Drug interactions
Clomipramine + Neostigmine
Severity: Moderate
Clomipramine and Neostigmine: 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
Clomipramine blocks muscarinic receptors and can counteract the cholinergic effects of neostigmine. This may reduce neostigmine efficacy in myasthenia gravis or reversal of neuromuscular blockade, though the effect is variable.
What this interaction means in plain words
Clomipramine and Neostigmine 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; Neostigmine belongs to Central Nervous System.
Why it happens
Pharmacodynamic antagonism between cholinesterase inhibition and anticholinergic receptor blockade.
What to do
Monitor response to neostigmine, including muscle strength or reversal of blockade, and adjust the dose accordingly. Consider an alternative antidepressant in myasthenia patients.
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 Neostigmine
Frequently asked questions
Can I take Clomipramine with Neostigmine?
MediHelp rates the interaction as moderate. Clomipramine and Neostigmine 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 blocks muscarinic receptors and can counteract the cholinergic effects of neostigmine. This may reduce neostigmine efficacy in myasthenia gravis or reversal of neuromuscular blockade, though the effect is variable.
How serious is the interaction between Clomipramine and Neostigmine?
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 response to neostigmine, including muscle strength or reversal of blockade, and adjust the dose accordingly. Consider an alternative antidepressant in myasthenia patients.
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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