clomipramine (Anafranil)

  • Pharmacy Author:
    Omudhome Ogbru, PharmD

    Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

  • Medical and Pharmacy Editor: Jay W. Marks, MD
    Jay W. Marks, MD

    Jay W. Marks, MD

    Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

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Less common but serious side effects include:

  • hypersensitivity type reactions,
  • suicidal ideation,
  • serotonin syndrome, and
  • others.



PREPARATIONS: Oral tablets: 25, 50, and 75 mg.

STORAGE: Tablets should be stored at room temperature, between 15 C to 30 C (59 F to 86 F). As with all medications, clomipramine tablets should be kept out of the reach of children and pets.

DOSING: Treatment with clomipramine should be started at the lowest recommended dose and increased slowly based on patient response to minimize the risk for side effects. Clomipramine tablets are better tolerated when administered with meals.

For the treatment of obsessive-compulsive disorder in adults: Treatment is generally started with 25 mg by mouth once daily. Dosage may be gradually increased by 25 mg increments every 3-4 days up to a total daily dose of 100 mg by the end of 2 weeks. Thereafter, the dose may be gradually increased over a period of several weeks to 250 mg. Total daily dose is usually given in divided doses with meals to decrease the occurrence of gastrointestinal (stomach related) side effects. Once tolerated, the total dose may be given at bedtime.

For the treatment of obsessive-compulsive disorder in children and adolescents: For children between the ages of 10 and 17, the usual recommended starting dose is 25 mg per day. Dosage may be increased in 25 mg increments every 3-4 days as tolerated up to 100 mg/day or 3 mg/kg/day, whichever is the smaller, over the first 2 weeks. Thereafter, dosage may be increased slowly as necessary to a daily maximum of 3 mg/kg/day or 200 mg/day, whichever is smaller.

The safety and effectiveness of clomipramine treatment has not been evaluated in children less than 10 years of age.

DRUG INTERACTIONS: Patients starting treatment with clomipramine should consult with their doctor or pharmacist to find out if any of their current medications or supplements have any drug interactions with clomipramine. Also, patients receiving treatment with clomipramine should always consult with their doctor before starting treatment with any new medications.

Clomipramine generally is not recommended to be used with other tricyclic antidepressants or related cyclic antidepressants. Co-administration with medications that share similar properties increases the risk for side effects. Examples of similar antidepressants are amoxapine, imipramine (Tofranil), and desipramine (Norpramin).

Medically Reviewed by a Doctor on 12/10/2014
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