Drug interactions
Clomipramine + Letermovir
Severity: Moderate
Clomipramine and Letermovir: moderate 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
Letermovir is a moderate CYP3A4 inhibitor and may raise clomipramine exposure, which is partly cleared by CYP3A4 and CYP2C19. Higher tricyclic levels can increase anticholinergic effects, sedation, seizure risk and QT prolongation.
What this interaction means in plain words
Clomipramine and Letermovir can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Clomipramine belongs to Central Nervous System; Letermovir belongs to Anti Virals.
Why it happens
Letermovir inhibits CYP3A4-mediated metabolism of clomipramine, raising plasma concentrations.
What to do
Monitor for tricyclic toxicity and consider an ECG in at-risk patients. Reduce the clomipramine dose or check drug levels if adverse effects emerge.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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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 Letermovir
- Ergotamine + Letermovir Contraindicated
- Letermovir + Pimozide Contraindicated
- Apalutamide + Letermovir Major
- Atorvastatin + Letermovir Major
- Carbamazepine + Letermovir Major
- Colchicine + Letermovir Major
Frequently asked questions
Can I take Clomipramine with Letermovir?
MediHelp rates the interaction as moderate. Clomipramine and Letermovir can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Letermovir is a moderate CYP3A4 inhibitor and may raise clomipramine exposure, which is partly cleared by CYP3A4 and CYP2C19. Higher tricyclic levels can increase anticholinergic effects, sedation, seizure risk and QT prolongation.
How serious is the interaction between Clomipramine and Letermovir?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for tricyclic toxicity and consider an ECG in at-risk patients. Reduce the clomipramine dose or check drug levels if adverse effects emerge.
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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