Drug interactions
Clomipramine + Epinephrine racemic
Severity: Major
Clomipramine and Epinephrine racemic: 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
Tricyclic antidepressants can markedly potentiate the pressor and arrhythmogenic effects of epinephrine. Severe hypertension and ventricular arrhythmias have been reported, especially with systemic doses.
What this interaction means in plain words
Clomipramine and Epinephrine racemic 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.
Why it happens
Clomipramine blocks neuronal catecholamine reuptake, increasing adrenergic receptor stimulation.
What to do
Use the lowest effective epinephrine dose and monitor ECG and blood pressure. Limit epinephrine in local anesthetics.
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
Frequently asked questions
Can I take Clomipramine with Epinephrine racemic?
MediHelp rates the interaction as major. Clomipramine and Epinephrine racemic 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. Tricyclic antidepressants can markedly potentiate the pressor and arrhythmogenic effects of epinephrine. Severe hypertension and ventricular arrhythmias have been reported, especially with systemic doses.
How serious is the interaction between Clomipramine and Epinephrine racemic?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use the lowest effective epinephrine dose and monitor ECG and blood pressure. Limit epinephrine in local anesthetics.
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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