Citalopram Digoxin

Citalopram 40 mg/day for 4 weeks did not alter the pharmacokinetics of digoxin 1 mg orally (34). Digoxin is not a CYP substrate, so an interaction with SSRIs is unlikely, but the authors cited a report that fluoxetine increased plasma digoxin concentrations (35). 

Larsen F, Priskorn M, Overo KF. Lack of citalopram effect on oral digoxin pharmacokinetics. J Clin Pharmacol 2001 41(3) 340-6. 

In 11 healthy adults citalopram 40 mg/day had no effect on the pharmacokinetics of a single oral dose of digoxin 1 mg (255). Digoxin did not affect citalopram pharmacokinetics. 

Digitalis glycoside Neither citalopram nor fluvoxamine appear to interact with digoxin, but an isolated report describes increased serum digoxin levels attributed to the use of fluoxetine. 

Citalopram, fiuvoxamine, paroxetine, and sertraline appear not to affect the pharmacokinetics of digoxin. However, one case-control study found a small increased risk of digoxin toxicity after starting sertraline, paroxetine, fluoxetine or fiuvoxamine, and two isolated reports describe increased serum digoxin levels attributed to the use of fluoxetine or paroxetine. 

A study in 11 healthy subjects found that citalopram 40 mg once daily for 28 days did not have any significant effect on the pharmacokinetics of a single 1-mg dose of digoxin taken on day 21. No clinically significant ECG changes were observed. ... 

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