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All about: Clomipramine

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Generic Name: Clomipramine (kloe-MIP-ra-meen)
Brand Name: Anafranil

Antidepressants may increase the risk of suicidal thoughts or actions in children and teenagers. The risk may be greater during the first few months that patients take Clomipramine . Be sure that the benefits of using Clomipramine outweigh the risks. Talk with the patient's doctor if you have any questions.

Family and caregivers must closely observe patients who take Clomipramine . It is important to keep in close contact with the patient's doctor. Tell the doctor right away if the patient has symptoms like worsened depression, suicidal thoughts, or changes in behavior.


Clomipramine is used for:

Treating obsessive-compulsive disorder (OCD). It may also be used for other conditions as determined by your doctor.

Clomipramine is a tricyclic antidepressant. It works by increasing the activity of certain chemicals in the brain, which helps to reduce obsessive-compulsive behaviors.

Do NOT use Clomipramine if:

  • you are allergic to any ingredient in Clomipramine or to similar medicines
  • you have taken furazolidone or a monoamine oxidase inhibitor (MAOI) (eg, phenelzine) within the last 14 days, or you are taking astemizole or terfenadine
  • you are recovering from a recent heart attack

Contact your doctor or health care provider right away if any of these apply to you.

Before using Clomipramine :

Some medical conditions may interact with Clomipramine . Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

  • if you are pregnant, planning to become pregnant, or are breast-feeding
  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
  • if you have allergies to medicines, foods, or other substances
  • if you drink alcohol-containing beverages daily or have a history of alcohol abuse
  • if you take thyroid medicine or have a history of an overactive thyroid
  • if you have a history of adrenal gland problems, glaucoma, heart problems, kidney or liver problems, diabetes, seizures, trouble urinating, the blood disease porphyria, or other blood problems
  • if you have a history of suicidal thoughts or behavior, bipolar disorder, or any other mental disorders
  • if you are undergoing electroshock therapy or you are scheduled to have any surgery

Some MEDICINES MAY INTERACT with Clomipramine . Tell your health care provider if you are taking any other medicines, especially any of the following:

  • Azole antifungals (eg, fluconazole), cimetidine, duloxetine, haloperidol, methylphenidate, mibefradil, phenothiazines (eg, chlorpromazine), selective serotonin reuptake inhibitors (SSRIs) (eg, fluoxetine), terbinafine, or valproic acid because they may increase the risk of Clomipramine 's side effects
  • Astemizole, furazolidone, ketolide antibiotics (eg, telithromycin), macrolide antibiotics (eg, erythromycin), MAOIs (eg, phenelzine), pimozide, or terfenadine because the risk of high blood pressure, serious heart problems (eg, irregular heartbeat), or seizures may be increased
  • Barbiturates (eg, phenobarbital) or phenytoin because they may decrease Clomipramine 's effectiveness
  • Anticoagulants (eg, warfarin), carbamazepine, or sympathomimetics (eg, phenylephrine) because the risk of their side effects may be increased by Clomipramine
  • Clonidine, guanethidine, or guanfacine because their effectiveness may be decreased by Clomipramine

This may not be a complete list of all interactions that may occur. Ask your health care provider if Clomipramine may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Clomipramine :

Use Clomipramine as directed by your doctor. Check the label on the medicine for exact dosing instructions.

  • Clomipramine comes with an extra patient information sheet called a Medication Guide. Read it carefully. Read it again each time you get Clomipramine refilled.
  • Take Clomipramine by mouth with food to decrease stomach upset.
  • It may take 2 to 3 weeks before you notice the effect of Clomipramine . Continue to use Clomipramine even if you feel well. Do not miss any doses.
  • If you miss a dose of Clomipramine , take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once. If you take 1 dose daily at bedtime, do not take the missed dose the next morning.

Ask your health care provider any questions you may have about how to use Clomipramine .

Important safety information:

  • Clomipramine may cause drowsiness, dizziness, or blurred vision. These effects may be worse if you take it with alcohol or certain medicines. Use Clomipramine with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
  • Do not drink alcohol or use medicines that may cause drowsiness (eg, sleep aids, muscle relaxers) while you are using Clomipramine ; it may add to their effects. Ask your pharmacist if you have questions about which medicines may cause drowsiness.
  • Clomipramine may cause dizziness, lightheadedness, or fainting; alcohol, hot weather, exercise, or fever may increase these effects. To prevent them, sit up or stand slowly, especially in the morning. Sit or lie down at the first sign of any of these effects.
  • Do not become overheated in hot weather or while you are being active; heatstroke may occur.
  • Children and teenagers who take Clomipramine may be at increased risk for suicidal thoughts or actions. Adults may also be affected. The risk may be greater in patients who have had suicidal thoughts or actions in the past. The risk may also be greater in patients who have had bipolar (manic-depressive) illness, or if their family members have had it. Watch patients who take Clomipramine closely. Contact the doctor at once if new, worsened, or sudden symptoms such as depressed mood; anxious, restless, or irritable behavior; panic attacks; or any unusual change in mood or behavior occur. Contact the doctor right away if any signs of suicidal thoughts or actions occur.
  • Clomipramine may cause you to become sunburned more easily. Avoid the sun, sunlamps, or tanning booths until you know how you react to Clomipramine . Use a sunscreen or wear protective clothing if you must be outside for more than a short time.
  • Tell your doctor or dentist that you take Clomipramine before you receive any medical or dental care, emergency care, or surgery.
  • Lab tests, including complete blood cell counts, may be performed while you use Clomipramine . These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
  • Use Clomipramine with caution in the ELDERLY; they may be more sensitive to its effects, especially those with heart problems.
  • Clomipramine should be used with extreme caution in CHILDREN younger than 10 years old; safety and effectiveness in these children have not been confirmed.
  • PREGNANCY and BREAST-FEEDING: It is not known if Clomipramine can cause harm to the fetus. If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Clomipramine while you are pregnant. Clomipramine is found in breast milk. Do not breast-feed while taking Clomipramine .

If you suddenly stop taking Clomipramine , you may have WITHDRAWAL symptoms. Symptoms may include dizziness, headache, irritability, nausea, tiredness, trouble sleeping, and vomiting.

Possible side effects of Clomipramine :

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Constipation; diarrhea; dizziness; drowsiness; dry mouth; headache; irritability; loss of appetite; nausea; nightmares; sweating; tiredness; upset stomach; vomiting; weakness; weight loss or gain.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); blurred vision or other vision changes; changes in sex drive; chest pain; confusion; decreased sexual ability; fainting; fast, slow, or irregular heartbeat; fever; flushing; frequent or difficult urination; impulsive behavior or other unusual changes in behavior; mental or mood changes (eg, increased anxiety, mood swings, agitation, irritability, nervousness, restlessness); numbness or tingling of the skin; panic attacks; ringing in the ears; seizures; severe dizziness or drowsiness; sore throat; stomach pain; suicidal thinking or behavior; swelling of the testicles; tremor; trouble sleeping; trouble walking or keeping your balance; twitching of the face or tongue; uncontrolled movements or stiffness of arms and legs; unusual bleeding or bruising; worsening of depression; yellowing of the skin or eyes.

This is not a complete list of all side effects that may occur. If you have questions or need medical advice about side effects, contact your doctor or health care provider. You may report side effects to the FDA at 1-800-FDA-1088 (1-800-332-1088) or at http://www.fda.gov/medwatch.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center (http://www.aapcc.org/findyour.htm), or emergency room immediately. Symptoms may include agitation; bluish skin or mucous membranes; breathing problems; chest pain; coma; confusion; dry mouth; enlarged pupils; excess sweating; fainting; fast or irregular heartbeat; flushing; incoordination; involuntary movements; loss of consciousness; restlessness; rigid muscles; seizures; severe drowsiness; shock; stupor; vomiting.

Proper storage of Clomipramine :

Store Clomipramine at room temperature, between 68 and 77 degrees F (20 and 25 degrees C), in a tightly sealed container. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Clomipramine out of the reach of children and away from pets.

General information:

  • If you have any questions about Clomipramine , please talk with your doctor, pharmacist, or other health care provider.
  • Clomipramine is to be used only by the patient for whom it is prescribed. Do not share it with other people.
  • If your symptoms do not improve or if they become worse, check with your doctor.

This information is a summary only. It does not contain all information about Clomipramine . If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

Issue Date: September 5, 2007
Database Edition 07.3.1.003
Copyright © 2007 Wolters Kluwer Health, Inc.

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