Drug Interaction Report

Anagrelide and Citalopram: Interaction Details

A pharmacist-reviewed analysis of the Anagrelide and Citalopram interaction: the documented clinical effects, severity rating, onset, mechanism, and management considerations, with cited references throughout.

AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature

Anagrelide

Agrylin Agrylin®
+

Citalopram

Celexa
Dr. Brian Staiger, PharmD, BCPS
Medically reviewed by
Dr. Brian Staiger, PharmD, BCPS
Updated Aug 8, 2026
Editorial policy · Data sources
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Interaction severity
Major
Potentially serious — often needs a change or close monitoring.
How we grade severity & evidence

Severity levels

  • Contraindicated: These should generally not be used together.
  • Major: Potentially serious — often needs a change or close monitoring.
  • Moderate: Can be significant — usually manageable with monitoring.
  • Minor: Usually limited clinical impact.

Evidence grades

  • Established: Well documented — supported by controlled studies or strong clinical data.
  • Probable: Good supporting evidence, though not definitively proven.
  • Suspected: Some evidence suggests this interaction, but it is not well established.
  • Possible: Limited or conflicting evidence; the interaction may occur.
  • Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.

Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.

Of 434 documented Anagrelide interactions, 376 are rated major — including this one.
Worried about symptoms right now? Contact your pharmacist or prescriber, or call Poison Control at 1-800-222-1222 (US). Call 911 for an emergency.
Onset
unspecified
Evidence
theoretical
Severity
Major

What happens

An increased risk of QT interval prolongation and an increased risk of bleeding

Interaction Deep Dive

Anagrelide has been associated with QT interval prolongation. Coadministration with another drug known to prolong the QT interval, such as citalopram, should be avoided because of risk for additive effects on the QT interval that can lead to serious cardiac adverse effects, including torsade de pointes12. If coadministration is required, do not exceed citalopram doses of 40 mg/day, and ECG monitoring is recommended. Discontinue citalopram in patients who have persistent QTc measurements greater than 500 milliseconds 2. Coadministration of anagrelide with citalopram may also increase the risk of bleeding. Monitor patients for bleeding if coadministration is required 1.

Why it happens (mechanism)

Additive QT interval prolongation; additive effects on hemostasis

Literature reports

1 report — tap to read

a) Case reports and epidemiological studies (case-control and cohort studies) have demonstrated an association between the use of drugs that interfere with serotonin reuptake and the occurrence of gastrointestinal bleeding. Based on data from published observational studies, exposure to SSRIs, particularly in the month before delivery, has been associated with a less than 2-fold increase in the risk of postpartum hemorrhage. Bleeding events related to SSRIs and SNRIs have ranged from ecchymosis, hematoma, epistaxis, and petechiae to life-threatening hemorrhages 2.

Common questions

Can I take Anagrelide and Citalopram together?

An increased risk of QT interval prolongation and an increased risk of bleeding Always confirm with your pharmacist or prescriber before making any change.

How serious is the Anagrelide and Citalopram interaction?

It is rated major. Potentially serious — often needs a change or close monitoring.

How quickly could this interaction happen?

The documented onset is "unspecified". The timing of this interaction is not well characterized.

How strong is the evidence for this interaction?

The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.

Questions for your pharmacist

  • Does my dose of Anagrelide or Citalopram need adjusting while I take them together?
  • What symptoms should prompt me to call you or my prescriber right away?
  • Does the timing of my doses matter for this combination?
  • Is there a safer alternative to one of these medications for me?

References (2)

  1. Product Information: AGRYLIN(R) oral capsules, anagrelide HCl oral capsules. Shire US Inc. (per FDA), Wayne, PA, 2014. DailyMed
  2. Product Information: CELEXA(R) oral tablets, citalopram oral tablets. Allergan USA Inc (per FDA), Madison, NJ, 2023. DailyMed
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Anagrelide

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All Anagrelide interactions (434) Anagrelide drug information
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Citalopram

Keep reading about Citalopram

All Citalopram interactions (132)
Also serious with: Linezolid Injection Metoclopramide Nasal Spray Metoclopramide Injection Palonosetron Injection
Beyond drug–drug

These medications also interact with supplements

Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:

Anagrelide + Activated Charcoal Danshen Piracetam Aconite Adrafinil African Wild Potato Allspice Aloe + 257 more
Citalopram + Activated Charcoal Grapefruit Lithium St. John's Wort 5-htp Acacia Rigidula Acetyl-l-carnitine Adrafinil + 183 more

major · moderate · minor — check everything you take with our drug–supplement interaction checker.

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This information is for education, not a substitute for professional medical advice. Do not start, stop, or change any medication without talking to your pharmacist or prescriber.