High doses and prolonged use of these medications can increase the risk, but genetic differences and other medical conditions can also make some individuals more sensitive to these interactions. (6)

Older people may be at higher risk due to changes in metabolism, but this is not always the case. Similarly, if you are on several medications at once, it can be riskier because there are more chances for drugs to interact with each other. (6)

Remember that your doctor considers all these factors when deciding which medications to prescribe. Always tell your healthcare provider about all the medications you’re taking. If you have concerns about potential interactions, discuss them with your doctor.

How to manage the side effects of taking citalopram with flecainide?

Managing the side effects and potential interactions of taking citalopram with flecainide requires careful monitoring and guidance from a healthcare professional. Here are some general steps to manage these medications effectively: (2,3)

Consult your healthcare provider: Always consult with your doctor before starting or stopping any medication, especially when taking multiple drugs with potential interactions. They can provide personalized advice and adjust the treatment plan as needed.
Dose adjustment: Your healthcare provider may consider adjusting the doses of citalopram and flecainide to minimize the risk of interactions.
Monitoring for symptoms: Be vigilant for any signs of side effects or toxicity. This includes symptoms of serotonin syndrome (agitation, confusion, rapid heart rate, etc) or heart rhythm disturbances.
Lifestyle and Diet: Maintain a healthy lifestyle with regular exercise, a balanced diet, and adequate sleep.
Avoid alcohol: You must avoid alcohol consumption and intake of other illicit drugs.
Hydration: Staying well hydrated is important, as certain side effects of these medications, such as flecainide, can be worsened by dehydration.

Conclusion:

In this article, we have discussed the potential interactions between citalopram and flecainide, the signs and symptoms caused by their toxicity and the effective manageable ways to treat it.

However, from my perspective, the decision to combine these medications should be guided by healthcare providers who can weigh the risks and benefits. Patients should monitor their health and seek medical attention if they are experiencing any side effects, ensuring the most appropriate treatment.