Drug interactions
Clomipramine + Methylene blue
Severity: Contraindicated
Clomipramine and Methylene blue: contraindicated 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
Methylene blue inhibits monoamine oxidase A, and combining it with a strongly serotonergic tricyclic can cause serotonin syndrome. Severe cases involve hyperthermia, rigidity, seizures and altered consciousness.
What this interaction means in plain words
Clomipramine and Methylene blue are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.
Why it happens
MAO-A inhibition by methylene blue combined with serotonin reuptake inhibition by clomipramine leads to excess serotonin.
What to do
Avoid unless methylene blue is needed for a life-threatening condition. If it is, stop clomipramine and monitor for serotonin toxicity; do not restart for at least 24 hours after the last methylene blue dose.
What to ask your pharmacist
- Is there an alternative to one of these two medicines for me?
- If both are essential, who is monitoring me and how often?
- Which symptoms mean I should stop and seek help straight away?
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Other interactions of Clomipramine
- Arsenic trioxide + Clomipramine Contraindicated
- Clomipramine + Dofetilide Contraindicated
- Clomipramine + Droperidol Contraindicated
- Clomipramine + Isocarboxazid Contraindicated
- Clomipramine + Pentamidine Contraindicated
- Clomipramine + Phenelzine Contraindicated
Frequently asked questions
Can I take Clomipramine with Methylene blue?
MediHelp rates the interaction as contraindicated. Clomipramine and Methylene blue are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Methylene blue inhibits monoamine oxidase A, and combining it with a strongly serotonergic tricyclic can cause serotonin syndrome. Severe cases involve hyperthermia, rigidity, seizures and altered consciousness.
How serious is the interaction between Clomipramine and Methylene blue?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid unless methylene blue is needed for a life-threatening condition. If it is, stop clomipramine and monitor for serotonin toxicity; do not restart for at least 24 hours after the last methylene blue 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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