Drug interactions
Chlorpromazine + Clomipramine
Severity: Major
Chlorpromazine 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
Both drugs can prolong the QT interval, and chlorpromazine inhibits CYP2D6, which can raise clomipramine levels. The combination increases the risk of arrhythmia, seizures, sedation, hypotension and anticholinergic effects.
What this interaction means in plain words
Chlorpromazine 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.
Chlorpromazine belongs to Central Nervous System; Clomipramine belongs to Central Nervous System.
Why it happens
Additive QT prolongation and anticholinergic effects, with CYP2D6 inhibition by chlorpromazine.
What to do
Obtain a baseline ECG, correct electrolytes and monitor the QTc. Use the lowest effective doses or choose an alternative.
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
Other interactions of Chlorpromazine
- Chlorpromazine + Dofetilide Contraindicated
- Chlorpromazine + Dronedarone Contraindicated
- Chlorpromazine + Droperidol Contraindicated
- Chlorpromazine + Ibutilide Contraindicated
- Chlorpromazine + Metrizamide Contraindicated
- Chlorpromazine + Panobinostat Contraindicated
Frequently asked questions
Can I take Chlorpromazine with Clomipramine?
MediHelp rates the interaction as major. Chlorpromazine 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. Both drugs can prolong the QT interval, and chlorpromazine inhibits CYP2D6, which can raise clomipramine levels. The combination increases the risk of arrhythmia, seizures, sedation, hypotension and anticholinergic effects.
How serious is the interaction between Chlorpromazine 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: Obtain a baseline ECG, correct electrolytes and monitor the QTc. Use the lowest effective doses or choose an alternative.
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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