<unk>  is metabolized in the liver mostly by CYP2C19, but also by CYP3A4 and CYP2D6. Metabolites desmethylcitalopram and didesmethylcitalopram are significantly less energetic and their contribution to the overall action of<unk>  is negligible. The half-life of<unk>  is about 35 hours. Approximately 80% is cleared by the liver and 20% by the kidneys. The elimination process is slower in the elderly and in patients with liver or kidney failure. With once-daily dosing, steady plasma concentrations are achieved in about a week. Potent inhibitors of CYP2C19 and 3A4 might decrease<unk>  clearance. Tobacco smoke exposure was found to inhibit the biotransformation of<unk>  in animals, suggesting that the elimination rate of<unk>  is decreased after tobacco smoke exposure. After intragastric administration, the half-life of the racemic mixture of<unk>  was increased by about 287%. Metabolism of<unk>  in humans.
Citalopram
Escitalopram
Atomoxetine
Sertraline
Dapoxetine
Duloxetine
Fluoxetine
Desipramine