CriticalFluoroquinolone antibacterials×SSRI (selective serotonin reuptake inhibitor)
Updated · Methodology
Mechanism
Ciprofloxacin is a fluoroquinolone, and its SmPC lists concomitant QT-prolonging drugs among the risk factors that call for caution. The citalopram SmPC lists ongoing treatment with any drug capable of prolonging the QT interval among its contraindications, with no exceptions.
Symptoms
QTc prolongation on ECG, palpitations, dizziness, syncope. The end point is polymorphic ventricular tachycardia of the torsade type progressing to ventricular fibrillation. The risk is higher with hypokalaemia, hypomagnesaemia, bradycardia, decompensated heart failure and in women.
Management
The pair sits in the citalopram SmPC contraindications, so the question is which drug stays, not how far to cut the dose. Ciprofloxacin's cardiac effect is weaker than moxifloxacin's, yet the SSRI ban makes no exception for weaker effects. Urinary tract infections have replacements outside the fluoroquinolones.
Check the full regimen, not just this pair
Opens the checker with these two drugs prefilled. Add the rest of the regimen and recompute additive risks.
Summary of a multi-drug list →
Medicine list: everything you take in one place →
Sources
- AEMPS: Ficha técnica de Ciprofloxacino Cinfa 500 mg (2025)– AEMPS CIMA, nregistro 62765, revisión 11/2025, secciones 4.4 y 4.5
- AEMPS: Ficha técnica de Seropram 30 mg (citalopram) (2024)– AEMPS CIMA, nregistro 63564, revisión 01/2024, secciones 4.2, 4.3 y 4.4