Drug interactions
Citalopram + Clomipramine
Severity: Major
Citalopram 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 are serotonergic and can prolong the QT interval, and citalopram may raise tricyclic levels. The combination increases the risk of serotonin syndrome and ventricular arrhythmia.
What this interaction means in plain words
Citalopram 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.
Citalopram belongs to Central Nervous System; Clomipramine belongs to Central Nervous System.
Why it happens
Additive serotonergic activity and QT prolongation, with CYP2D6 inhibition by citalopram raising clomipramine exposure.
What to do
Avoid if possible. If combined, keep the citalopram dose within labeled limits, monitor ECG and electrolytes, and watch for serotonin toxicity.
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 Citalopram
- Cisapride + Citalopram Contraindicated
- Citalopram + Dronedarone Contraindicated
- Citalopram + Escitalopram Contraindicated
- Citalopram + Isocarboxazid Contraindicated
- Citalopram + Methylene blue Contraindicated
- Citalopram + Phenelzine Contraindicated
Frequently asked questions
Can I take Citalopram with Clomipramine?
MediHelp rates the interaction as major. Citalopram 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 are serotonergic and can prolong the QT interval, and citalopram may raise tricyclic levels. The combination increases the risk of serotonin syndrome and ventricular arrhythmia.
How serious is the interaction between Citalopram 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: Avoid if possible. If combined, keep the citalopram dose within labeled limits, monitor ECG and electrolytes, and watch for serotonin toxicity.
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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