Drug interactions
Clomipramine + L-tryptophan
Severity: Major
Clomipramine and L-tryptophan: 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
L-tryptophan is a serotonin precursor, and with clomipramine's potent serotonin reuptake inhibition it can precipitate serotonin syndrome. Case reports describe agitation, tremor, and hyperthermia with this type of combination.
What this interaction means in plain words
Clomipramine and L-tryptophan 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
Increased serotonin synthesis combined with inhibition of serotonin reuptake produces additive serotonergic effects.
What to do
Avoid the combination where possible. If used, start with low doses and monitor for symptoms of 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
Frequently asked questions
Can I take Clomipramine with L-tryptophan?
MediHelp rates the interaction as major. Clomipramine and L-tryptophan 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. L-tryptophan is a serotonin precursor, and with clomipramine's potent serotonin reuptake inhibition it can precipitate serotonin syndrome. Case reports describe agitation, tremor, and hyperthermia with this type of combination.
How serious is the interaction between Clomipramine and L-tryptophan?
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 used, start with low doses and monitor for symptoms of 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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