Drug interactions
Clomipramine + Morphine
Severity: Major
Clomipramine and Morphine: 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 adds sedation to morphine, and as a strongly serotonergic tricyclic it may rarely contribute to serotonin toxicity with opioids. Clomipramine may also modestly increase opioid-related CNS effects.
What this interaction means in plain words
Clomipramine and Morphine 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; Morphine belongs to Musculoskeletal.
Why it happens
Additive CNS depression, with a possible serotonergic contribution from clomipramine's reuptake inhibition.
What to do
Monitor for sedation and for signs of serotonin syndrome such as agitation, tremor, hyperthermia and clonus, especially after dose changes. Start with lower doses and titrate gradually.
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 Morphine
- Alvimopan + Morphine Contraindicated
- Isocarboxazid + Morphine Contraindicated
- Morphine + Olanzapine / samidorphan Contraindicated
- Morphine + Phenelzine Contraindicated
- Morphine + Tranylcypromine Contraindicated
- Alfentanil + Morphine Major
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 Morphine?
MediHelp rates the interaction as major. Clomipramine and Morphine 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 adds sedation to morphine, and as a strongly serotonergic tricyclic it may rarely contribute to serotonin toxicity with opioids. Clomipramine may also modestly increase opioid-related CNS effects.
How serious is the interaction between Clomipramine and Morphine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for sedation and for signs of serotonin syndrome such as agitation, tremor, hyperthermia and clonus, especially after dose changes. Start with lower doses and titrate gradually.
What other medicines interact with Morphine?
MediHelp also lists interactions of Morphine with, for example, Alvimopan, Isocarboxazid, Olanzapine / samidorphan. The full list is on the Morphine page.
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