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Clomipramine

Generic Name: clomipramine (kloe MI pra meen)
Brand Name: Anafranil

Medically reviewed: November 3, 2017

What is clomipramine?

Clomipramine is a tricyclic antidepressant. It affects chemicals in the brain that may be unbalanced.

Clomipramine is used to treat symptoms of obsessive-compulsive disorder (OCD) such as recurrent thoughts or feelings and repetitive actions.

Clomipramine may also be used for purposes not listed in this medication guide.

Important Information

Do not use this medicine if you have used an MAO inhibitor in the past 14 days, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, or tranylcypromine.

Some young people have thoughts about suicide when first taking an antidepressant. Stay alert to changes in your mood or symptoms. Report any new or worsening symptoms to your doctor.

Before taking this medicine

You should not take this medicine if you are allergic to clomipramine or to similar antidepressants (amitriptyline, amoxapine, desipramine, doxepin, imipramine, nortriptyline, protriptyline, or trimipramine).

Do not use clomipramine if you have used an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others.

Before taking clomipramine, tell your doctor if you have used an "SSRI" antidepressant in the past 5 weeks, such as citalopram, escitalopram, fluoxetine (Prozac), fluvoxamine, paroxetine (Paxil), sertraline (Zoloft), trazodone, or vilazodone (Viibryd).

To make sure clomipramine is safe for you, tell your doctor if you have ever had:

Some young people have thoughts about suicide when first taking an antidepressant. Your doctor will need to check your progress at regular visits while you are using clomipramine. Your family or other caregivers should also be alert to changes in your mood or symptoms.

Some medicines can interact with clomipramine and cause a serious condition called serotonin syndrome. Be sure your doctor knows if you also take stimulant medicine, opioid medicine, herbal products, or medicine for depression, mental illness, Parkinson's disease, migraine headaches, serious infections, or prevention of nausea and vomiting. Ask your doctor before making any changes in how or when you take your medications.

It is not known whether this medicine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

Clomipramine can pass into breast milk and may harm a nursing baby. You should not breast-feed while you are using this medicine.

Do not give clomipramine to anyone younger than 18 years old without the advice of a doctor.

How should I take clomipramine?

Follow all directions on your prescription label. Your doctor may occasionally change your dose. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Take clomipramine with food to reduce stomach upset.

It may take up to 4 weeks before your symptoms improve. Keep using the medication as directed and tell your doctor if your symptoms do not improve after 4 weeks of treatment.

Call your doctor if your symptoms do not improve, or if they get worse.

If you need surgery, tell the surgeon ahead of time that you are using clomipramine. You may need to stop using the medicine for a short time.

Do not stop using clomipramine suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using clomipramine.

Store at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of clomipramine can be fatal.

Overdose symptoms may include vomiting, fast or uneven heart rate, loss of balance or coordination, extreme drowsiness, fever, severe sweating, stiff muscles, increased or decreased urination, blue lips or fingernails, weak or shallow breathing, fainting, seizure (convulsions) or coma.

What should I avoid while taking clomipramine?

Avoid drinking alcohol. Dangerous side effects could occur.

This medicine may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Clomipramine side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Seek medical treatment if you have a serious drug reaction that can affect many parts of your body. Symptoms may include: skin rash, fever, swollen glands, flu-like symptoms, muscle aches, severe weakness, unusual bruising, or yellowing of your skin or eyes. This reaction may occur several weeks after you began using clomipramine.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

Call your doctor at once if you have:

  • blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights;

  • rapid heart rate, tremors or shaking;

  • confusion, extreme fear, thoughts of hurting yourself;

  • painful or difficult urination; or

  • a seizure (convulsions).

Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.

Common side effects may include:

  • dry mouth, nausea, upset stomach, loss of appetite, constipation;

  • feeling anxious, restless, dizzy, drowsy, or tired;

  • sleep problems (insomnia);

  • appetite or weight changes;

  • memory problems, trouble concentrating;

  • increased sweating, numbness or tingling;

  • vision changes; or

  • decreased sex drive, impotence, or difficulty having an orgasm.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Clomipramine dosing information

Usual Adult Dose for Obsessive Compulsive Disorder:

Initial dose: 25 mg orally once a day at bedtime
Maintenance dose: 100 mg orally per day
Maximum dose: 250 mg/day

Comments:
-The dose should be increased gradually, as tolerated, to 100 mg during the first 2 weeks. After the initial titration, the dose may be increased gradually over the next several weeks to a maximum of 250 mg/day.
-During initial titration, this drug should be given in divided doses with meals to reduce gastrointestinal side effects.
-During maintenance, the total daily dose may be given once a day at bedtime to minimize daytime sedation.
-Dosage adjustments should be made to maintain the patient on the lowest effective dosage.

Use: Treatment of obsessions and compulsions in patients with Obsessive-Compulsive Disorder (OCD) who have obsessions/compulsions that must cause marked distress, be time consuming, or significantly interfere with social/occupational functioning

Usual Pediatric Dose for Obsessive Compulsive Disorder:

10 to 17 years:
-Initial dose: 25 mg orally once a day at bedtime
-Maintenance dose: May increase to 3 mg/kg or 100 mg orally per day, whichever is the smaller dose
-Maximum dose: 3 mg/kg/day or 200 mg/day, whichever is the smaller dose

Comments:
-During initial titration, this drug should be given in divided doses with meals to reduce gastrointestinal side effects.
-After titration, the total daily dose may be given once a day at bedtime to minimize daytime sedation.
-Dosage adjustments should be made to maintain the patient on the lowest effective dosage.

Use: Treatment of obsessions and compulsions in patients with OCD who have obsessions/compulsions that must cause marked distress, be time consuming, or significantly interfere with social/occupational functioning

What other drugs will affect clomipramine?

Taking clomipramine with other drugs that make you sleepy can worsen this effect. Ask your doctor before taking a sleeping pill, opioid pain medication, muscle relaxer, or medicine for anxiety, depression, or seizures.

Many drugs can interact with clomipramine. Not all possible interactions are listed here. Tell your doctor about all your current medicines and any you start or stop using, especially:

Many drugs can interact with clomipramine. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide. Tell your doctor about all medicines you use, and those you start or stop using during your treatment with clomipramine. Give a list of all your medicines to any healthcare provider who treats you.

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer

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