Citalopram
Celexa
Also known as: Lozol, Natrilix
Thiazide-like diuretic that both wastes potassium and carries a conditional torsades-de-pointes association of its own — the two effects compound rather than substitute for each other.
Severity
Major risk
Mechanism
QT-interval prolongation
Protocol Status
Continue as prescribed — cleared by a measured lab value, not a waiting period
Restart Delay
Physician discretion
What "Major risk" Means
Serious clinical risk requiring physician-led tapering, washout, and monitoring. Treatment may proceed once the medication is appropriately cleared or transitioned.
Clinical Action
Baseline ECG and serum K+/Mg2+ before dosing. Correct electrolytes and re-evaluate QTc on a repeat tracing rather than a time interval.
Where the Washout Happens
Continue as prescribed — cleared by a measured lab value, not a waiting period
This medication is not stopped for treatment, and should not be stopped on our initiative — the condition it treats usually outranks the interaction. What it changes is monitoring: serum potassium and magnesium are measured before the flood dose and corrected to target, and the dose is deferred until those numbers are right rather than until a number of days have passed. Any change to the prescription belongs to the prescribing physician.
Post-Treatment Restart
Restart at physician discretion once acute window closes.
The Pharmacology
Ibogaine and noribogaine block the cardiac hERG (IKr) potassium channel, which lengthens ventricular repolarisation and the QTc interval on a 12-lead EKG. Adding a second QT-prolonging drug compounds the effect and raises the risk of torsades de pointes — a polymorphic ventricular tachycardia that can be fatal. Every patient receives a baseline EKG, electrolyte panel, and continuous cardiac monitoring; medications in this class must be washed out long enough to return QTc into a safe range.
Same Mechanism
Same Severity Tier
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Opioid receptor potentiation
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Common Questions
Major risk. Thiazide-like diuretic that both wastes potassium and carries a conditional torsades-de-pointes association of its own — the two effects compound rather than substitute for each other. Baseline ECG and serum K+/Mg2+ before dosing. Correct electrolytes and re-evaluate QTc on a repeat tracing rather than a time interval.
Continue as prescribed — cleared by a measured lab value, not a waiting period. This medication is not stopped for treatment, and should not be stopped on our initiative — the condition it treats usually outranks the interaction. What it changes is monitoring: serum potassium and magnesium are measured before the flood dose and corrected to target, and the dose is deferred until those numbers are right rather than until a number of days have passed. Any change to the prescription belongs to the prescribing physician.
QT-interval prolongation. Ibogaine and noribogaine block the cardiac hERG (IKr) potassium channel, which lengthens ventricular repolarisation and the QTc interval on a 12-lead EKG. Adding a second QT-prolonging drug compounds the effect and raises the risk of torsades de pointes — a polymorphic ventricular tachycardia that can be fatal. Every patient receives a baseline EKG, electrolyte panel, and continuous cardiac monitoring; medications in this class must be washed out long enough to return QTc into a safe range.
In many cases yes. Our medical team works with your prescribing physician to taper or substitute medications safely before treatment. The right substitution depends on the underlying condition you are treating with Indapamide — contact us for an individual review.
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