Clomipramine should not be used with MAO inhibitors.
Source: NLP:clomipramine hydrochloride
Brand names: Clomipramine Hydrochloride
Route: Oral
FDA Black Box Warning
Suicidality and Antidepressant Drugs Antidepressants increased the risk compared to placebo of suicidal thinking and behavior (suicidality) in children, adolescents, and young adults in short-term studies of major depressive disorder (MDD) and other psychiatric disorders. Anyone considering the use of clomipramine hydrochloride or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. Short-term studies did not show an increase in the risk of suicidality with antidepressants compared to placebo in adults beyond age 24; there was a reduction in risk with antidepressants compared to placebo in adults aged 65 and older. Depression and certain other psychiatric disorders are themselves associated with increases in the risk of suicide. Patients of all ages who are started on antidepressant therapy should be monitored appropriately and observed closely for clinical worsening, suicidality, or unusual changes in behavior. Families and caregivers should be advised of the need for close observation and communication with the prescriber. Clomipramine hydrochloride is not approved for use in pediatric patients except for patients with obsessive compulsive disorder (OCD) ( see WARNINGS, Clinical Worsening and Suicide Risk ; PRECAUTIONS, Information for Patients ; and PRECAUTIONS, Pediatric Use ).
Contraindications
CONTRAINDICATIONS Clomipramine hydrochloride capsules are contraindicated in patients with a history of hypersensitivity to clomipramine hydrochloride or other tricyclic antidepressants. Monoamine Oxidase Inhibitors (MAOIs) The use of MAOIs intended to treat psychiatric disorders with clomipramine hydrochloride or within 14 days of stopping treatment with clomipramine hydrochloride is contraindicated because of an increased risk of serotonin syndrome. The use of clomipramine hydrochloride within 14 days of stopping an MAOI intended to treat psychiatric disorders is also contraindicated ( see WARNINGS and DOSAGE AND ADMINISTRATION ). Starting clomipramine hydrochloride in a patient who is being treated with linezolid or intravenous methylene blue is also contraindicated because of an increased risk of serotonin syndrome ( see WARNINGS and DOSAGE AND ADMINISTRATION ). Myocardial Infarction Clomipramine hydrochloride is contraindicated during the acute recovery period after a myocardial infarction.
Pregnancy & Breastfeeding
Pregnancy No teratogenic effects were observed in studies performed in rats and mice at doses up to 100 mg/kg, which is 24 times the maximum recommended human daily dose (MRHD) on a mg/kg basis and 4 times (rats) and 2 times (mice) the MRHD on a mg/m 2 basis. Slight nonspecific embryo/fetotoxic effects were seen in the offspring of treated rats given 50 and 100 mg/kg and of treated mice given 100 mg/kg. There are no adequate or well-controlled studies in pregnant women. Withdrawal symptoms, including jitteriness, tremor, and seizures, have been reported in neonates whose mothers had taken clomipramine hydrochloride until delivery. Clomipramine hydrochloride should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.
18 interactions on record
Clomipramine should not be used with MAO inhibitors.
Source: NLP:clomipramine hydrochloride
Type 1C antiarrhythmic that inhibits P450 2D6 and may increase clomipramine plasma levels, potentially causing toxicity.
Source: NLP:clomipramine hydrochloride
Inhibits P450 2D6 and may increase clomipramine plasma levels, potentially causing toxicity in normal metabolizers.
Source: NLP:clomipramine hydrochloride
SSRI that inhibits P450 2D6 and P450 1A2, both involved in clomipramine metabolism, may increase plasma levels.
Source: NLP:clomipramine hydrochloride
SSRI that inhibits P450 2D6 and may increase clomipramine plasma levels, potentially causing toxicity.
Source: NLP:clomipramine hydrochloride
Type 1C antiarrhythmic that inhibits P450 2D6 and may increase clomipramine plasma levels, potentially causing toxicity.
Source: NLP:clomipramine hydrochloride
Inhibits P450 2D6 and may increase clomipramine plasma levels, potentially causing toxicity.
Source: NLP:clomipramine hydrochloride
SSRI that inhibits P450 2D6 and may increase clomipramine plasma levels, potentially causing toxicity.
Source: NLP:clomipramine hydrochloride
Barbiturates decrease plasma levels of clomipramine.
Source: NLP:clomipramine hydrochloride
Cimetidine increases plasma levels of clomipramine through cytochrome P450 2D6 inhibition.
Source: NLP:clomipramine hydrochloride
Tricyclic antidepressants may block the pharmacologic effects of clonidine.
Source: NLP:clomipramine hydrochloride
Caution is advised when using clomipramine concomitantly with other CNS-active drugs due to primary CNS effects of clomipramine.
Source: NLP:clomipramine hydrochloride
Tricyclic antidepressants may block the pharmacologic effects of guanethidine.
Source: NLP:clomipramine hydrochloride
Haloperidol increases plasma concentration of clomipramine.
Source: NLP:clomipramine hydrochloride
Methylphenidate increases plasma levels of tricyclic antidepressants including clomipramine.
Source: NLP:clomipramine hydrochloride
Clomipramine administration increases plasma levels of phenobarbital when given concomitantly.
Source: NLP:clomipramine hydrochloride
Substrates for P450 2D6 that inhibit the enzyme and may increase clomipramine plasma concentrations.
Source: NLP:clomipramine hydrochloride
Phenytoin decreases plasma levels of clomipramine.
Source: NLP:clomipramine hydrochloride