Drug interactions
Clomipramine + Parecoxib
Severity: Moderate
Clomipramine and Parecoxib: 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
Parecoxib is converted to valdecoxib, which may modestly raise tricyclic exposure through CYP2D6 effects, though this is poorly established. Antidepressants that block serotonin reuptake can also impair platelet function and add to the gastrointestinal bleeding risk of NSAIDs.
What this interaction means in plain words
Clomipramine and Parecoxib 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 weak CYP2D6 inhibition by valdecoxib raising clomipramine levels, plus additive impairment of hemostasis from platelet serotonin depletion and NSAID effects.
What to do
Monitor for signs of gastrointestinal bleeding and for anticholinergic or cardiac adverse effects of clomipramine. Consider gastroprotection in patients with other bleeding risk factors.
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
Frequently asked questions
Can I take Clomipramine with Parecoxib?
MediHelp rates the interaction as moderate. Clomipramine and Parecoxib 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. Parecoxib is converted to valdecoxib, which may modestly raise tricyclic exposure through CYP2D6 effects, though this is poorly established. Antidepressants that block serotonin reuptake can also impair platelet function and add to the gastrointestinal bleeding risk of NSAIDs.
How serious is the interaction between Clomipramine and Parecoxib?
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 gastrointestinal bleeding and for anticholinergic or cardiac adverse effects of clomipramine. Consider gastroprotection in patients with other bleeding risk factors.
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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