Clomipramine hydrochloride

By Medically reviewed by hellodoktor

Generic Name: Clomipramine hydrochloride Brand Name(s): Generics only. No brands available.

Uses

What is clomipramine HCL used for?

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

Clomipramine HCL is commonly used for treating obsessive-compulsive disorder (OCD). It may also be used for other conditions as determined by your doctor.

How should I take clomipramine HCL?

Take clomipramine HCL 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 HCL even if you feel well. Do not miss any doses.

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

How do I store clomipramine HCL?

Clomipramine HCL is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store clomipramine HCL in the bathroom or the freezer. There may be different brands of clomipramine HCL that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush clomipramine HCL down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Precautions & warnings

What should I know before using clomipramine HCL?

Before using clomipramine HCL, tell your doctor if:

  • You are pregnant, planning to become pregnant, or are breastfeeding.
  • You are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement.
  • You have allergies to medicines, foods, or other substances.
  • You are allergic to any ingredient in clomipramine HCL or to similar medicines.
  • You have taken linezolid or a monoamine oxidase inhibitor (MAOI) (e.g., phenelzine) within the last 14 days.
  • You are recovering from a recent heart attack.
  • You are scheduled to have any surgery.

Clomipramine HCL may cause drowsiness, dizziness, or blurred vision. These effects may be worse if you take it with alcohol or certain medicines. Use clomipramine HCL with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.

Clomipramine HCL may cause dizziness, light-headedness, 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, teenagers, and young adults who take clomipramine HCL 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 all patients who take clomipramine HCL 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.

Serotonin syndrome is a possibly fatal syndrome that can be caused by clomipramine. Your risk may be greater if you take clomipramine HCL with certain other medicines (e.g., triptans, MAOIs, SSRIs). Symptoms may include agitation; confusion; hallucinations; coma; fever; fast or irregular heartbeat; tremor; excessive sweating; and nausea, vomiting, or diarrhea. Contact your doctor at once if you have any of these symptoms.

Is it safe during pregnancy or breastfeeding?

There are no adequate studies in women for determining risk when using clomipramine HCL during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking clomipramine HCL. Clomipramine HCL is pregnancy risk category C, according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

  • A=No risk
  • B=No risk in some studies
  • C=There may be some risk
  • D=Positive evidence of risk
  • X=Contraindicated
  • N=Unknown

Side effects

What side effects can occur from clomipramine HCL?

Some common side effects may include:

  • 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 you have any of these severe side effects:

  • Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue)
  • 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 (e.g., increased anxiety, mood swings, agitation, irritability, nervousness, restlessness)
  • Numbness or tingling of the skin
  • Panic attacks
  • Ringing in the ears
  • Seizure
  • Severe dizziness or drowsiness
  • Sore throat
  • 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

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with clomipramine HCL?

Clomipramine HCL may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs, and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Especially if you are taking:

  • Buspirone, cimetidine, fentanyl, flecainide, haloperidol, lithium, methylphenidate, phenothiazines (e.g., chlorpromazine), propafenone, quinidine, selective serotonin reuptake inhibitors (SSRIs) (e.g., fluoxetine), serotonin-norepinephrine reuptake inhibitors (SNRIs) (e.g., duloxetine), St. John’s wort, tramadol, triptans (e.g., sumatriptan), or tryptophan, because they may increase the risk of clomipramine’s side effects.
  • Linezolid or MAOIs (e.g., phenelzine), because the risk of high blood pressure, serious heart problems (e.g., irregular heartbeat), or seizures may be increased.
  • Barbiturates (e.g., phenobarbital) or phenytoin, because they may decrease clomipramine’s effectiveness.
  • Anticholinergics (e.g., benztropine), anticoagulants (e.g., warfarin), carbamazepine, digoxin, or sympathomimetics (e.g., 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.

Does food or alcohol interact with clomipramine HCL?

Clomipramine HCL may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with clomipramine HCL?

Clomipramine HCL may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have.

These health conditions may include:

  • A history of alcohol abuse
  • A history of an overactive thyroid
  • A history of adrenal gland problems
  • Glaucoma or increased eye pressure
  • Heart problems
  • Kidney or liver problems
  • Diabetes
  • Seizures
  • Trouble urinating
  • The blood disease porphyria
  • Other blood problems
  • A history of suicidal thoughts or behavior
  • Bipolar disorder
  • Other mental disorders
  • Electroshock therapy

Dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using clomipramine HCL.

What is the dose of clomipramine HCL for an adult?

Obsessive-compulsive disorder – adult

The recommended dose is 25 mg orally qDay initially.

Gradually increase to 100 mg/day (divided with meals) over 2 weeks. May increase further to 250 mg/day maximum; may give as single daily dose qHS once tolerated.

Obsessive-compulsive disorder – geriatric

Avoid; strong anticholinergic and sedative effects; may cause orthostatic hypotension (Beers criteria).

Consider alternatives; if must use, initiate with lower initial dose.

The recommended dose is 25 mg orally qDay initially.

Gradually increase to 100 mg/day (divided with meals) over 2 weeks. May increase further to 250 mg/day maximum; may give as single daily dose qHS once tolerated.

What is the dose of clomipramine HCL for a child?

Obsessive-compulsive disorder

<10 years: Safety and efficacy not established

≥10 years: The recommended dose is 25 mg PO qDay initially.

Gradually increase to maximum 3 mg/kg/day or 100 mg/day, whichever is less. May further increase to maximum 3 mg/kg/day or 200 mg/day, whichever is less; may give as single dose qHS once tolerated.

How is clomipramine HCL available?

Clomipramine HCL is available in the following dosage forms and strengths:

  • Clomipramine HCL 25mg capsules
  • Clomipramine HCL 50mg capsules
  • Clomipramine HCL 75mg capsules

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of clomipramine HCL, 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.

Hello Health Group does not provide medical advice, diagnosis or treatment.

msBahasa Malaysia

Review Date: April 1, 2017 | Last Modified: September 12, 2019

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