Avoid combining escitalopram with MAO inhibitors. This combination can cause a serious, even life-threatening reaction called serotonin syndrome. Allow at least 14 days between stopping an MAOI and starting escitalopram, and vice versa.
Certain medications can increase escitalopram levels in your blood, leading to increased side effects. These include some antifungals (like ketoconazole), antibiotics (like erythromycin), and HIV medications (like ritonavir). Discuss these with your doctor before combining them.
Drugs Affecting Serotonin Levels
Be cautious when using escitalopram with other drugs that affect serotonin levels, such as other antidepressants (including SSRIs, SNRIs, and tricyclic antidepressants), St. John’s Wort, tramadol, and tryptophan supplements. This can heighten the risk of serotonin syndrome.
Drugs Metabolized by the Liver
Escitalopram is metabolized by the liver. Concomitant use with drugs that strongly inhibit or induce liver enzymes can alter escitalopram levels. Your doctor should carefully consider this interaction when prescribing other medications.
Alcohol and Escitalopram
While not a formal drug interaction, combining alcohol with escitalopram can worsen side effects, especially drowsiness and dizziness. Limit alcohol consumption while taking escitalopram.
Always consult your doctor or pharmacist before starting or stopping any medication, including over-the-counter drugs, supplements, and herbal remedies, while taking escitalopram. They can help you assess potential interactions and ensure your safety.
Specific examples of drugs to discuss with your doctor:
This list isn’t exhaustive, but highlights some commonly interacting drugs. Your doctor can provide a more complete list for your specific circumstances.
Antidepressants: Fluoxetine, sertraline, venlafaxine, amitriptyline
Antifungal agents: Ketoconazole, itraconazole
Antibiotics: Erythromycin, clarithromycin
