On-call scenario 3: Sources
Information sources that you might have thought about looking in, include:- BNF
- SmPCs via the emc
- Stockley’s Drug Interactions
- Drugdex (if you have access)
- There guidance on the SPS website entitled "What issues should be considered regarding drug induced QT prolongation?" You can see it here.
The SmPC for citalopram contraindicates its use with other drugs that prolong the QT interval because of the additive risk. Therefore, according to the UK licence, the combination would be contraindicated. Clarithromycin may also increase the plasma levels of citalopram through a CYP3A4 mediated interaction and could put the patient at a further increased risk of side effects.
Now that you have this information, how will you advise the registrar?
When you've come up with a plan, click Next Page.