Drug interactions
Clomipramine + Methylthioninium chloride
Severity: Major
Clomipramine and Methylthioninium chloride: major 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
Clomipramine is a potent serotonin reuptake inhibitor, and with the MAO-A inhibiting effect of methylene blue it can precipitate serious, potentially fatal serotonin syndrome.
What this interaction means in plain words
Clomipramine and Methylthioninium chloride 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; Methylthioninium chloride belongs to Miscellaneous.
Why it happens
MAO-A inhibition by methylene blue plus serotonin reuptake inhibition by clomipramine.
What to do
Avoid; if methylene blue is urgent, stop clomipramine and monitor closely for serotonin toxicity for several days.
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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Other interactions of Methylthioninium chloride
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 Methylthioninium chloride?
MediHelp rates the interaction as major. Clomipramine and Methylthioninium chloride 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 with the MAO-A inhibiting effect of methylene blue it can precipitate serious, potentially fatal serotonin syndrome.
How serious is the interaction between Clomipramine and Methylthioninium chloride?
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; if methylene blue is urgent, stop clomipramine and monitor closely for serotonin toxicity for several days.
What other medicines interact with Methylthioninium chloride?
MediHelp also lists interactions of Methylthioninium chloride with, for example, Levomilnacipran, Linezolid, Bupropion. The full list is on the Methylthioninium chloride page.
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