Drug interactions
Clomipramine + Elvitegravir / cobicistat / emtricitabine / tenofovir df
Severity: Moderate
Clomipramine and Elvitegravir / cobicistat / emtricitabine / tenofovir df: moderate interaction.
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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
Cobicistat inhibits CYP2D6 and CYP3A4, both involved in clomipramine metabolism, so clomipramine and its active metabolite levels may rise. This can increase the risk of anticholinergic effects, seizures, serotonergic effects and QT prolongation.
What this interaction means in plain words
Clomipramine and Elvitegravir / cobicistat / emtricitabine / tenofovir df 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
Inhibition of CYP2D6 and CYP3A4 by cobicistat reduces clearance of clomipramine.
What to do
Start clomipramine at a low dose and titrate according to response and tolerability. Monitor for toxicity and consider an ECG or plasma levels in high-risk patients.
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 Clomipramine with Elvitegravir / cobicistat / emtricitabine / tenofovir df?
MediHelp rates the interaction as moderate. Clomipramine and Elvitegravir / cobicistat / emtricitabine / tenofovir df 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. Cobicistat inhibits CYP2D6 and CYP3A4, both involved in clomipramine metabolism, so clomipramine and its active metabolite levels may rise. This can increase the risk of anticholinergic effects, seizures, serotonergic effects and QT prolongation.
How serious is the interaction between Clomipramine and Elvitegravir / cobicistat / emtricitabine / tenofovir df?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Start clomipramine at a low dose and titrate according to response and tolerability. Monitor for toxicity and consider an ECG or plasma levels in high-risk patients.
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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