Uses
Clomipramine is a medication that is used to treat
Clomipramine is a medication that is used to treat the obsessive-compulsive disorder (OCD). It aids in the reduction of persistent/unwanted thoughts (obsessions) and the urge to perform repetitive tasks (compulsions such as hand-washing, counting, and checking) that obstruct daily living. This medication is classified as a tricyclic antidepressant. It works by rebalancing certain natural substances in the brain (among them, serotonin).
How to use Clomipramine HCL
Before you begin taking clomipramine, and each time you receive a refill, read the Medication Guide provided by your pharmacist. Consult your physician or pharmacist if you have any questions.
As directed by your doctor, take this medication by mouth with or without food. Clomipramine may be started at a low dose and gradually increased as your body adjusts to minimize side effects such as stomach upset. Once the optimal amount has been established, the total quantity can be taken daily, usually at bedtime, to avoid daytime drowsiness or as directed by your doctor.
Adhere strictly to your doctor’s instructions. Take no more or less medication than prescribed, or take it more frequently than recommended. Your condition will not improve any faster, and you may experience adverse effects such as seizures. The recommended dose is determined by your medical condition and response to therapy.
Unless otherwise directed by your doctor, avoid eating grapefruit or drinking grapefruit juice while taking this medication. Grapefruit has been shown to increase the concentration of certain drugs in the bloodstream. Consult your physician or pharmacist for additional information.
Utilize this medication consistently to obtain the maximum benefit.
Continue taking it even if you are feeling well. Utilize it at the same time(s) each day to aid in memory. [1]
Do not abruptly discontinue taking this medication without first consulting your physician. Certain conditions may deteriorate when the drug is abruptly discontinued. If you suddenly stop taking this medication, you may experience sweating, dizziness, nausea, vomiting, headache, or irritability. Your dose may need to be tapered gradually.
It may take up to two to three weeks or longer for the full effects of this medication to become apparent. Notify your physician if your condition persists or worsens.
Side Effects
It is possible to experience dizziness, drowsiness, dry mouth, constipation, stomach upset, nausea, vomiting, changes in appetite/weight, flushing, sweating, fatigue, and blurred vision. When you first begin taking clomipramine, anxiety symptoms may temporarily worsen. Notify your doctor or pharmacist promptly if any of these effects persist or worsen.
Suck on (sugar-free) hard candy or ice chips, chew on (sugar-free) gum, drink water, or use a saliva substitute to alleviate dry mouth.
Consume dietary fiber, drink plenty of water, and exercise to avoid constipation. Additionally, you may require a laxative. Consult your pharmacist to determine the best laxative for you.
Bear in mind that your doctor prescribed this medication because your benefit outweighs the risk of side effects. Many people who take this medication do not experience significant side effects.
Inform your doctor immediately if you experience any severe side effects, including the following: mental/mood changes (e.g., confusion, depression, memory problems), enlarged/painful breasts, unwanted breast milk production, irregular/painful menstrual periods, muscle stiffness, ringing in the ears, sexual problems (e.g., decreased sexual ability, changes in desire), shakiness (tremors), numbness/tingling of the hands.
This medication may cause an increase in serotonin levels and, in rare cases, a life-threatening condition called serotonin syndrome/toxicity. The risk increases if you take other serotonin-stimulating medications, so inform your doctor or pharmacist of all medications you are taking. Seek immediate medical attention if you develop any following symptoms: rapid heartbeat, hallucinations, loss of coordination, severe dizziness, severe nausea/vomiting/diarrhea, muscle twitching, unexplained fever, unusual agitation/restlessness.
Seek immediate medical attention if you experience any of the following severe side effects: black stools, chest pain, fainting, slow/fast/irregular heartbeat, seizures, vomit that resembles coffee grounds, eye pain/swelling/redness, dilated pupils, or vision changes (such as seeing rainbows around lights at night).
A severe allergic reaction to this medication is uncommon. However, seek medical attention immediately if you experience any of the following symptoms of a severe allergic reaction: fever, swollen lymph nodes, rash, itching/swelling (particularly of the face/tongue/throat), severe dizziness, or difficulty breathing.
This is not an exhaustive list of possible adverse reactions. Consult your doctor or pharmacist if you notice any other effects not listed above.
In the United States –
Consult your physician for medical advice regarding possible side effects. You may report adverse reactions to the FDA by calling 1-800-FDA-1088 or visiting www.fda.gov/medwatch.
In Canada – Consult your physician regarding possible side effects. You may contact Health Canada at 1-866-234-2345 to report side effects.
Precautions
Inform your doctor or pharmacist before taking clomipramine if you are allergic to it, other tricyclic antidepressants (e.g., imipramine, nortriptyline), or any other medications. This product may contain inactive ingredients that may cause allergic reactions or other adverse reactions. Consult your pharmacist for additional information.
Inform your doctor or pharmacist of your medical history, particularly of any blood problems (e.g., purpura, thrombocytopenia), breathing problems (e.g., asthma, chronic bronchitis), personal or family history of glaucoma (angle-closure type), eating disorders (e.g., bulimia), heart problems (e.g., arrhythmias, coronary artery disease, recent heart attack), or intestinal problems (e.g., pheochromocytoma, neuroblastoma).
Clomipramine may cause an irregular heart rhythm (QT prolongation). QT prolongation is uncommon but can result in serious (rarely fatal) fast/irregular heartbeat and other symptoms (such as severe dizziness, fainting) that require immediate medical attention.
If you have certain medical conditions or are taking other medications that may cause QT prolongation, your risk of QT prolongation may be increased. Inform your doctor or pharmacist before using clomipramine of all medicines you take and if you have any of the following conditions: specific heart problems (heart failure, slow heartbeat, QT prolongation on the electrocardiogram), family history of particular heart problems (QT prolongation in the EKG, sudden cardiac death).
Low potassium or magnesium levels in the blood may also contribute to an increased risk of QT prolongation. This risk may be increased if you take certain medications (for example, diuretics/”water pills”) or have certain medical conditions such as excessive sweating, diarrhea, or vomiting. Consult your physician about the safe use of clomipramine.
This medication may cause dizziness or drowsiness, as well as temporary blurred vision. Alcohol and marijuana (cannabis) can increase your dizziness or drowsiness. Do not drive, operate machinery, or perform any other activity that requires alertness or clear vision until you can do so safely. Consume alcoholic beverages in moderation. Consult your physician if you are a marijuana user (cannabis).
To avoid feeling dizzy or lightheaded, slowly rise from a seated or lying position.
Inform your doctor or dentist that you are taking this medication before surgery.
Caution should be exercised when administering this medication to children who participate in active sports, increasing the risk of developing heart problems. (Also, see the Caution section.)
Elderly adults may be more susceptible to the drug’s adverse effects, particularly bleeding, confusion, dizziness, and QT prolongation (see above). Dizziness and confusion can both contribute to an increased risk of falling. Seniors may also be more prone to develop low sodium levels in the blood, mainly if they take “water pills” (diuretics).
This medication should be used during pregnancy only when necessary. Clomipramine may cause withdrawal symptoms or adverse effects in newborns exposed to the drug during pregnancy. Notify your doctor immediately if your newborn exhibits jitteriness, shaking, feeding difficulties, rapid breathing, or seizures.
Due to the severe nature of untreated mental/mood problems (such as obsessive-compulsive disorder, depression, or panic attack), do not stop taking this medication unless directed by your doctor. If you are planning to become pregnant, are already pregnant, or believe you may be pregnant, speak with your doctor immediately about the benefits and risks of using this medication during pregnancy.
This medication is excreted in breast milk and may have adverse effects on a nursing infant. Consult your physician before breastfeeding.
Interactions
Interactions between medications can alter the way they work or increase your risk of experiencing severe side effects. This document is not exhaustive in its coverage of possible drug interactions. Maintain a list of all products you use (including prescription/over-the-counter medications and herbal supplements) and share it with your doctor and pharmacist. Without your doctor’s approval, do not begin, stop, or change the dosage of any medication.
Several products may interact with this medication, including anticholinergics (e.g., atropine, belladonna alkaloids, scopolamine), certain blood pressure medications (e.g., clonidine, guanethidine), cisapride, digoxin, thyroid supplements, and valproic acid, as well as medications that can cause bleeding/bruising (e.g., “blood thinners” such as warfarin/heparin,
Combining this medication with MAO inhibitors may result in a serious (possibly fatal) drug interaction. Take MAO inhibitors (isocarboxazid, linezolid, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, safinamide, selegiline, tranylcypromine) with caution while taking this medication. Additionally, most MAO inhibitors should be avoided for two weeks before and following treatment with this medication. Consult your physician regarding the appropriate time to begin or stop taking this medication.
Suppose you are also taking other drugs that increase serotonin, the risk of serotonin syndrome/toxicity increases. Among others, MDMA/”ecstasy,” St. John’s wort, and certain antidepressants (including SSRIs such as fluoxetine/paroxetine and SNRIs such as duloxetine/venlafaxine) are examples. When you begin or increase the dose of these drugs, the risk of serotonin syndrome/toxicity may increase.
In addition to clomipramine, numerous medications may cause QT prolongation, including amiodarone, dofetilide, quinidine, sotalol, pimozide, procainamide, and macrolide antibiotics (such as erythromycin). Before beginning to take clomipramine, inform your doctor or pharmacist of all medications, you are currently taking.
Other medications may impair clomipramine’s elimination from the body, degrading its effectiveness. Examples include artemether/lumefantrine, barbiturates (such as phenobarbital), cimetidine, haloperidol, certain heart rhythm medications (such as flecainide/propafenone), phenothiazines (such as thioridazine), certain anti-seizure medications (such as phenytoin), and terbinafine.
Inform your doctor or pharmacist if you are taking any other drowsy products, such as alcohol, marijuana (cannabis), antihistamines (such as cetirizine, diphenhydramine), sleep or anxiety medications (such as alprazolam, diazepam, zolpidem), muscle relaxants (such as carisoprodol, cyclobenzaprine), or opioid pain relievers (such as codeine, hydrocodone).
Check the labels of all prescription and nonprescription medications carefully because many contain nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen, or naproxen that, when combined with this medication, may increase your risk of bleeding. Low-dose aspirin should be continued as prescribed by your doctor for specific medical reasons such as heart attack or stroke prevention (typically 81-162 milligrams per day). Consult your physician or pharmacist for additional information.
Check the labels of all your medications (e.g., cough-and-cold products) because they may contain ingredients that cause drowsiness or decongestants that may cause an increase in your heart rate or blood pressure. Consult your pharmacist for information on the safe use of these products.
Cigarette smoking reduces the amount of this medication in the blood. Inform your doctor if you smoke or have recently quit.
Overdose
Call 911 if someone has overdosed and is experiencing severe symptoms such as passing out or difficulty breathing. Otherwise, immediately contact a poison control center. Residents of the United States of America can contact their local poison control center at 1-800-222-1222. Residents of Canada may contact a provincial poison control center. Overdose symptoms include a rapid/irregular heartbeat, severe dizziness, fainting, delirium, seizures, and loss of consciousness.
Notes
Do not give this medication to anyone else.
Laboratory and/or medical tests (e.g., electrocardiograms, liver function tests, and blood counts) may be performed regularly to monitor your progress or look for side effects. Consult your physician for additional information.
Missed a Dose
If you forget to take a dose, take it as soon as possible. If the following amount is approaching, skip the missed dose. Take the next dose at the regularly scheduled time. Do not double the dose to make up for missed doses.
Storage
Keep at room temperature and out of direct sunlight and moisture. Keep out of the bathroom. All medications should be kept out of the reach of children and pets.
Unless otherwise directed, do not flush medications down the toilet or pour them down a drain. Discard this product properly when it has expired or is no longer needed. Consult your pharmacist or a waste management company in your area.
Clomipramine FAQ’s
Is clomipramine good for anxiety?
- Clomipramine User Reviews for Panic Disorder. Clomipramine has an average rating of 8.6 out of 10 for the treatment of Panic Disorder based on 33 ratings. 79% of reviewers reported a beneficial effect, while 6% reported a detrimental effect.
How does clomipramine make you feel?
- Because clomipramine can cause sleepiness, your doctor may advise you to begin with a low dose and gradually increase it as your body adjusts. Clomipramine is typically taken once daily at bedtime, but it can also be taken in smaller doses twice or three times daily.
Is clomipramine a sedating?
- Clomipramine has a sedative effect, which makes it an effective treatment option for depression in people who also suffer from anxiety or have difficulty sleeping.
How long does it take for clomipramine to start working?
- When used to treat OCD, clomipramine may need to be taken for six to twelve weeks before symptoms improve. The full effect of this medication may take four to six months to manifest.
References
https://www.webmd.com/drugs/2/drug-1305/clomipramine-oral/details
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