Drug interactions
Clomipramine + Netupitant / palonosetron
Severity: Moderate
Clomipramine and Netupitant / palonosetron: 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
Palonosetron is a 5-HT3 antagonist, and serotonin syndrome has been reported when such agents are used with serotonergic drugs. Netupitant also inhibits CYP3A4, which may modestly raise clomipramine exposure.
What this interaction means in plain words
Clomipramine and Netupitant / palonosetron 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.
Why it happens
Possible additive serotonergic effects, plus CYP3A4 inhibition by netupitant reducing clomipramine clearance.
What to do
Monitor for signs of serotonin syndrome and tricyclic toxicity after the antiemetic dose. Usually a single-dose regimen is acceptable with observation.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Clomipramine and Netupitant / palonosetron, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
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 Netupitant / palonosetron?
MediHelp rates the interaction as moderate. Clomipramine and Netupitant / palonosetron 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. Palonosetron is a 5-HT3 antagonist, and serotonin syndrome has been reported when such agents are used with serotonergic drugs. Netupitant also inhibits CYP3A4, which may modestly raise clomipramine exposure.
How serious is the interaction between Clomipramine and Netupitant / palonosetron?
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 for signs of serotonin syndrome and tricyclic toxicity after the antiemetic dose. Usually a single-dose regimen is acceptable with observation.
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.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
