Drug interactions
Atazanavir + Clomipramine
Severity: Moderate
Atazanavir and Clomipramine: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Atazanavir inhibits CYP3A4 and can raise clomipramine concentrations. Higher tricyclic levels increase the risk of anticholinergic effects, sedation, seizures and cardiac conduction abnormalities. Atazanavir itself can prolong the PR interval.
What this interaction means in plain words
Atazanavir and Clomipramine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Atazanavir belongs to Anti Virals; Clomipramine belongs to Central Nervous System.
Why it happens
Inhibition of CYP3A4-mediated clomipramine metabolism by atazanavir, with additive cardiac conduction effects.
What to do
Start with a lower clomipramine dose and titrate by response, with clomipramine levels if available. Monitor the ECG and for toxicity signs.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Clomipramine
- Arsenic trioxide + Clomipramine Contraindicated
- Clomipramine + Dofetilide Contraindicated
- Clomipramine + Droperidol Contraindicated
- Clomipramine + Isocarboxazid Contraindicated
- Clomipramine + Methylene blue Contraindicated
- Clomipramine + Pentamidine Contraindicated
Other interactions of Atazanavir
- Alfuzosin + Atazanavir Contraindicated
- Atazanavir + Avanafil Contraindicated
- Atazanavir + Dronedarone Contraindicated
- Atazanavir + Eletriptan Contraindicated
- Atazanavir + Eplerenone Contraindicated
- Atazanavir + Ergotamine Contraindicated
Frequently asked questions
Can I take Atazanavir with Clomipramine?
MediHelp rates the interaction as moderate. Atazanavir and Clomipramine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Atazanavir inhibits CYP3A4 and can raise clomipramine concentrations. Higher tricyclic levels increase the risk of anticholinergic effects, sedation, seizures and cardiac conduction abnormalities. Atazanavir itself can prolong the PR interval.
How serious is the interaction between Atazanavir and Clomipramine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Start with a lower clomipramine dose and titrate by response, with clomipramine levels if available. Monitor the ECG and for toxicity signs.
What other medicines interact with Clomipramine?
MediHelp also lists interactions of Clomipramine with, for example, Arsenic trioxide, Dofetilide, Droperidol. The full list is on the Clomipramine page.
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