Drug interactions
Clomipramine + Desipramine
Severity: Major
Clomipramine and Desipramine: 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 are tricyclic antidepressants, and desipramine is also the active metabolite of imipramine-type drugs, with clomipramine's own metabolite sharing its properties. Combining them adds up cardiac conduction, anticholinergic, seizure and serotonergic effects, and clomipramine can inhibit CYP2D6 and raise desipramine levels.
What this interaction means in plain words
Clomipramine and Desipramine 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; Desipramine belongs to Central Nervous System.
Why it happens
Duplicate tricyclic effects with additive QT prolongation and competition at CYP2D6, raising desipramine concentrations.
What to do
Avoid using two tricyclics together. If desipramine must be used, monitor ECG and plasma levels.
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 Desipramine
- Desipramine + Disopyramide Contraindicated
- Desipramine + Dofetilide Contraindicated
- Desipramine + Ibutilide Contraindicated
- Desipramine + Isocarboxazid Contraindicated
- Desipramine + Methylene blue Contraindicated
- Desipramine + Pentamidine Contraindicated
Frequently asked questions
Can I take Clomipramine with Desipramine?
MediHelp rates the interaction as major. Clomipramine and Desipramine 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 are tricyclic antidepressants, and desipramine is also the active metabolite of imipramine-type drugs, with clomipramine's own metabolite sharing its properties. Combining them adds up cardiac conduction, anticholinergic, seizure and serotonergic effects, and clomipramine can inhibit CYP2D6 and raise desipramine levels.
How serious is the interaction between Clomipramine and Desipramine?
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 using two tricyclics together. If desipramine must be used, monitor ECG and plasma levels.
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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