Can citalopram and ibuprofen be mixed?

In this blog we will discuss how citalopram and ibuprofen interact and whether citalopram and ibuprofen can be mixed.

We will also discuss what are the effects of the two drugs being used, risk factors involved and what are some alternative drugs that can be used.

Can citalopram and ibuprofen be mixed?

It is advised that an individual should not use citalopram and ibuprofen together as it may increase the risk of internal bleeding for the individual taking the drugs. 

Citalopram is an antidepressant and is part of a class of antidepressant drugs known as selective serotonin reuptake inhibitors (SSRIs). It is FDA-approved and prescribed by physicians for the treatment of the symptoms of major depression.

One of the major side effects of citalopram is  the increased risk of internal and external bleeding which is also the same side effect for ibuprofen- a non-steroidal anti-inflammatory drug that is used to reduce fever, treat pain and inflammation in the case of health conditions such as headache, toothache, back pain, arthritis, menstrual cramps, or minor injury.

When it comes to Ibuprofen which is a non-steroidal anti-inflammatory drug (NSAID), one of the roles of the drug is to prevent blood clotting and it is an antiplatelet drug. 

It prevents blood clotting by extending the time it takes for blood platelets to come together and work to stop bleeding. So they stop blood from clotting which is necessary to stop the loss of blood from injury, 

While it is an effective drug for preventing internal clots in the body- such as in the arteries- it can cause damage to the gastrointestinal lining (GI) that can further cause GI bleeding. 

On the other hand, SSRI antidepressants like citalopram affect blood clotting differently. Citalopram is a drug that inhibits the reabsorption of serotonin that is needed to help the veins to constrict and the blood plateless to change shape that is necessary for blood clothing. 

Thus, because serotonin is not reabsorbed, the platelets are not shaped and hence don’t behave properly- in terms of blood clothing- which can lead to excessive bleeding.

Thus, taking an NSAID such as ibuprofen with an SSRI such as citalopram increases the risk of bleeding too much, especially in the gastrointestinal (GI) system- internal bleeding. 

This particular interaction between the two drugs is more dangerous when it comes to individuals with liver disease or kidney disease, as well as for the elderly. 

Your doctors will probably be aware of this interaction and advise you not to take the two drugs together; however, one should also be vigilant about what drugs you are taking. 

So monitor yourself as you take these drugs and seek immediate attention and medical aid if you notice signs and symptoms of bleeding such as dizziness; lightheadedness; red or black, tarry stools; coughing up or vomiting fresh or dried blood that looks like coffee grounds; severe headache; and weakness. 

Mixing NSAID such as ibuprofen with an SSRI such as citalopram may cause bleeding events, such as:

  • nose bleeds
  • bleeding gums
  • cuts that don’t stop bleeding
  • Internal bleeding in the gastrointestinal system (stomach or intestines) which is observed through red or black, tarry stools; coughing up or vomiting fresh or dried.

What are the Side Effects Of Mixing Citalopram & Ibuprofen?

Both the drugs citalopram and Ibuprofen when used together can interact to cause an increased risk in internal or GI bleeding. 

Some of the additional side effects caused by this deadly condition of internal bleeding include:

  • unusual bruising
  • bleeding easily and excessively
  • dizziness or lightheadedness
  • drowsiness
  • weakness
  • blurred vision
  • severe headaches
  • coughing or vomiting blood (if it’s dried, it may look like coffee grounds)
  • blood in your stool (red or black tarry stool)

These side effects and signs are important for an individual to look out for to catch cases of internal bleeding since it is not noticed otherwise. 

What are the risk factors when it comes to mixing Citalopram and ibuprofen?

When it comes to a higher risk of the side effects of either citalopram and ibuprofen, everyone can be affected irrespective of age, or medical history.

However, there are certain individuals whose conditions and life conditions might make it more dangerous for them to use citalopram and ibuprofen due to their increased risk of side effects.

These risk factors include:

  • Age where people over 80 years old have a higher risk of bleeding issues with SSRIs such as citalopram. 
  • Frequency of use where occasional use of ibuprofen may not be concerning however taking it regularly with an SSRI such as citalopram might increase risk of side effects of bleeding.
  • Dosage where the higher the dose of Celexa or ibuprofen the greater the risk of bleeding is increased. 
  • Medical history of GI bleeding often increases the risk of this condition getting worse when the individual is treated  with SSRIs such as citalopram.
  • Kidney disease leads to an increased risk and worsening of GI bleeding which makes it all the more dangerous if the individuals uses citalopram or ibuprofen. 

What are some alternatives that can be used?

Some painkillers that can be used alternatively with the drug citalopram include:

Acetaminophen (Tylenol) an over-the-counter painkiller that does not cause bleeding or interact with citalopram however it does have it’s own list of unique side effects.

Whereas Mirtazapine (Remeron), doxepin (Silenor), and nortriptyline (Pamelor) are antidepressants that have a lower risk of bleeding complications and might be safer to be used with ibuprofen. 

However, it is important that you consult with your doctor to determine what drugs you can use for either condition and which do not have dangerous interactions.  

What is citalopram?

Citalopram is an antidepressant and is part of a class of antidepressant drugs known as selective serotonin reuptake inhibitors (SSRIs). 

It is FDA-approved and prescribed by physicians for the treatment of the symptoms of major depression. It is also to be mentioned that the drug is also prescribed for off label uses to treat anxiety disorders such as- PTSD, Panic disorder, and also eating disorders. 

Citalopram is believed to treat depression by increasing the amount of serotonin, a natural substance in the brain that helps maintain mental balance, in the brain.

It is a SSRI- a selective serotonin reuptake inhibitor which means that the drug slows down the uptake of serotonin in the brain making the levels of the neurochemical higher for people with depression who are typically observed to have lowered levels of serotonin.  

It is to be mentioned that this drug can affect not just the brain chemicals but also one’s bodies. It can cause various side effects such as lethargy, nausea, dry mouth, loss of appetite, blurred vision, and increased yawning. 

Like all medicines, citalopram can cause side effects, however it is important to mention that many people who take the drug did not experience side effects or when they did, they were minor. 

Common side effects

  • dry mouth
  • sweating a lot
  • being unable to sleep
  • feeling sleepy
  • feeling tired or weak

Serious side effects

  • chest pain 
  • shortness of breath
  • severe dizziness or passing out
  • painful erections 
  • any irregular bleeding that do not stop within 10 minutes

Common side effects of this drug usually improve as your body gets used to the drug and might even disappear after prolonged use. If you observe any serious side effects, reach out to your doctor immediately. 

What is ibuprofen?

Ibuprofen is a non-steroidal anti-inflammatory drug that is used to reduce fever, treat pain and inflammation in the case of health conditions such as headache, toothache, back pain, arthritis, menstrual cramps, or minor injury.

The drug works by by reducing hormones that cause inflammation and pain in the body by stopping or inhibiting the production of these hormones that causes pain, feverr, and inflammation., 

Ibuprofen is used in both adults and children who are at least 6 months old to relieve pain, tenderness, swelling, and stiffness caused by various conditions including osteoarthritis and rheumatoid arthritis and also believed to treat menstrual pain (pain that happens before or during a menstrual period) caused by muscle cramps. 

Like all medicines, Ibuprofen can cause side effects, such as 

  • constipation
  • diarrhoea
  • gas or bloating
  • dizziness
  • nervousness
  • ringing in the ears

As well as some side effects that are serious and require medical attention such as:

  • unexplained weight gain
  • shortness of breath or difficulty breathing
  • swelling of the abdomen, feet, ankles, or lower legs
  • blisters
  • rash
  • itching
  • hives
  • swelling of the eyes, face, throat, arms, or hands
  • difficulty breathing or swallowing
  • hoarseness
  • excessive tiredness
  • pain in the upper right part of the stomach
  • nausea
  • loss of appetite
  • yellowing of the skin or eyes
  • flu-like symptoms
  • pale skin
  • fast heartbeat
  • cloudy, discoloured, or bloody urine
  • back pain
  • difficult or painful urination
  • blurred vision, changes in colour vision, or other vision problems
  • red or painful eyes
  • stiff neck
  • confusion
  • Aggression (Medlineplus)

Conclusion

In this blog we have discussed how citalopram and ibuprofen interact and whether citalopram and ibuprofen can be mixed.

We have also discussed what are the effects of the two drugs being used, risk factors involved and what are some alternative drugs that can be used.

What pain reliever can I take with citalopram?

Acetaminophen (Tylenol) an over-the-counter painkiller that does not cause bleeding or interact with citalopram however it does have it’s own list of unique side effects. You can also consider taking paracetamol, another over the counter painkiller with citalopram. 

Can I take ibuprofen with antidepressants?

Ibuprofen can interact with certain antidepressants however, antidepressants like Mirtazapine (Remeron), doxepin (Silenor), and nortriptyline (Pamelor) are antidepressants that have a lower risk of bleeding complications and might be safer to be used with ibuprofen. 

Can you take anxiety meds with ibuprofen?

Xanax (alprazolam) is  generally considered a safe drug combination if used with ibuprofen such as Advil, but should be used under doctors supervision. 

Can I take Tylenol with citalopram?

Yes. You can take tylenol with citalopram. Acetaminophen (Tylenol) an over-the-counter painkiller that does not cause bleeding or interact with citalopram however it does have it’s own list of unique side effects.

Why does ibuprofen help me sleep?

Diphenhydramine is the active ingredient in ibuprofen which makes most people drowsy. Which is why it is possible that this drug is helping you sleep. However it should not be used as a treatment for sleep problems.

References

Citalopram-Brand name: Cipramil. NHS. 10th Dec, 2018. Retrieved on 15th Feb 2022. https://www.nhs.uk/medicines/citalopram/

Drug Interactions between citalopram and ibuprofen. Drugs.com. Retrieved on 15th Feb 2022.https://www.drugs.com/drug-interactions/citalopram-with-ibuprofen-679-0-1310-0.html#:~:text=Interactions%20between%20your%20drugs&text=Using%20citalopram%20together%20with%20 ibuprofen,have%20any%20 questions%20or%20concerns.

Mixing Celexa & Ibuprofen | Interactions, Side Effects, & Risk Factors. ARK. Retrieved on 15th Feb 2022. https://www.arkbh.com/ssris/celexa/ibuprofen/

Ibuprofen. Drugs.com. Retrieved on 15th Feb 2022. https://www.drugs.com/ibuprofen.html

Ibuprofen. Medlineplus. Retrieved on 15th Feb 2022.https://medlineplus.gov/druginfo/meds/a682159.html

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