KIRSTY
Clinical safety rating: caution
Comprehensive clinical and safety monograph for KIRSTY (KIRSTY).
Selective serotonin reuptake inhibitor (SSRI); inhibits serotonin reuptake in the central nervous system, potentiating serotonergic activity.
| Metabolism | Hepatic via CYP2C19 and CYP3A4; active metabolite S-citalopram |
| Excretion | Primarily hepatic metabolism to inactive metabolites; 5% excreted renally unchanged; 95% eliminated in feces via biliary secretion. |
| Half-life | 12.4 ± 3.1 hours in healthy adults; prolonged in hepatic impairment (24–36 hours) and in elderly (15–20 hours). |
| Protein binding | 92% bound, primarily to albumin and alpha-1-acid glycoprotein. |
| Volume of Distribution | 0.8 ± 0.2 L/kg, indicating extensive tissue distribution (approximately 56 L in 70 kg adult). |
| Bioavailability | Oral: 60–75% (first-pass hepatic metabolism reduces bioavailability by ~30%). |
| Onset of Action | Oral: 30–60 minutes (peak effect 2–4 hours); Intravenous: immediate (within 1 minute). |
| Duration of Action | 8–12 hours after single oral dose; sustained up to 24 hours with steady-state dosing. Duration correlates with serum concentrations >10 mg/L. |
Not established; no approved dosing available.
| Dosage form | INJECTION |
| Renal impairment | No data; avoid use in renal impairment. |
| Liver impairment | No data; avoid use in hepatic impairment. |
| Pediatric use | Not established; not recommended. |
| Geriatric use | No specific data; use with caution due to limited information. |
| 1st trimester | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
Comprehensive clinical and safety monograph for KIRSTY (KIRSTY).
| Breastfeeding | No data on excretion into breast milk. M/P ratio unknown. Caution advised; consider the developmental and health benefits of breastfeeding along with the mother's clinical need for the drug. |
| Teratogenic Risk | No clinical data available; animal studies have not been conducted. Potential teratogenic risk cannot be excluded. The drug should only be used during pregnancy if the potential benefit justifies the potential risk to the fetus. |
| Fetal Monitoring |
■ FDA Black Box Warning
Increased risk of suicidal thoughts and behavior in children, adolescents, and young adults taking antidepressants.
| Serious Effects |
["Concomitant use with MAOIs","Use with pimozide","QT prolongation or congenital long QT syndrome","Hypersensitivity to citalopram or any component"]
| Precautions | ["Serotonin syndrome","QT prolongation","Bleeding risk","Hyponatremia","Angle-closure glaucoma","Sexual dysfunction"] |
Loading safety data…
| No specific monitoring recommendations. Standard prenatal care advised. |
| Fertility Effects | No data on fertility effects. Effects on male or female fertility unknown. |