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Anafranil Side Effects

Generic Name: clomipramine

Note: This page contains information about the side effects of clomipramine. Some of the dosage forms included on this document may not apply to the brand name Anafranil.

In Summary

Common side effects of Anafranil include: constipation, dizziness, drowsiness, dyspepsia, ejaculatory disorder, fatigue, headache, insomnia, myoclonus, nausea, nervousness, paresthesia, tremor, urination disorder, visual disturbance, weight gain, anorexia, diaphoresis, and xerostomia. Other side effects include: anxiety, fever, hot flash, hypertonia, memory impairment, muscle twitching, non-puerperal lactation, orthostatic hypotension, pruritus, skin rash, sleep disorder, tachycardia, tinnitus, vomiting, flushing, and taste disorder. See below for a comprehensive list of adverse effects.

For the Consumer

Applies to clomipramine: oral capsule, oral tablet

In addition to its needed effects, some unwanted effects may be caused by clomipramine (the active ingredient contained in Anafranil). In the event that any of these side effects do occur, they may require medical attention.

Major Side Effects

You should check with your doctor immediately if any of these side effects occur when taking clomipramine:

More common:
  • Bladder pain
  • bloody or cloudy urine
  • blurred vision
  • body aches or pain
  • burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
  • confusion
  • difficult, burning, or painful urination
  • dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
  • excessive muscle tone
  • fear or nervousness
  • feeling sad or empty
  • fever
  • hearing changes
  • irritability
  • lower back or side pain
  • muscle stiffness, tension, or tightness
  • poor concentration
  • rhythmic movement of muscles
  • shortness of breath or troubled breathing
  • sneezing
  • tightness of the chest or wheezing
  • unusual tiredness or weakness
  • voice changes
Less common:
  • Anger that is hard to control
  • breast enlargement
  • burning while urinating
  • changes in vision
  • chills
  • decrease in the frequency of urination
  • difficulty in passing urine (dribbling)
  • difficulty in speaking
  • dry mouth
  • fast, irregular, pounding, or racing heartbeat or pulse
  • headache, severe and throbbing
  • hyperventilation
  • irregular heartbeats
  • irritability
  • nausea or vomiting
  • numbness, tingling, pain, or weakness in the hands or feet
  • pain during sexual intercourse
  • panic attacks
  • paranoia
  • rapidly changing moods
  • restlessness
  • shaking
  • swelling of the face, fingers, feet, or lower legs

Minor Side Effects

Some of the side effects that can occur with clomipramine may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:

More common:
  • Acid or sour stomach
  • blistering, crusting, irritation, itching, or reddening of the skin
  • change in taste
  • constipation
  • cracked, dry, or scaly skin
  • change in interest in sexual intercourse
  • diarrhea
  • dry skin
  • heartburn
  • hives or welts, skin rash
  • inability to have or keep an erection
  • increased interest in sexual intercourse
  • joint pain
  • pimples
  • redness of the face, neck, arms, and occasionally, upper chest
  • shakiness in the legs, arms, hands, or feet
  • stomach discomfort, upset, or pain
  • swelling
  • swollen joints
  • trembling or shaking of the hands or feet
Less common:
  • Absent, missed, or irregular menstrual periods
  • breast pain
  • sores, ulcers, or white spots on the lips or tongue or inside the mouth

For Healthcare Professionals

Applies to clomipramine: oral capsule

Nervous system

Very common (10% or more): Somnolence (up to 54%), tremor (up to 54%), dizziness (up to 54%), headache (up to 52%), nervousness (up to 18%), myoclonus (up to 13%)
Common (1% to 10%): Paraesthesia, twitching, hypertonia, confusion, speech disorder, migraine, paresis, taste perversion, abnormal thinking, vertigo
Uncommon (0.1% to 1%): Abnormal coordination, abnormal EEG, abnormal gait, ataxia, coma, convulsions, dyskinesia, dysphonia, encephalopathy, euphoria, extrapyramidal disorder, hyperkinesia, hypokinesia, neuralgia, sensory disturbance, somnambulism, stimulation
Rare (less than 0.1%): Cerebral hemorrhage, anticholinergic syndrome, aphasia, apraxia, cholinergic syndrome, choreoathetosis, generalized spasm, hemiparesis, hyperesthesia, hyperreflexia, hypoesthesia, indecisiveness, neuropathy, nystagmus, oculomotor nerve paralysis, stupor
Frequency not reported: Neuroleptic malignant syndrome[Ref]


Common (1% to 10%): Flushing, chest pain, postural hypotension, palpitation, tachycardia, syncope
Uncommon (0.1% to 1%): Abnormal ECG, arrhythmia, bradycardia, cardiac arrest, extrasystoles, pallor, increased blood pressure
Rare (less than 0.1%): Cyanosis, aneurysm, atrial flutter, bundle branch block, cardiac failure, heart block, myocardial infarction, myocardial ischemia, peripheral ischemia, thrombophlebitis, vasospasm, ventricular tachycardia[Ref]


Very common (10% or more): Insomnia (up to 25%)
Common (1% to 10%): Anxiety, memory impairment, impaired concentration, depression, sleep disorder, psychosomatic disorder, abnormal dreaming, agitation, depersonalization, irritability, emotional lability, panic reaction, aggressive reaction
Uncommon (0.1% to 1%): Delirium, delusion, apathy, euphoria, catalepsy, illusion, impaired impulse control, mutism, oculogyric crisis, hallucinations, hostility, hypnagogic hallucinations, manic reaction, paranoia, phobic disorder, suicidal ideation, suicide attempt, psychosis
Rare (less than 0.1%): Withdrawal syndrome, schizophrenic reaction[Ref]


Very common (10% or more): Dry mouth (up to 84%), constipation (up to 47%), nausea (up to 33%), dyspepsia (up to 22%), diarrhea (up to 13%), abdominal pain (up to 11%)
Common (1% to 10%): Vomiting, flatulence, tooth disorder, gastrointestinal disorder, dysphagia, esophagitis, eructation, ulcerative stomatitis, halitosis
Uncommon (0.1% to 1%): Blood in stool, teeth-grinding, colitis, duodenitis, gastric ulcer, gastritis, gastroesophageal reflux, gingivitis, glossitis, hemorrhoids, increased saliva, irritable bowel syndrome, peptic ulcer, rectal hemorrhage, tongue ulceration, tooth caries
Rare (less than 0.1%): Cheilitis, chronic enteritis, discolored feces, gastric dilatation, gingival bleeding, hiccup, intestinal obstruction, oral/pharyngeal edema, paralytic ileus, salivary gland enlargement[Ref]


The most commonly reported side effects were somnolence, tremor, dizziness, headache, dry mouth, constipation, and nausea.[Ref]


Very common (10% or more): Libido change (up to 21%), micturition disorder (up to 14%), dysmenorrhea (up to 12%)
Common (1% to 10%): Urinary tract infection, micturition frequency, urinary retention, dysuria, cystitis, lactation (nonpuerperal), menstrual disorder, vaginitis, leukorrhea, breast enlargement, breast pain, amenorrhea, ejaculation failure, impotence
Uncommon (0.1% to 1%): Endometriosis, epididymitis, hematuria, nocturia, oliguria, ovarian cyst, perineal pain, polyuria, prostatic disorder, urethral disorder, urinary incontinence, uterine hemorrhage, vaginal hemorrhage
Rare (less than 0.1%): Albuminuria, anorgasmy, breast engorgement, breast fibroadenosis, cervical dysplasia, endometrial hyperplasia, premature ejaculation, pyelonephritis, pyuria, uterine inflammation, vulvar disorder[Ref]


Common (1% to 10%): Purpura, anemia
Uncommon (0.1% to 1%): Lymphadenopathy
Rare (less than 0.1%): Leukemoid reaction, lymphoma-like disorder, marrow depression
Very rare (less than 0.01%): Leucopenia, agranulocytosis, thrombocytopenia, eosinophilia[Ref]


Common (1% to 10%): Hot flushes, galactorrhea
Uncommon (0.1% to 1%): Hypothyroidism
Rare (less than 0.1%): Goiter, gynecomastia, hyperthyroidism
Very rare (less than 0.01%): SIADH (inappropriate antidiuretic hormone secretion syndrome)
Frequency not reported: Increased blood prolactin[Ref]


Uncommon (0.1% to 1%): Abnormal hepatic function, hepatitis[Ref]


Very common (10% or more): Increased sweating (up to 29%)
Common (1% to 10%): Rash, pruritus, dermatitis, acne, dry skin, urticaria, abnormal skin odor[Ref]


Very common (10% or more): Fatigue (up to 39%)
Common (1% to 10%): Fever, pain, local edema, chills, otitis media, asthenia, tinnitus, vestibular disorder
Uncommon (0.1% to 1%): Malaise, deafness, earache, foreign body sensation, hyperacusis, parosmia
Rare (less than 0.1%): Dependent edema, labyrinth disorder[Ref]


Very common (10% or more): Weight increase (up to 18%), anorexia (up to 12%), increased appetite (up to 11%)
Common (1% to 10%): Weight decrease, thirst, decreased appetite
Uncommon (0.1%): Dehydration, diabetes mellitus, gout, hypercholesterolemia, hyperglycemia, hyperuricemia, hypokalemia
Rare (less than 0.1%): Fat intolerance, glycosuria[Ref]


Common (1% to 10%): Allergy
Very rare (less than 0.01%): Anaphylactic and anaphylactoid reactions[Ref]


Very common (10% or more): Pharyngitis (up to 14%), rhinitis (up to 12%)
Common (1% to 10%): Yawning, sinusitis, coughing, bronchospasm, epistaxis, dyspnea, laryngitis
Uncommon (0.1% to 1%): Bronchitis, hyperventilation, increased sputum, pneumonia
Rare (less than 1%): Hemoptysis, hypoventilation, laryngismus
Very rare (less than 0.01%): Pneumonitis[Ref]


Very common (10% or more): Abnormal vision (up to 18%)
Common (1% to 10%): Abnormal lacrimation, mydriasis, conjunctivitis, anisocoria, blepharospasm, ocular allergy
Uncommon (0.1% to 1%): Abnormal accomodation, diplopia, eye pain, photophobia, scleritis
Rare (less than 0.1%): Blepharitis, chromatopsia, conjunctival hemorrhage, exophthalmos, glaucoma, keratitis, night blindness, retinal disorder, strabismus, visual field defect
Postmarketing reports: Angle-closure glaucoma[Ref]


Very common (10% or more): Myalgia (13%)
Common (1% to 10%): Back pain, arthralgia, muscle weakness
Uncommon (0.1% to 1%): Arthrosis
Rare (less than 0.1%): Dystonia, exostosis, myopathy, myositis, polyarteritis nodosa, torticollis
Frequency nor reported: Rhabdomyolysis[Ref]


Uncommon (0.1% to 1%): Increased susceptibility to infection[Ref]


Uncommon (0.1% to 1%): Renal calculus, renal pain
Rare (less than 0.1%): Renal cyst[Ref]


1. "Product Information. Anafranil (clomipramine)." Basel Pharmaceuticals, Summit, NJ.

2. Cerner Multum, Inc. "Australian Product Information." O 0

3. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0

Not all side effects for Anafranil may be reported. You should always consult a doctor or healthcare professional for medical advice. Side effects can be reported to the FDA here.

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