Drug interactions
Clomipramine + Escitalopram
Severity: Major
Clomipramine and Escitalopram: 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 drugs increase serotonergic activity, and escitalopram can modestly raise tricyclic levels via CYP2D6 inhibition. Combined use increases the risk of serotonin syndrome and QT prolongation.
What this interaction means in plain words
Clomipramine and Escitalopram 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; Escitalopram belongs to Central Nervous System.
Why it happens
Additive serotonin reuptake inhibition, additive QT effects and mild CYP2D6 inhibition.
What to do
Avoid if possible. If combined, use low doses, obtain an ECG and monitor for serotonin toxicity.
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 Escitalopram
- Cisapride + Escitalopram Contraindicated
- Citalopram + Escitalopram Contraindicated
- Escitalopram + Isocarboxazid Contraindicated
- Escitalopram + Methylene blue Contraindicated
- Escitalopram + Phenelzine Contraindicated
- Escitalopram + Pimozide Contraindicated
Frequently asked questions
Can I take Clomipramine with Escitalopram?
MediHelp rates the interaction as major. Clomipramine and Escitalopram 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 increase serotonergic activity, and escitalopram can modestly raise tricyclic levels via CYP2D6 inhibition. Combined use increases the risk of serotonin syndrome and QT prolongation.
How serious is the interaction between Clomipramine and Escitalopram?
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 if possible. If combined, use low doses, obtain an ECG and monitor for serotonin toxicity.
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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