Citalopram: Drug absorption and Oral Bioavailability

6 Drug Profile activities for Module 5 Section 1: Life stages as a factor in variability Before administration of citalopram, a thorough evaluation of personal health details should be carried out. Citalopram dose differs greatly between patients of various ages. The initial daily dose of an adult suffering from depression is set at 20mg. This dosage may however, be increased by 20mg to a maximum dose of 40mg once every week. Maintenance dose of citalopram for adults is 20-40mg (Schatzberg & Nemeroff 2009). Initial daily dose of citalopram for children below the age of 11 years is 10mg. This dosage can however, be increased gradually by 5mg per day after every two weeks for children not responding to the initial doses. For persons between the age of 12 and 18 years the initial dose for this drug is set at 20mg per day.

This dose can be increased gradually by 10mg per day every two weeks in accordance with the clinical requirement of a patient (Ayd 2000).

Section 2: Impact of disease states: Dosage adjustment in individuals with hepatic disease The fact that citalopram is metabolized in the liver implies that disorders affecting the liver can have negative implications on metabolism and clearance of this drug. The rate of elimination of citalopram is usually slower in persons presenting with abnormal hepatic conditions (Schatzberg & Nemeroff 2009). It has also been revealed that steady state concentrations for citalopram at a given dose are almost twice as high in a person presenting with liver disorders as compared to a person whose liver is functioning normally. As a result, people with hepatic disorders should be prescribed with minimal dosages of citalopram in order to minimize potential cases of hepatotoxicity (Schatzberg & Nemeroff 2009). The recommended daily dose of citalopram for people suffering from hepatic conditions is 20mg. The dose may however, be increased by 20mg daily for patients who are not responding (Pato & Zohar 2001).