Drug interactions
Buprenorphine transdermal + Clomipramine
Severity: Major
Buprenorphine transdermal and Clomipramine: major interaction.
Last updated Sources: US FDA label
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
Transdermal buprenorphine can prolong the QT interval at higher doses, and clomipramine does so as well. Both cause sedation, so the combination increases the risk of arrhythmia and respiratory depression.
What this interaction means in plain words
Buprenorphine transdermal and Clomipramine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Why it happens
Additive QT prolongation and CNS depression.
What to do
Monitor for sedation and respiratory depression, and obtain an ECG when other QT risks are present. Use the lowest effective doses.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
Other interactions of Clomipramine
- Arsenic trioxide + Clomipramine Contraindicated
- Clomipramine + Dofetilide Contraindicated
- Clomipramine + Droperidol Contraindicated
- Clomipramine + Isocarboxazid Contraindicated
- Clomipramine + Methylene blue Contraindicated
- Clomipramine + Pentamidine Contraindicated
Frequently asked questions
Can I take Buprenorphine transdermal with Clomipramine?
MediHelp rates the interaction as major. Buprenorphine transdermal and Clomipramine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Transdermal buprenorphine can prolong the QT interval at higher doses, and clomipramine does so as well. Both cause sedation, so the combination increases the risk of arrhythmia and respiratory depression.
How serious is the interaction between Buprenorphine transdermal and Clomipramine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for sedation and respiratory depression, and obtain an ECG when other QT risks are present. Use the lowest effective doses.
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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