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Drug interactions

Clomipramine + Pefloxacin

Severity: Moderate

Clomipramine and Pefloxacin: 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

Pefloxacin inhibits CYP1A2, one of the pathways metabolising clomipramine, so levels may rise and cause tricyclic adverse effects. Fluoroquinolones can also prolong the QT interval and lower the seizure threshold.

What this interaction means in plain words

Clomipramine and Pefloxacin 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; Pefloxacin belongs to Anti Bacterial.

Evidence level: Low

Why it happens

CYP1A2 inhibition by pefloxacin reduces clomipramine clearance, with additive QT and seizure-threshold effects.

What to do

Monitor for anticholinergic, cardiac and neurological toxicity and consider an ECG; choose a non-quinolone antibiotic if possible.

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?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Frequently asked questions

Can I take Clomipramine with Pefloxacin?

MediHelp rates the interaction as moderate. Clomipramine and Pefloxacin 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. Pefloxacin inhibits CYP1A2, one of the pathways metabolising clomipramine, so levels may rise and cause tricyclic adverse effects. Fluoroquinolones can also prolong the QT interval and lower the seizure threshold.

How serious is the interaction between Clomipramine and Pefloxacin?

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 anticholinergic, cardiac and neurological toxicity and consider an ECG; choose a non-quinolone antibiotic if possible.

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

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