Drug interactions
Clomipramine + Midodrine
Severity: Moderate
Clomipramine and Midodrine: 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
Midodrine is a direct alpha-1 agonist, and tricyclic antidepressants can increase pressor responses to adrenergic agents. This may produce excessive hypertension, particularly supine hypertension, or bradycardia and arrhythmia.
What this interaction means in plain words
Clomipramine and Midodrine 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; Midodrine belongs to Miscellaneous.
Why it happens
Tricyclic inhibition of norepinephrine reuptake and enhanced adrenergic sensitivity add to alpha-1 agonism.
What to do
Monitor supine and standing blood pressure and heart rate, and reduce the midodrine dose if hypertension develops.
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 Midodrine
- Isocarboxazid + Midodrine Contraindicated
- Midodrine + Phenelzine Contraindicated
- Midodrine + Tranylcypromine Contraindicated
- Dextroamphetamine + Midodrine Major
- Dihydroergotamine intranasal + Midodrine Major
- Dihydroergotamine + Midodrine Major
Frequently asked questions
Can I take Clomipramine with Midodrine?
MediHelp rates the interaction as moderate. Clomipramine and Midodrine 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. Midodrine is a direct alpha-1 agonist, and tricyclic antidepressants can increase pressor responses to adrenergic agents. This may produce excessive hypertension, particularly supine hypertension, or bradycardia and arrhythmia.
How serious is the interaction between Clomipramine and Midodrine?
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 supine and standing blood pressure and heart rate, and reduce the midodrine dose if hypertension develops.
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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