Drug interactions
Clomipramine + Methylenedioxymethamphetamine
Severity: Major
Clomipramine and Methylenedioxymethamphetamine: 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
MDMA releases serotonin and norepinephrine, and clomipramine blocks their reuptake, so together they raise the risk of serotonin syndrome, hypertension, tachycardia and arrhythmias. Clomipramine may also alter MDMA effects unpredictably and CYP2D6 competition may raise levels.
What this interaction means in plain words
Clomipramine and Methylenedioxymethamphetamine 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
Additive serotonergic and noradrenergic activity, with possible CYP2D6-mediated pharmacokinetic interaction.
What to do
Avoid the combination and counsel patients against recreational MDMA use. Provide urgent care if hyperthermia, agitation or marked hemodynamic changes occur.
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 Methylenedioxymethamphetamine?
MediHelp rates the interaction as major. Clomipramine and Methylenedioxymethamphetamine 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. MDMA releases serotonin and norepinephrine, and clomipramine blocks their reuptake, so together they raise the risk of serotonin syndrome, hypertension, tachycardia and arrhythmias. Clomipramine may also alter MDMA effects unpredictably and CYP2D6 competition may raise levels.
How serious is the interaction between Clomipramine and Methylenedioxymethamphetamine?
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 and counsel patients against recreational MDMA use. Provide urgent care if hyperthermia, agitation or marked hemodynamic changes occur.
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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