Precautions and warnings

Cardiovascular insufficiency; narrow-angle glaucoma; urinary retention; history of epilepsy; renal or hepatic dysfunction; electroconvulsive therapy; hypotension; hyperthyroidism or concomitant treatment with thyroid preparations; suicidal tendencies; surgery; pregnancy and lactation; tasks requiring mental alertness; elderly; avoid abrupt withdrawal.

Drug Interactions

Barbiturates increase metabolism of tricyclic antidepressants; conversely cimetidine, guanethidine, haloperidol and phenothiazines block the tricyclic metabolism. CNS effects of alcohol enhanced.
Potentially Fatal: If clomipramine is to be substituted for MAOIs, at least 3 wk should elapse after discontinuing MAOIs. Risk of hypertension and arrhythmias if co-administered with adrenaline and noradrenaline.

Contraindications

Hypersensitivity. Concomitant use of MAOIs; recovery phase following MI, heartblock or other arrhythmias; mania; childn.

Mode of actions

Clomipramine is a potent inhibitor of serotonin re-uptake in the brain. Significant antagonism at cholinergic and ?1-receptors. Weak antagonism at dopamine receptors. It has also antidepressant, sedative and anticholinergic effects.

Dosage & Administration

Adult: PO Adjunct in cataplexy associated w/ narcolepsy Initial: 10 mg/day, up to 75 mg/day.
Obsessive-compulsive disorder; Panic disorder; Phobias Initial: 25 mg/day, gradually increase up to 100-150 mg/day if needed. Max: 250 mg/day.
Depression Initial: 10 mg/day, up to 30-150 mg/day if needed. >250 mg/day may be needed in severe cases.

Pregnancy & Lactation

Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks

Pack Size & Price