Drug interactions
Clomipramine + Clozapine
Severity: Major
Clomipramine and Clozapine: major 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
Both drugs are sedating, anticholinergic and lower the seizure threshold, so combined use raises the risk of seizures, excessive sedation, constipation and tachycardia. Clomipramine may also raise clozapine levels through CYP inhibition, and both can affect cardiac conduction.
What this interaction means in plain words
Clomipramine and Clozapine 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.
Clomipramine belongs to Central Nervous System; Clozapine belongs to Central Nervous System.
Why it happens
Additive CNS, anticholinergic, seizure-threshold lowering and cardiac effects, with possible pharmacokinetic inhibition of clozapine metabolism.
What to do
Monitor sedation, bowel function, ECG and seizure risk, and consider clozapine levels. Use the lowest effective doses and titrate slowly.
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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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 Clozapine
- Clozapine + Deferiprone Contraindicated
- Clozapine + Irinotecan Contraindicated
- Clozapine + Pimozide Contraindicated
- Clozapine + Thioridazine Contraindicated
- Acalabrutinib + Clozapine Major
- Adagrasib + Clozapine Major
Frequently asked questions
Can I take Clomipramine with Clozapine?
MediHelp rates the interaction as major. Clomipramine and Clozapine 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 sedating, anticholinergic and lower the seizure threshold, so combined use raises the risk of seizures, excessive sedation, constipation and tachycardia. Clomipramine may also raise clozapine levels through CYP inhibition, and both can affect cardiac conduction.
How serious is the interaction between Clomipramine and Clozapine?
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 sedation, bowel function, ECG and seizure risk, and consider clozapine levels. Use the lowest effective doses and titrate slowly.
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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