Find Cameroon: clomipramine

kloe-MIP-ra-meen

Oral route(Capsule)

Antidepressants increased the risk of suicidal thinking and behavior in children, adolescents, and young adults in short-term studies with major depressive disorder (MDD) and other psychiatric disorders. Short term studies did not show an increase in the risk of suicidality with antidepressants compared to placebo in adults beyond age 24, and there was a reduction in risk with antidepressants compared to placebo in adults aged 65 and older. This risk must be balanced with the clinical need. Monitor patients 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. Not approved for use in pediatric patients except for patients with obsessive compulsive disorder (OCD) .

Commonly used brand name(s)

In the U.S.

Anafranil

Available Dosage Forms:

Capsule

Tablet

Therapeutic Class: Antidepressant

Pharmacologic Class: Antidepressant, Tricyclic

Uses For clomipramine

Clomipramine is used to treat obsessive compulsive disorder (OCD). clomipramine is a tricyclic antidepressant (TCA). OCD is a nervous condition where a person has recurring thoughts or ideas, or does repetitive things because they are anxious .

Clomipramine works on the central nervous system (CNS) to relieve the symptoms of OCD. It is thought to work by increasing the activity of a chemical called serotonin in the brain .

clomipramine is available only with your doctor's prescription .

Before Using clomipramine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For clomipramine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to clomipramine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of clomipramine in children younger than 10 years of age. Safety and efficacy have not been established .

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of clomipramine in the elderly. However, elderly patients are more likely to have age-related kidney, liver, or heart problems, which may require an adjustment in the dose for patients receiving clomipramine .

Pregnancy

	Pregnancy Category	Explanation
All Trimesters	C	Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking clomipramine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using clomipramine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

Bepridil

Cisapride

Clorgyline

Dronedarone

Grepafloxacin

Isocarboxazid

Linezolid

Mesoridazine

Methylene Blue

Metoclopramide

Moclobemide

Phenelzine

Pimozide

Ranolazine

Selegiline

Sparfloxacin

Thioridazine

Tranylcypromine

Using clomipramine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Alfuzosin

Amiodarone

Amitriptyline

Amoxapine

Amprenavir

Apomorphine

Arsenic Trioxide

Asenapine

Astemizole

Atazanavir

Azithromycin

Chloroquine

Chlorpromazine

Ciprofloxacin

Citalopram

Clarithromycin

Clonidine

Clozapine

Crizotinib

Dasatinib

Desipramine

Dextromethorphan

Disopyramide

Dofetilide

Dolasetron

Droperidol

Epinephrine

Erythromycin

Etilefrine

Flecainide

Fluconazole

Gatifloxacin

Gemifloxacin

Granisetron

Halofantrine

Haloperidol

Ibutilide

Iloperidone

Imipramine

Indacaterol

Iproniazid

Lapatinib

Levofloxacin

Lopinavir

Lumefantrine

Mefloquine

Methadone

Methoxamine

Midodrine

Moricizine

Moxifloxacin

Nefopam

Nialamide

Nilotinib

Norepinephrine

Norfloxacin

Nortriptyline

Octreotide

Ofloxacin

Olanzapine

Ondansetron

Oxilofrine

Paliperidone

Pargyline

Pazopanib

Perflutren Lipid Microsphere

Phenylephrine

Posaconazole

Procainamide

Procarbazine

Prochlorperazine

Promethazine

Propafenone

Protriptyline

Quetiapine

Quinidine

Quinine

Rasagiline

Saquinavir

Sertraline

Sodium Phosphate

Sodium Phosphate, Dibasic

Sodium Phosphate, Monobasic

Solifenacin

Sorafenib

Sotalol

Sunitinib

Tapentadol

Telavancin

Telithromycin

Terfenadine

Tetrabenazine

Toloxatone

Toremifene

Tramadol

Trazodone

Trifluoperazine

Trimipramine

Vandetanib

Vardenafil

Vasopressin

Vemurafenib

Venlafaxine

Voriconazole

Ziprasidone

Using clomipramine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Acenocoumarol

Arbutamine

Atomoxetine

Cannabis

Dicumarol

Enalaprilat

Enalapril Maleate

Fluvoxamine

Modafinil

Paroxetine

Phenprocoumon

S-Adenosylmethionine

Valproic Acid

Yohimbine

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using clomipramine with any of the following may cause an increased risk of certain side effects but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use clomipramine, or give you special instructions about the use of food, alcohol, or tobacco.

Grapefruit Juice

Proper Use of clomipramine

Take clomipramine only as directed by your doctor to benefit your condition as much as possible. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered .

It is best to take clomipramine with food .

clomipramine should come with a Medication Guide. Read and follow these instructions carefully. Ask your doctor or pharmacist if you have any questions. Ask your pharmacist for the Medication Guide if you do not have one .

Dosing

The dose of clomipramine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of clomipramine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

For oral dosage form (capsules):
- For obsessive-compulsive disorder:
  - Adults, teenagers, and children above 10 years of age—At first, 25 milligrams (mg) once a day with a meal. Your doctor may increase your dose if needed, and tell you to take the daily dose in evenly divided portions during the day. However, the dose is usually not more than 250 mg per day for adults and 200 mg per day for children.
  - Children below 10 years of age—Use and dose must be determined by your doctor .

Missed Dose

If you miss a dose of clomipramine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions While Using clomipramine

It is very important that your doctor check your progress at regular visits to allow for changes in your dose and to check for any unwanted effects. Blood tests may be needed to check for any unwanted effects .

Clomipramine may cause some people to be agitated, irritable, or display other abnormal behaviors. It may also cause some people to have suicidal thoughts and tendencies or to become more depressed. If you, your child, or your caregiver notice any of these side effects, tell your doctor or your child's doctor right away .

Do not take clomipramine if you have taken a monoamine oxidase (MAO) inhibitor (isocarboxazid [Marplan®], phenelzine [Nardil®], selegiline [Eldepryl®], or tranylcypromine [Parnate®]) in the past 2 weeks. Do not start taking a MAO inhibitor within 2 weeks of stopping clomipramine. If you do, you may develop confusion, agitation, restlessness, stomach or intestinal symptoms, sudden high body temperature, extremely high blood pressure, or severe convulsions .

Do not stop taking clomipramine without first checking with your doctor. Your doctor may want you to gradually reduce the amount you are using before stopping completely. This may help prevent a possible worsening of your condition and reduce the possibility of withdrawal symptoms such as dizziness, headache, nausea, vomiting, trouble sleeping, irritability, high fever, or a general feeling of discomfort or illness .

clomipramine will add to the effects of alcohol and other central nervous system (CNS) depressants (medicines that cause drowsiness). Some examples of CNS depressants are antihistamines or medicine for hay fever, other allergies or colds; sedatives, tranquilizers, or sleeping medicines; prescription pain medicine or narcotics; barbiturates; medicine for seizures; muscle relaxants; or anesthetics, including some dental anesthetics. Check with your doctor before taking any of the above while you are using clomipramine.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements .

Before having any kind of surgery, dental treatment, or emergency treatment, tell the medical doctor or dentist in charge that you are using clomipramine. Taking clomipramine together with medicines used during surgery or dental or emergency treatments may increase the risk of side effects .

clomipramine may cause men to have problems with sex. Check with your doctor if you are having an abnormal ejaculation or decreased sexual performance or desire .

Weight changes may occur during treatment with clomipramine. Talk with your doctor if this is a concern for you .

clomipramine may cause some people to become drowsy or less alert than they are normally. Make sure you know how you react to clomipramine before you drive, use machines, or do anything else that could be dangerous if you are drowsy or not alert.

clomipramine Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

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

congestion

continuing ringing or buzzing or other unexplained noise in ears

cough

difficult, burning, or painful urination

discouragement

dizziness, faintness, or lightheadedness when getting up from a lying or sitting position suddenly

dryness or soreness of throat

excessive muscle tone

fear or nervousness

feeling sad or empty

fever

frequent urge to urinate

hearing loss

hoarseness

irritability

lack of appetite

loss of interest or pleasure

lower back or side pain

muscle stiffness

muscle tension or tightness

muscle twitching or jerking

pain or tenderness around eyes and cheekbones

poor concentration

problems in urination or increase in amount of urine

rhythmic movement of muscles

runny nose

shortness of breath or troubled breathing

sleeplessness

sneezing

stuffy nose

sweating

tender, swollen glands in neck

tightness of chest or wheezing

tiredness trouble concentrating

trouble in swallowing

trouble remembering

trouble sleeping

unable to sleep

unusual tiredness or weakness

voice changes

Less common

Anxiety

attack, assault, force

bloody nose

breast enlargement

burning, dry, or itching eyes

burning while urinating

changes in vision

chills

crying

decrease in frequency of urination

decrease in urine volume

depersonalization

difficulty in passing urine (dribbling)

difficulty in speaking

discharge, excessive tearing

dry mouth

dysphoria

earache

euphoria

fast, irregular, pounding, or racing heartbeat or pulse

feeling of unreality

headache, severe and throbbing

hyperventilation

increased clear or white vaginal discharge

increased watering of the mouth

irregular heartbeats

irritability

itching of the vagina or genital area

mental depression

nausea or vomiting

numbness, tingling, pain, or weakness in hands or feet

pain during sexual intercourse

painful urination

pale skin

panic reaction

paranoia

partial or slight paralysis

quick to react or overreact emotionally

rapidly changing moods

redness or swelling in ear

redness, pain, or swelling of eye, eyelid, or inner lining of eyelid

restlessness

sense of detachment from self or body

shaking

swelling of face, fingers, feet, and/or lower legs

thick, white vaginal discharge with no odor or with a mild odor

troubled breathing with exertion

unusual bleeding or bruising

Get emergency help immediately if any of the following symptoms of overdose occur:

Symptoms of overdose

Bigger, dilated, or enlarged pupils (black part of eye)

cold clammy skin

confusion as to time, place, or person

decreased awareness or responsiveness

disorientation

drowsiness to profound coma

hallucination

holding false beliefs that cannot be changed by fact

increased or excessive unconscious or jerking movements

increased sensitivity of eyes to light

irregular, fast or slow, or shallow breathing

lethargy

mood or other mental changes

pale or blue lips, fingernails, or skin

seizures

severe sleepiness

unusual excitement, nervousness, or restlessness

wheezing

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Acid or sour stomach

bad, unusual or unpleasant aftertaste

belching

blemishes on the skin

blistering, crusting, irritation, itching, or reddening of skin

bloated

change in taste

change or problem with discharge of semen

changes in vision

constipation

cracked, dry, or scaly skin

cramps

darkening or lightening of skin color

decreased interest in sexual intercourse

diarrhea

difficulty in moving

dry skin

excess air or gas in stomach or intestines

feeling of warmth

full feeling

heartburn

heavy bleeding

hives or welts

inability to have or keep an erection

increased appetite

increased in sexual ability, desire, drive, or performance

increased interest in sexual intercourse

indigestion

joint pain

loss in sexual ability, desire, drive, or performance

pain

passing gas

pimples

redness of skin

redness of the face, neck, arms and occasionally, upper chest

shakiness in legs, arms, hands, or feet

skin rash

stomach discomfort, upset, or pain

swelling

swollen joints

tooth disorder

trembling or shaking of hands or feet

Less common

Absent, missed, or irregular menstrual periods

breast pain

difficulty swallowing

increased yawning

pinpoint red or purple spots on skin

sores, ulcers, or white spots on lips or tongue or inside the mouth

stopping of menstrual bleeding

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See also: clomipramine side effects (in more detail)

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More clomipramine resources

Clomipramine Side Effects (in more detail)
Clomipramine Use in Pregnancy & Breastfeeding
Drug Images
Clomipramine Drug Interactions
Clomipramine Support Group
20 Reviews for Clomipramine - Add your own review/rating

clomipramine Concise Consumer Information (Cerner Multum)

Anafranil Prescribing Information (FDA)

Anafranil Monograph (AHFS DI)

Clomipramine MedFacts Consumer Leaflet (Wolters Kluwer)

Compare clomipramine with other medications

Depression
Irritable Bowel Syndrome
Obsessive Compulsive Disorder
Panic Disorder

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Thursday, October 13, 2016

clomipramine