Drug interactions
Clomipramine + Gepirone
Severity: Major
Clomipramine and Gepirone: 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 enhance serotonergic transmission, so combined use may cause serotonin syndrome. Both can also prolong the QT interval, adding to arrhythmia risk. Clomipramine may also raise gepirone exposure through CYP3A4 or CYP2D6 effects.
What this interaction means in plain words
Clomipramine and Gepirone 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; Gepirone belongs to Central Nervous System.
Why it happens
Additive serotonergic activity (serotonin reuptake inhibition plus 5-HT1A agonism) and additive QT prolongation.
What to do
Avoid the combination where possible, or obtain a baseline ECG and correct potassium and magnesium. Monitor for serotonin syndrome and QT changes and stop one agent if they occur.
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 Gepirone
- Clarithromycin + Gepirone Contraindicated
- Gepirone + Isocarboxazid Contraindicated
- Gepirone + Itraconazole Contraindicated
- Gepirone + Ketoconazole Contraindicated
- Gepirone + Linezolid Contraindicated
- Gepirone + Phenelzine Contraindicated
Frequently asked questions
Can I take Clomipramine with Gepirone?
MediHelp rates the interaction as major. Clomipramine and Gepirone 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 enhance serotonergic transmission, so combined use may cause serotonin syndrome. Both can also prolong the QT interval, adding to arrhythmia risk. Clomipramine may also raise gepirone exposure through CYP3A4 or CYP2D6 effects.
How serious is the interaction between Clomipramine and Gepirone?
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, or obtain a baseline ECG and correct potassium and magnesium. Monitor for serotonin syndrome and QT changes and stop one agent if they occur.
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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