Citalopram is not recommended for use at doses greater than 40 mg per day because such doses cause too large an effect on the QT interval and confer no additional benefit.

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Francine is a 60-year-old woman who was recently diagnosed with type 2 diabetes mellitus. She has a medical history significant for hyperlipidemia, osteoarthritis, migraine headaches, and obesity. Her chronic medications include lovastatin, ibuprofen, and propranolol.

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In November 2009, The Medicines and Healthcare Regulatory Agency published a Drug Safety Update which outlined changes to the product literature for the group of drugs known as the statins (HMG Co-A Reductase Inhibitors e.g. simvastatin, atorvastatin, pravastatin, fluvastatin and rosuvastatin).

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Due to their effect on altering physiological interactions between vasodilator and vasoconstrictor autacoids in normal pregnancies, antidepressants may be associated with the risk of pregnancy-induced hypertension. The authors evaluated the impact of antidepressant use during pregnancy on the risk of pregnancy-induced hypertension.

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There are two published case reports of increased INR in patients receiving warfarin who self-medicated with glucosamine-chondroitin supplements. Since chondroitin is a component of danaparoid, an anticoagulant that works by inhibiting activated factor X, it might have an anticoagulant effect and could increase the risk of bleeding in patients who are already receiving anticoagulants. Caution is advised for anyone taking chondroitin with warfarin or other anticoagulants or antiplatelet agents. Monitoring for bleeding episodes/changes in coagulation parameters when adding chondroitin to an anticoagulant or antiplatelet, or changing the dose of chondroitin is recommended. [Welsh meds Info 23 March 2012]

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