Drug interactions
Clomipramine + Meperidine
Severity: Major
Clomipramine and Meperidine: 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
Clomipramine is a potent serotonin reuptake inhibitor and, combined with meperidine, markedly increases the risk of serotonin syndrome. Additive sedation and lowered seizure threshold also contribute to the risk.
What this interaction means in plain words
Clomipramine and Meperidine 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; Meperidine belongs to Musculoskeletal.
Why it happens
Additive serotonergic effects through reuptake inhibition.
What to do
Avoid meperidine in patients taking clomipramine and use a non-serotonergic opioid. If exposure occurs, monitor closely for agitation, clonus, hyperthermia and autonomic instability.
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 Meperidine
- Alvimopan + Meperidine Contraindicated
- Isocarboxazid + Meperidine Contraindicated
- Meperidine + Methylene blue Contraindicated
- Meperidine + Olanzapine / samidorphan Contraindicated
- Meperidine + Phenelzine Contraindicated
- Meperidine + Procarbazine Contraindicated
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 Meperidine?
MediHelp rates the interaction as major. Clomipramine and Meperidine 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 is a potent serotonin reuptake inhibitor and, combined with meperidine, markedly increases the risk of serotonin syndrome. Additive sedation and lowered seizure threshold also contribute to the risk.
How serious is the interaction between Clomipramine and Meperidine?
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 meperidine in patients taking clomipramine and use a non-serotonergic opioid. If exposure occurs, monitor closely for agitation, clonus, hyperthermia and autonomic instability.
What other medicines interact with Meperidine?
MediHelp also lists interactions of Meperidine with, for example, Alvimopan, Isocarboxazid, Methylene blue. The full list is on the Meperidine page.
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