Drug interactions
Clomipramine + Donepezil
Severity: Moderate
Clomipramine and Donepezil: 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
Clomipramine's anticholinergic activity opposes the cholinesterase inhibition of donepezil, which may reduce the benefit in dementia. Both drugs can also affect cardiac conduction and QT interval, and donepezil may cause bradycardia.
What this interaction means in plain words
Clomipramine and Donepezil 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.
Clomipramine belongs to Central Nervous System; Donepezil belongs to Central Nervous System.
Why it happens
Pharmacodynamic antagonism of cholinergic effects plus additive QT prolongation.
What to do
Avoid anticholinergic antidepressants in dementia if possible and choose an alternative such as an SSRI. If combined, monitor cognition, heart rate and ECG.
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
Other interactions of Donepezil
- Donepezil + Dronedarone Contraindicated
- Donepezil + Pimozide Contraindicated
- Donepezil + Thioridazine Contraindicated
- Donepezil + Vandetanib Contraindicated
- Amiodarone + Donepezil Major
- Amisulpride + Donepezil Major
Frequently asked questions
Can I take Clomipramine with Donepezil?
MediHelp rates the interaction as moderate. Clomipramine and Donepezil 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. Clomipramine's anticholinergic activity opposes the cholinesterase inhibition of donepezil, which may reduce the benefit in dementia. Both drugs can also affect cardiac conduction and QT interval, and donepezil may cause bradycardia.
How serious is the interaction between Clomipramine and Donepezil?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid anticholinergic antidepressants in dementia if possible and choose an alternative such as an SSRI. If combined, monitor cognition, heart rate and ECG.
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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