Drug interactions
Clomipramine + Fluphenazine
Severity: Major
Clomipramine and Fluphenazine: 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 can prolong the QT interval, so using them together raises the risk of torsades de pointes and other ventricular arrhythmias. Fluphenazine may also modestly raise tricyclic levels through CYP2D6 competition, and anticholinergic and sedative effects add up.
What this interaction means in plain words
Clomipramine and Fluphenazine 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; Fluphenazine belongs to Central Nervous System.
Why it happens
Additive QT prolongation through cardiac ion channel blockade, with possible CYP2D6-mediated increase in clomipramine exposure.
What to do
Avoid the combination where possible; if it is necessary, obtain a baseline ECG, correct potassium and magnesium, and repeat the ECG after dose changes. Consider an alternative antipsychotic with less QT effect.
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 Fluphenazine
- Arsenic trioxide + Fluphenazine Contraindicated
- Dofetilide + Fluphenazine Contraindicated
- Fluphenazine + Ibutilide Contraindicated
- Fluphenazine + Pimozide Contraindicated
- Adagrasib + Fluphenazine Major
- Alfentanil + Fluphenazine Major
Frequently asked questions
Can I take Clomipramine with Fluphenazine?
MediHelp rates the interaction as major. Clomipramine and Fluphenazine 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 can prolong the QT interval, so using them together raises the risk of torsades de pointes and other ventricular arrhythmias. Fluphenazine may also modestly raise tricyclic levels through CYP2D6 competition, and anticholinergic and sedative effects add up.
How serious is the interaction between Clomipramine and Fluphenazine?
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 the combination where possible; if it is necessary, obtain a baseline ECG, correct potassium and magnesium, and repeat the ECG after dose changes. Consider an alternative antipsychotic with less QT effect.
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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