clomipramine (Anafranil) (cont.)
Omudhome Ogbru, PharmD
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:
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).
Clomipramine shares pharmacological properties with Class IA and Class III antiarrhythmic medications. Co-administration increases the risk for QT prolongation and life-threatening arrhythmias. For this reason, use of clomipramine should be avoided with bretylium, dofetilide (Tikosyn), dronedarone (Multaq), flecainide (Tambocor), sotalol (Betapace), quinidine (Quinidex), procainamide (Pronestyl), propafenone (Rythmol), ranolazine (Ranexa), ibutilide (Corvert), and others.
Medically Reviewed by a Doctor on 12/10/2014
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