Seropram 30 mg film-coated tablets

Package leaflet: Information for the user

Introduction

Package leaflet: information for the user

Seropram 30 mg Film-coated Tablets

citalopram

Read the entire leaflet carefully before you start taking this medicine, because it contains important information for you.

• Keep this leaflet, as you may need to read it again.
• If you have any questions, ask your doctor or pharmacist.
• This medicine has been prescribed for you only, and you should not give it to other people, even if they have the same symptoms as you, because it may harm them.
• If you experience any adverse effects, consult your doctor or pharmacist, even if they are adverse effects not listed in this leaflet. See section 4.

Leaflet contents:

1. What Seropram is and what it is used for
2. What you need to know before taking Seropram
3. How to take Seropram
4. Possible side effects
5. How to store Seropram
6. Contents of the pack and other information

1. What Seropram is and what it is used for

Seropram is a selective serotonin reuptake inhibitor (SSRI) and belongs to a group of medicines known as antidepressants. These medicines help correct certain chemical imbalances in the brain that cause the symptoms of your illness.

Seropram is indicated for the treatment of:

• Depression and prevention of relapses and recurrences.
• Panic disorder with or without agoraphobia.
• Obsessive-compulsive disorder (OCD).

However, your doctor may prescribe Seropram for any other purpose. If you have any doubts about why Seropram has been prescribed for you, ask your doctor.

2. What you need to know before taking Seropram

Do not take Seropram

• If you are allergic to citalopram or any of the other ingredients of this medicine (listed in section 6).
• If you are taking other medicines belonging to a group called monoamine oxidase inhibitors (MAOIs). MAOIs include medicines such as phenelzine, iproniazid, isocarboxazide, nialamide, tranylcypromine, selegiline (used in the treatment of Parkinson’s disease), moclobemide (used for the treatment of depression), and linezolid (an antibiotic).
• If you have a congenital heart rhythm disorder or have ever experienced an episode of such a disorder (this is detected by electrocardiogram, a test used to assess heart function).
• If you are taking medicines for a condition that affects your heart rhythm.
• If you are taking medicines that may affect your heart rhythm.
• See also the section “Use of Seropram with other medicines” below.

Even if you have completed treatment with MAOIs, you must wait 2 weeks before starting treatment with Seropram.

You must wait one day after taking moclobemide.

After stopping Seropram, you must wait one week before taking any MAOI.

Warnings and precautions

Talk to your doctor or pharmacist before starting to take Seropram.

Please inform your doctor if you have any other condition or illness, as your doctor may need to take this into account. In particular, tell your doctor:

• If you have manic episodes or panic disorder.
• If you have liver or kidney impairment. Your doctor may need to adjust your dose.
• If you have diabetes. Treatment with Seropram may alter glycaemic control. You may need an adjustment of insulin and/or oral hypoglycaemic agent doses.
• If you have epilepsy. Treatment with Seropram should be discontinued if seizures occur or if there is an increase in seizure frequency (see also section 4 "Possible side effects").
• If you have a history of bleeding disorders or develop unusual bruising, or if you are pregnant (see 'Pregnancy, breastfeeding and fertility').
• If you have low sodium levels in your blood.
• If you are receiving electroconvulsive therapy.
• If you have or have had heart problems or have recently suffered a heart attack.

If your heart beats slowly at rest (known as bradycardia) and/or if you think your body may be losing salts, for example due to severe diarrhoea and vomiting over several days or due to use of diuretics (medicines to increase urine production).

• If you notice your heartbeat is fast or irregular, or if you experience fainting or dizziness when standing up from a sitting or lying position. This could indicate a heart rhythm disorder.
• If you have or have had eye problems previously, such as certain types of glaucoma (increased pressure in the eye).

Talk to your doctor, even if any of the above circumstances occurred in the past.

Some patients with bipolar disorder may enter a manic phase. This is characterised by unusually rapid and frequent changes in thoughts, excessive happiness, and excessive physical activity. If you experience this, contact your doctor.

Symptoms such as restlessness or difficulty sitting or standing still (akathisia) may also occur during the first few weeks of treatment. Inform your doctor immediately if you experience these symptoms.

Some medicines in the same class as Seropram (called SSRIs/SNRIs) may cause sexual dysfunction symptoms (see section 4). In some cases, these symptoms persist after stopping treatment.

Special information related to your condition

Like other medicines used to treat depression or related disorders, improvement is not immediate. After starting treatment with Seropram, it may take several weeks before you notice any improvement.

In the treatment of panic disorder, improvement is usually observed after 2–4 weeks.

At the beginning of treatment, some patients may experience increased anxiety, which will resolve with continued treatment. Therefore, it is very important to follow your doctor’s instructions exactly and not stop treatment or change the dose without consulting your doctor.

Suicidal thoughts and worsening of depression or anxiety disorder

If you are depressed and/or suffer from an anxiety disorder, you may occasionally have thoughts about harming yourself or ending your life. These thoughts may increase when starting antidepressants, as all such medicines require time to take effect, usually around two weeks, although in some cases it may take longer.

You may be more likely to have such thoughts:

• If you have previously had thoughts about harming yourself or ending your life.
• If you are a young adult. Clinical trial data have shown an increased risk of suicidal behaviour in young adults (under 25 years) with psychiatric disorders who were treated with an antidepressant.

If at any time you have thoughts about harming yourself or ending your life, contact your doctor or go directly to a hospital.

It may be helpful for you to tell a family member or close friend that you are depressed or have an anxiety disorder and ask them to read this leaflet. You may ask them whether they think your depression or anxiety disorder has worsened, or if they are concerned about changes in your behaviour.

Children and adolescents

Seropram should not normally be used in the treatment of children and adolescents under 18 years of age. Also, you should be aware that in patients under 18 years of age, there is an increased risk of adverse effects such as suicide attempts, suicidal ideation, and hostility (predominantly aggression, confrontation behaviour, and irritability) when taking this type of medicine. Nevertheless, your doctor may prescribe Seropram for patients under 18 years of age if they decide it is the most appropriate treatment. If your doctor has prescribed Seropram for a patient under 18 years of age and you wish to discuss this decision, please return to your doctor. You must inform your doctor if any of the symptoms described above worsen or become complicated while patients under 18 years of age are taking Seropram. In addition, the long-term effects on safety, growth, maturation, and cognitive and behavioural development of Seropram in this age group have not yet been established.

Use of Seropram with other medicines

Tell your doctor or pharmacist if you are taking, have recently taken, or might need to take any other medicines.

Some medicines may affect the action of others and this may sometimes cause serious adverse reactions.

Inform your doctor if you are taking any of the following medicines:

• Non-selective monoamine oxidase inhibitors (MAOIs) containing phenelzine, iproniazid, isocarboxazide, nialamide, or tranylcypromine as active substances. If you have taken any of these medicines, you must wait 14 days before starting Seropram. After stopping Seropram, you must wait 7 days before taking any of these medicines.
• Reversible selective MAO-A inhibitors containing moclobemide (used for the treatment of depression).
• The antibiotic linezolid.
• Lithium (used for prophylaxis and treatment of bipolar disorder) and tryptophan.
• Imipramine and desipramine (both used to treat depression).
• Irreversible MAO-B inhibitors containing selegiline (used for the treatment of Parkinson’s disease); these increase the risk of adverse effects. The selegiline dose must not exceed 10 mg per day.
• Metoprolol (used for high blood pressure and/or heart disease); blood levels of metoprolol increase, but no signs of increased effect or adverse effects of metoprolol have been observed.
• Sumatriptan and similar medicines (used to treat migraine) and tramadol and similar medicines (opioids, used for severe pain) increase the risk of adverse effects. If you experience any unusual symptoms while taking this combination, see your doctor.
• Cimetidine, lansoprazole, and omeprazole (used to treat stomach ulcers), fluconazole (used to treat fungal infections), fluvoxamine (an antidepressant), and ticlopidine (used to reduce the risk of stroke). Blood levels of citalopram may be increased, but no increase in Seropram adverse effects has been reported.
• Medicines affecting platelet function, for example, some antipsychotics, acetylsalicylic acid (used for pain), non-steroidal anti-inflammatory drugs (used for arthritis); these slightly increase the risk of bleeding disorders.
• St. John’s wort (Hypericum perforatum) (a herbal remedy used for depression); concomitant use with Seropram may increase the risk of adverse effects.
• Mefloquine (used to treat malaria), bupropion (used to treat depression), and tramadol (used to treat severe pain) due to a possible risk of lowering the seizure threshold.
• Neuroleptics (medicines for treating schizophrenia, psychosis), due to a possible risk of lowering the seizure threshold, and antidepressants.
• Class IA and III antiarrhythmics, antipsychotics (e.g. phenothiazine derivatives, pimozide, haloperidol), tricyclic antidepressants, certain antimicrobial agents (sparfloxacin, moxifloxacin, IV erythromycin, pentamidine, antimalarials particularly halofantrine), certain antihistamines (astemizole, mizolastine).
• Medicines that reduce potassium or magnesium levels in blood, as this increases the risk of life-threatening heart rhythm disturbances.

Do not take Seropram if you are taking medicines for a heart rhythm disorder or if you are taking medicines that may affect heart rhythm.

If you have any doubts about this, consult your doctor.

Taking Seropram with food, drinks and alcohol

Seropram can be taken with or without food (see section 3, “How to take Seropram”).

It has been observed that Seropram does not increase the effects of alcohol. However, it is advisable to avoid alcohol consumption during treatment with Seropram.

Pregnancy, breastfeeding and fertility

Inform your doctor if you are pregnant or planning to become pregnant. Pregnant women should normally not take Seropram, and mothers should not breastfeed while taking this medicine, unless you and your doctor have discussed the risks and benefits involved.

If you take Seropram during the last 3 months of pregnancy and up to delivery, be aware that the following effects may occur in the newborn baby: breathing difficulties, bluish skin, seizures, changes in body temperature, feeding difficulties, vomiting, low blood sugar, muscle stiffness or floppiness, exaggerated reflexes, tremors, restlessness, irritability, lethargy, constant crying, drowsiness, and sleep difficulties. If your newborn baby shows any of these symptoms, please contact your doctor immediately.

If you take citalopram in late pregnancy, there may be an increased risk of heavy vaginal bleeding shortly after delivery, especially if you have a history of bleeding disorders. Your doctor or midwife should be aware that you are taking citalopram so they can advise you.

Citalopram passes into breast milk in small amounts. There is a risk of effects on the infant. If you are taking Seropram, inform your doctor before starting breastfeeding.

Ensure that your midwife and/or doctor are aware that you are being treated with Seropram.

During pregnancy, particularly in the last 3 months, medicines like Seropram may increase the risk of a serious condition in newborns called persistent pulmonary hypertension of the newborn (PPHN), in which the baby breathes rapidly and appears blue. These symptoms usually begin within the first 24 hours after birth. If they occur in your baby, contact your midwife and/or doctor immediately.

Citalopram has been shown to reduce sperm quality in animal models. Theoretically, this effect could affect fertility, but to date, no impact on human fertility has been observed.

Driving and using machines

Generally, Seropram does not cause drowsiness; however, if you feel dizzy or sleepy when starting this medicine, do not drive or operate tools or machinery until these effects have passed.

Seropram contains lactose

If your doctor has told you that you have an intolerance to certain sugars, consult with them before taking this medicine.

Seropram contains sodium

This medicine contains less than 23 mg of sodium (1 mmol) per tablet; this is essentially “sodium-free”.

3. How to take Seropram

Follow exactly the instructions for use of this medicine as given by your doctor. If in doubt, consult your doctor or pharmacist again.

Adults

Depression

The recommended dose is 20 mg daily. If your doctor considers it necessary, they may increase this dose up to a maximum of 40 mg daily.

Panic disorder

The recommended initial dose is 10 mg daily for the first week, before increasing it to 20–30 mg daily. If your doctor considers it necessary, they may increase this dose up to a maximum of 40 mg daily.

Obsessive-compulsive disorder (OCD)

The recommended initial dose is 20 mg daily. If your doctor considers it necessary, they may increase this dose up to a maximum of 40 mg daily.

Elderly patients (over 65 years of age)

Treatment in elderly patients should be initiated at half the recommended dose, for example 10–20 mg daily.

In general, elderly patients should not take more than 20 mg daily.

Patients with special risks

Patients with liver disease should not take more than 20 mg daily.

Use in children and adolescents

Seropram must not be administered to children or adolescents. For further information, please see section 2 “What you need to know before taking Seropram”.

How and when to take Seropram

Seropram is taken every day as a single daily dose.

The tablets may be taken at any time of day, regardless of meals.

The tablets should be swallowed with a glass of water. Do not chew them (they have a bitter taste).

There are other commercial presentations with the same active substance that allow administration of 10, 20 or 40 mg of citalopram.

Duration of treatment

Like other medicines for depression, panic disorder and obsessive-compulsive disorder, it may take several weeks before you notice any improvement. Continue taking Seropram even if it takes some time before you feel better.

Never change the dose of this medicine without first talking to your doctor.

The duration of treatment is individual, but generally at least 6 months. Continue taking the tablets for the length of time recommended by your doctor. Do not stop taking them even if you feel better, unless your doctor has instructed you to do so. The underlying condition may persist for a long period, and if you stop treatment too early, your symptoms may return.

Patients with recurrent depression benefit from maintenance treatment, sometimes for several years, to prevent the occurrence of new depressive episodes.

If you take more Seropram than you should

If you think that you or someone else has taken more Seropram than you should, contact your doctor or pharmacist immediately, go to the nearest hospital emergency department, or call the Toxicology Information Service at telephone number 915 620 420, indicating the medicine and the amount taken.

Do this even if no discomfort or signs of poisoning are observed.

Take the Seropram packaging with you if you go to the doctor or hospital.

Some symptoms of an overdose may include irregular heartbeats with risk to life, seizures, changes in heart rhythm, drowsiness, coma, vomiting, tremors, decreased blood pressure, increased blood pressure, nausea (feeling sick), serotonin syndrome (see section 4 “Possible side effects”), agitation, dizziness, dilated pupils, sweating, bluish skin, hyperventilation (increased breathing rate).

If you forget to take Seropram

If you forget to take a dose, take the next dose at the usual time.

Do not take a double dose to make up for missed doses.

If you stop taking Seropram

Do not stop taking Seropram until your doctor tells you to do so. When you have completed your treatment period, it is generally recommended that the dose of Seropram be gradually reduced over several weeks.

Suddenly stopping the medication may cause some mild or transient disturbances such as dizziness, tingling sensations, sleep disturbances (vivid dreams, nightmares, inability to sleep), feeling of anxiety, headache, dizziness (nausea), vomiting, sweating, feeling restless or agitated, tremors, feeling confused or disoriented, feelings of emotion or irritability, diarrhoea (loose stools), visual disturbances, rapid pulse or palpitations.

When you have finished your treatment period, it is generally recommended that the dose of Seropram be gradually reduced over a couple of weeks rather than stopped abruptly.

If you have any further questions about the use of this medicine, ask your doctor or pharmacist.

4. Possible adverse effects

Like all medicines, this medicine can cause adverse effects, although not everyone will experience them.

Adverse effects usually disappear after a few weeks of treatment. Please note that many of these effects may also be symptoms of your illness and will therefore improve as you start to feel better.

Some patients have reported the following serious adverse effects.

If you experience any of the following symptoms, you must stop taking Prisdal and see your doctor immediately:

• High fever, agitation, confusion, tremors, and sudden muscle contractions; these may be signs of a rare condition called serotonin syndrome, which has been reported with the combined use of antidepressants.

• Swelling of the skin, tongue, lips, or face, or difficulty breathing or swallowing (allergic reaction).

• Unusual bleeding, including gastrointestinal bleeding.

Rare but serious adverse effects (may affect up to 1 in 1,000 people):

If you experience any of the following symptoms, you must stop taking Prisdal and contact your doctor immediately:

• Hyponatraemia: low sodium levels in the blood, which may cause fatigue, confusion, and muscle spasms.
• Rapid or irregular heartbeat, or feeling faint, as these may be symptoms of a serious heart condition known as torsade de pointes.

The following adverse effects are generally mild and usually disappear after a few days of treatment. Please be aware that several of the effects listed below may be symptoms of your illness and will therefore improve as you start to feel better.

If adverse effects are troublesome or last longer than a few days, consult your doctor.

Dry mouth increases the risk of tooth decay. Therefore, you should brush your teeth more often than usual.

Very common adverse effects (may affect more than 1 in 10 people):

• Drowsiness.
• Difficulty sleeping.
• Increased sweating.
• Dry mouth.
• Nausea (feeling sick).
• Headache.

Common adverse effects (may affect up to 1 in 10 people):

• Decreased appetite.
• Agitation.
• Reduced sexual drive.
• Anxiety.
• Restlessness.
• Confusional state.
• Abnormal dreams.
• Tremors.
• Tingling or numbness in hands or feet.
• Dizziness.
• Attention disturbance.
• Ringing in the ears (tinnitus).
• Yawning.
• Diarrhea.
• Vomiting.
• Constipation.
• Rash.
• Muscle and joint pain.
• Men may experience problems with ejaculation and erection.
• Women may experience difficulty reaching orgasm.
• Fatigue.
• Skin irritation.
• Weight loss.

Uncommon adverse effects (may affect up to 1 in 100 people):

• Bleeding disorders of the skin (easy bruising).
• Increased appetite.
• Aggressiveness.
• Depersonalization.
• Hallucinations.
• Mania.
• Fainting.
• Dilated pupils.
• Rapid heartbeat.
• Slow heartbeat.
• Hives.
• Hair loss.
• Skin rash.
• Light sensitivity.
• Urination difficulties.
• Difficulty starting to urinate, reduced urination.
• Excessive menstrual bleeding.
• Swelling of arms and legs.
• Weight gain.

Rare (may affect up to 1 in 1,000 people):

• Seizures.
• Involuntary movements.
• Taste disturbances.
• Bleeding.
• Hepatitis.
• Fever.

Frequency not known (cannot be estimated from available data):

• Thoughts of harming yourself or thoughts of suicide; see also section "Warnings and precautions".
• Reduction in blood platelets, increasing the risk of bleeding or bruising (haematoma).
• Hypersensitivity (rash).
• Severe allergic reaction causing difficulty breathing or dizziness.
• Hypokalaemia: low potassium levels in the blood, which may cause muscle weakness, cramps, or abnormal heart rhythm.
• Panic attacks.
• Teeth grinding.
• Restlessness.
• Abnormal muscle movements or stiffness.
• Akathisia (involuntary muscle movements).
• Vision disturbances.
• Low blood pressure.
• Nosebleeds.
• Bleeding disorders including bleeding of the skin and mucous membranes (ecchymoses).
• Heavy vaginal bleeding shortly after childbirth (postpartum haemorrhage); see 'Pregnancy, breastfeeding and fertility' in section 2 for more information.
• Sudden swelling of skin or mucous membranes.
• Painful erections.
• Increased levels of prolactin hormone in blood.
• Milk discharge in men and in women who are not breastfeeding.
• Irregular menstrual periods.
• Abnormal liver function tests.
• Orthostatic hypotension (a significant drop in blood pressure when standing up).
• An increased risk of bone fractures has been observed in patients treated with this type of medicine.
• Abnormal heart rhythm.

If you experience any adverse effects, consult your doctor or pharmacist, even if they are adverse effects not listed in this leaflet.

Reporting of adverse effects

If you experience any adverse effect, talk to your doctor, pharmacist, or nurse, even if it is a possible adverse effect not listed in this leaflet. You can also report them directly via the Spanish Pharmacovigilance System for Human Medicines: https://www.notificaram.es. By reporting adverse effects, you can help provide more information on the safety of this medicine.

5. Storage of Seropram

Keep this medicine out of the sight and reach of children.

Store below 30°C.

Expiry

Do not use this medicine after the expiry date stated on the packaging after EXP. The expiry date refers to the last day of the month indicated.

Medicines should not be disposed of via wastewater drains or household waste. Unused medicines and their containers should be taken to the SIGRE Point at your pharmacy. If you have any doubts, ask your pharmacist how to dispose of medicines and containers you no longer need. This will help protect the environment.

6. Contents of the pack and other information

Composition of Seropram

The active substance is citalopram (as hydrobromide). Each tablet contains 30 mg of citalopram (as citalopram hydrobromide).

The other components are: maize starch, lactose monohydrate, microcrystalline cellulose,
copovidone, glycerol 85%, sodium croscarmellose, magnesium stearate, hypromellose 5, macrogol 400 and titanium dioxide (E-171).

Appearance of the product and contents of the pack

Seropram 30 mg is presented as film-coated tablets.

The tablets are white, oval, scored, coated and marked with “C” and “P”.

Seropram 30 mg is available in packs of 28 tablets in blister packs.

Marketing Authorisation Holder and Manufacturer

Marketing Authorisation Holder

Lundbeck España, S.A.
Av. Diagonal 605
08028 Barcelona
Spain

Manufacturer

• Lundbeck A/S
  Ottiliavej 9
  2500 Valby
  Denmark

Date of latest review of this leaflet: June 2025

Detailed and up-to-date information on this medicinal product is available on the website of the Spanish Agency of Medicines and Medical Devices (AEMPS) http://www.aemps.gob.es/