Clomipramine

When and how do I take it?

• Swallow your Clomipramine tablets or capsules whole with a drink of water. Keep taking your medicine until your doctor tells you to stop. Do not stop because you do not feel any better. This medicine may take up to 4 weeks to work.
• The medicine may be taken as one dose at night, or split into several smaller doses and taken throughout the day. Your doctor will tell you what to do.

What’s the dose?

The usual dosages for adults are as follows:

For depression: 10mg - 150mg daily. Severe cases may need even higher doses.

For obsessions and phobias: 10mg - 150mg daily.

For cataplexy: 10mg - 75mg daily.

Could it interact with other tablets?

Clomipramine interacts with a large number of other medicines. Make sure your doctor or pharmacist knows if you are taking any of the following:

• Medicines for depression particularly MAOIs e.g. tranylcypromine, phenelzine; SSRIs e.g. fluoxetine, fluvoxamine; tricyclic and tetracyclic antidepressants e.g. amitriptyline, dothiepin, maprotiline, barbiturates, benzodiazepines
• Medicines for other mental illnesses such as schizophrenia or manic depression e.g. thioridazine, lithium
• Medicines for high blood pressure
• Medicines to treat heart disorders, particularly those used to treat an abnormal heart rhythm
• Betablockers e.g atenolol
• Diuretics e.g. bendroflumethiazide, furosemide
• Anticoagulants (blood thinning tablets like warfarin)
• Medicines for Parkinson's Disease
• Drugs which affect the liver (your doctor will know which these are). They include nicotine and barbiturates.
• Cold and flu drugs such as antihistamines and decongestants
• Carbamazepine or phenytoin (for epilepsy)
• Cimetidine (for stomach problems)
• Methylphenidate (Ritalin®) prescribed for children with ADHD
• Quinine (for cramp or malaria treatment)
• Strong painkillers such as morphine or morphine related substances e.g. codeine, dihydrocodeine
• Drugs of abuse including Ecstasy
• Atropine or similar medicines (including eye drops)
• Oestrogens (e.g. contraceptive pill or hormone replacement therapy)
• Medicines, called protease inhibitors, used to treat Human Immunodeficiency Virus e.g. ritonavir, indinavir.

Always tell your doctor or pharmacist about all the medicines you are taking. This means medicines you have bought yourself as well as medicines on prescription from your doctor.

Herbal products should also only be taken after consulting with a doctor.

What are the possible risks or side-effects?

Clomipramine is suitable for most people, but, like all medicines, it can sometimes cause side effects. The side effects are usually mild and disappear as treatment continues.

Stop taking Clomipramine and tell your doctor immediately if you notice the following very rare symptoms:

• Rash, changes in blood pressure, swelling and increased fluid in tissues, an increased heart rate, difficulty with breathing and collapse. These may all be the signs of a severe allergic reaction.
• A high temperature and sweating with rigid muscles and confusion or agitation, or if you experience jerky muscle movements which you can’t control. These may be the symptoms of a serious condition known as neuroleptic malignant syndrome.

The side effects listed below have also been reported:

• Increase in appetite and weight gain
• Headaches
• dizziness
• nausea
• constipation
• dry mouth
• increased sweating
• shaking hands
• tremor
• difficulty in passing urine
• problems with their eyes, feeling tired or sleepy
• sexual disturbances.

Up to 1 in 10 people have experienced:

• Loss of appetite
• stomach upset
• vomiting
• diarrhoea
• lightheadedness when standing up (due to low blood pressure)
• increased anxiety
• agitation
• hot flushes
• enlarged pupils
• speech disturbance
• yawning
• feeling slightly confused
• disorientated or over-excited
• sleep disturbances
• nightmares
• hallucinations
• thought disturbances
• worsening of existing depression
• impaired memory and concentration
• restlessness
• disturbances in heart rhythm
• increased sensitivity of the skin to sunlight, rash and itching
• breast changes
• numbness or tingling in the arms and legs
• muscle weakness
• movement disorder
• changes in liver function tests
• taste disturbances
• tinnitus

Up to 1 in 100 people have experienced:

• Mood changes including aggression
• fits
• movement disorders
• increased blood pressure

Can I drink alcohol while taking it?

Be careful when drinking alcohol - it may affect you more than usual.

What if I’m pregnant/breastfeeding?

Clomipramine should not be taken while pregnant unless your doctor deems it necessary. It should not be used while breast feeding.

If you have any more questions please ask your Pharmacist.

Remember to keep all medicines out of reach of children
Please Note: We have made every effort to ensure that the content of this information sheet is correct at time of publish, but remember that information about drugs may change. This sheet does not list all the uses and side-effects associated with this drug. For full details please see the drug information leaflet which comes with your medicine. Your doctor will assess your medical circumstances and draw your attention to any information or side-effects which may be relevant in your particular case.

References:

http://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=4074b555-7635-41a9-809d-fae3b3610059

http://www.rxlist.com/anafranil-drug.htm

http://www.drugs.com/cdi/anafranil.html

https://en.wikipedia.org/wiki/Clomipramine

http://www.emedicinehealth.com/drug-clomipramine/article_em.htm