clomipramine (Anafranil) (cont.)

Pharmacy Author:
Medical and Pharmacy Editor:

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.

Clomipramine should be avoided when possible or used cautiously with medications known to prolong the QTc interval. Examples of such medication are thioridazine (Mellaril), ziprasidone (Geodon), pimozide (Orap), and others.

Clomipramine increases the levels of serotonin in the brain. Co-administration with other medications that also increase serotonin levels increases the risk of serotonin syndrome. Symptoms of serotonin syndrome include rapid development of hyperthermia (high body temperature), high blood pressure, muscle rigidity, confusion, and delirium. Some medications that increase serotonin levels are monoamine oxidase inhibitors, selective serotonin reuptake inhibitors, serotonin norepinephrine reuptake inhibitors, tricyclic antidepressants, and linezolid (Zyvox). For a complete list, please ask your doctor or pharmacist.

Medically Reviewed by a Doctor on 12/10/2014


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