Drug interactions
Clomipramine + Fosamprenavir
Severity: Major
Clomipramine and Fosamprenavir: major 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
Ritonavir-boosted or unboosted amprenavir can inhibit the metabolism of clomipramine, raising its levels. This can increase tricyclic toxicity including sedation, anticholinergic effects and arrhythmia.
What this interaction means in plain words
Clomipramine and Fosamprenavir 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
Amprenavir inhibits CYP3A4 (and ritonavir additionally CYP2D6), reducing clomipramine clearance.
What to do
Consider an alternative antidepressant, or start clomipramine at a low dose and titrate. Monitor ECG and for signs of toxicity, with plasma levels if available.
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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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 Fosamprenavir?
MediHelp rates the interaction as major. Clomipramine and Fosamprenavir 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. Ritonavir-boosted or unboosted amprenavir can inhibit the metabolism of clomipramine, raising its levels. This can increase tricyclic toxicity including sedation, anticholinergic effects and arrhythmia.
How serious is the interaction between Clomipramine and Fosamprenavir?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Consider an alternative antidepressant, or start clomipramine at a low dose and titrate. Monitor ECG and for signs of toxicity, with plasma levels if available.
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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