Drug interactions
Clomipramine + Norepinephrine
Severity: Major
Clomipramine and Norepinephrine: 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
Tricyclic antidepressants block norepinephrine reuptake and can markedly potentiate the pressor response to infused norepinephrine. This may cause severe hypertension and arrhythmias.
What this interaction means in plain words
Clomipramine and Norepinephrine 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.
Why it happens
Inhibition of neuronal norepinephrine reuptake by clomipramine enhances adrenergic receptor stimulation.
What to do
If norepinephrine is required, start at a low dose and titrate cautiously with continuous blood pressure and ECG monitoring. Be prepared for exaggerated pressor responses.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Clomipramine and Norepinephrine, 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.
References
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 Norepinephrine?
MediHelp rates the interaction as major. Clomipramine and Norepinephrine 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. Tricyclic antidepressants block norepinephrine reuptake and can markedly potentiate the pressor response to infused norepinephrine. This may cause severe hypertension and arrhythmias.
How serious is the interaction between Clomipramine and Norepinephrine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: If norepinephrine is required, start at a low dose and titrate cautiously with continuous blood pressure and ECG monitoring. Be prepared for exaggerated pressor responses.
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.
