Drug interactions
Clomipramine + Iloperidone
Severity: Major
Clomipramine and Iloperidone: 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
Both drugs can prolong the QT interval, so combined use raises the risk of torsades de pointes. They also add to sedation, orthostatic hypotension and anticholinergic effects, and clomipramine may raise iloperidone levels through CYP2D6 inhibition.
What this interaction means in plain words
Clomipramine and Iloperidone 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; Iloperidone belongs to Central Nervous System.
Why it happens
Additive QT prolongation and CNS depression, with possible CYP2D6 inhibition raising iloperidone exposure.
What to do
Avoid the combination where possible, or obtain a baseline ECG and keep potassium and magnesium normal. Monitor the QTc and for sedation and hypotension, and consider reducing the iloperidone dose.
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
Other interactions of Iloperidone
- Iloperidone + Thioridazine Contraindicated
- Alfuzosin + Iloperidone Major
- Amiodarone + Iloperidone Major
- Amisulpride + Iloperidone Major
- Amitriptyline + Iloperidone Major
- Anagrelide + Iloperidone Major
Frequently asked questions
Can I take Clomipramine with Iloperidone?
MediHelp rates the interaction as major. Clomipramine and Iloperidone 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 combined use raises the risk of torsades de pointes. They also add to sedation, orthostatic hypotension and anticholinergic effects, and clomipramine may raise iloperidone levels through CYP2D6 inhibition.
How serious is the interaction between Clomipramine and Iloperidone?
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 keep potassium and magnesium normal. Monitor the QTc and for sedation and hypotension, and consider reducing the iloperidone dose.
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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