Clomi Pramine

Clomipramine is a tricyclic antidepressant. It affects chemicals in the brain that may become unbalanced.

Clomipramine is used to treat symptoms of obsessive-compulsive disorder (OCD) such as recurrent thoughts or feelings and repetitive actions.

Clomipramine may also be used for purposes not listed in this medication guide.

You should not take clomipramine if you are being treated with methylene blue injection.

Do not use clomipramine if you have used an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, phenelzine, rasagiline, selegiline, tranylcypromine, and others.

Some young people have thoughts about suicide when first taking an antidepressant. Your doctor will need to check your progress at regular visits while you are using clomipramine. Your family or other caregivers should also be alert to changes in your mood or symptoms.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

Do not give clomipramine to anyone younger than 18 years old without the advice of a doctor.

You should not take this medicine if you are allergic to clomipramine or to similar antidepressants such as amitriptyline, amoxapine, desipramine, doxepin, imipramine, nortriptyline, protriptyline, or trimipramine. You should not take clomipramine if you are being treated with methylene blue injection.

Do not use clomipramine if you have used an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, phenelzine, rasagiline, selegiline, tranylcypromine, and others.

To make sure clomipramine is safe for you, tell your doctor if you have any of these conditions:

• liver disease;
• kidney disease;
• bipolar disorder (manic-depression), schizophrenia or other mental illness;
• history of alcoholism;
• history of seizures or head injury;
• heart disease;
• low blood pressure;
• narrow-angle glaucoma;
• overactive thyroid or adrenal gland tumor (pheochromocytoma or neuroblastoma); or
• urination problems.

Some young people have thoughts about suicide when first taking an antidepressant. Your doctor will need to check your progress at regular visits while you are using clomipramine. Your family or other caregivers should also be alert to changes in your mood or symptoms.

FDA pregnancy category C. It is not known whether clomipramine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medicine.

Clomipramine can pass into breast milk and may harm a nursing baby. You should not breast-feed while you are using this medicine.

Do not give clomipramine to anyone younger than 18 years old without the advice of a doctor.

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

Call your doctor at once if you have:

• blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights;
• rapid heart rate, tremors or shaking;
• confusion, extreme fear, thoughts of hurting yourself;
• agitation, hallucinations, fever, overactive reflexes, vomiting, diarrhea, loss of coordination, fainting;
• painful or difficult urination;
• very stiff (rigid) muscles;
• seizure (convulsions), or
• tired feeling, weakness, easy bruising or bleeding (nosebleed, bleeding gums), pale skin, feeling light-headed or short of breath.

Common side effects may include:

• dry mouth, nausea, upset stomach, loss of appetite, constipation;
• feeling anxious, restless, dizzy, drowsy, or tired;
• sleep problems (insomnia);
• appetite or weight changes;
• memory problems, trouble concentrating;
• increased sweating, numbness or tingling;
• vision changes; or
• decreased sex drive, impotence, or difficulty having an orgasm.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Avoid drinking alcohol. It can cause dangerous side effects when taken together with clomipramine.

This medicine may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Taking this medicine with other drugs that make you sleepy can worsen this effect. Ask your doctor before taking clomipramine with a sleeping pill, narcotic pain medicine, muscle relaxer, or medicine for anxiety, depression, or seizures.

Before taking clomipramine, tell your doctor if you have used an "SSRI" antidepressant in the past 5 weeks, such as citalopram, escitalopram, fluoxetine (Prozac), fluvoxamine, paroxetine (Paxil), sertraline (Zoloft), trazodone, or vilazodone (Viibryd).

Many drugs can interact with clomipramine. Not all possible interactions are listed here. Tell your doctor about all your medications and any you start or stop using during treatment with clomipramine, especially:

• anagrelide;
• droperidol;
• methadone;
• ondansetron;
• an antibiotic--azithromycin, clarithromycin, erythromycin, levofloxacin, moxifloxacin, pentamidine;
• cancer medicine--arsenic trioxide, toremifene, vandetanib, vemurafenib;
• anti-malaria medication--chloroquine, halofantrine, lumefantrine;
• heart rhythm medicine--amiodarone, disopyramide, dofetilide, dronedarone, flecainide, ibutilide, procainamide, quinidine, sotalol; or
• medicine to treat a psychiatric disorder--chlorpromazine, haloperidol, pimozide, thioridazine, ziprasidone.

This list is not complete and many other drugs can interact with clomipramine. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Give a list of all your medicines to any healthcare provider who treats you.

Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Take clomipramine with food to reduce stomach upset.

It may take up to 4 weeks before your symptoms improve. Keep using the medication as directed and tell your doctor if your symptoms do not improve after 4 weeks of treatment.

If you need surgery, tell the surgeon ahead of time that you are using clomipramine. You may need to stop using the medicine for a short time.

Do not stop using clomipramine suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to avoid withdrawal symptoms when you stop using clomipramine.

Store at room temperature away from moisture and heat.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of clomipramine can be fatal.

Overdose symptoms may include vomiting, fast or uneven heart rate, loss of balance or coordination, extreme drowsiness, fever, severe sweating, stiff muscles, increased or decreased urination, blue lips or fingernails, weak or shallow breathing, fainting, seizure (convulsions) or coma.

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.