tagamet and Anafranil Interactions

Interactions between tagamet(cimetidine) and Anafranil (clomiPRAMINE)

cimetidine and clomiPRAMINE (Moderate Drug-Drug)

MONITOR: Cimetidine may increase the serum concentration of tricyclic antidepressants (TCAs) to toxic levels in some patients. The mechanism may be related to inhibition of CYP450 hepatic metabolism of TCAs.

MANAGEMENT: Close monitoring for clinical response and tolerance is recommended whenever cimetidine is added to or discontinued from a TCA regimen. Patients should be advised to notify their physician if they experience excessive TCA effects such as dry mouth, blurry vision, irregular or fast heartbeat, constipation, urinary retention, dizziness, or orthostatic hypotension. Lower doses of tricyclic antidepressants may be necessary. Ranitidine, famotidine, and nizatidine are not expected to interact and may be an alternative to cimetidine in this circumstance.