Drug interactions
Cigarette smoking + Clomipramine
Severity: Moderate
Cigarette smoking 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
Tobacco smoke induces CYP1A2, which contributes to clomipramine metabolism, so smokers may have lower plasma concentrations of the drug. Reduced exposure may blunt therapeutic response, and stopping smoking can raise levels and increase adverse effects.
What this interaction means in plain words
Cigarette smoking 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.
Why it happens
Polycyclic aromatic hydrocarbons in smoke induce CYP1A2 and increase clomipramine clearance.
What to do
Review smoking status when titrating clomipramine and consider therapeutic drug monitoring if response is poor. When a patient stops smoking, watch for anticholinergic, sedative and cardiac adverse effects and reduce the dose if needed.
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
Frequently asked questions
Can I take Cigarette smoking with Clomipramine?
MediHelp rates the interaction as moderate. Cigarette smoking 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. Tobacco smoke induces CYP1A2, which contributes to clomipramine metabolism, so smokers may have lower plasma concentrations of the drug. Reduced exposure may blunt therapeutic response, and stopping smoking can raise levels and increase adverse effects.
How serious is the interaction between Cigarette smoking 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: Review smoking status when titrating clomipramine and consider therapeutic drug monitoring if response is poor. When a patient stops smoking, watch for anticholinergic, sedative and cardiac adverse effects and reduce the dose if needed.
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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