Drug interactions
Clomipramine + Pentazocine
Severity: Major
Clomipramine and Pentazocine: 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
Clomipramine is a strongly serotonergic tricyclic antidepressant that is also sedating. With pentazocine, additive sedation and respiratory depression may occur, and serotonin syndrome has been reported with opioids and serotonergic antidepressants, though the risk with pentazocine is less well characterized.
What this interaction means in plain words
Clomipramine and Pentazocine 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.
Clomipramine belongs to Central Nervous System; Pentazocine belongs to Musculoskeletal.
Why it happens
Additive central nervous system depression plus possible additive serotonergic effects; clomipramine may also lower seizure threshold.
What to do
Avoid the combination where alternatives exist; otherwise use low doses and monitor for sedation, respiratory depression and signs of serotonin toxicity such as agitation, tremor, clonus and hyperthermia.
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?
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References
Other interactions of Pentazocine
- Calcium / magnesium / potassium / sodium oxybates + Pentazocine Contraindicated
- Olanzapine / samidorphan + Pentazocine Contraindicated
- Pentazocine + Phenelzine Contraindicated
- Pentazocine + Tranylcypromine Contraindicated
- Alfentanil + Pentazocine Major
- Alprazolam + Pentazocine Major
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 Pentazocine?
MediHelp rates the interaction as major. Clomipramine and Pentazocine 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. Clomipramine is a strongly serotonergic tricyclic antidepressant that is also sedating. With pentazocine, additive sedation and respiratory depression may occur, and serotonin syndrome has been reported with opioids and serotonergic antidepressants, though the risk with pentazocine is less well characterized.
How serious is the interaction between Clomipramine and Pentazocine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination where alternatives exist; otherwise use low doses and monitor for sedation, respiratory depression and signs of serotonin toxicity such as agitation, tremor, clonus and hyperthermia.
What other medicines interact with Pentazocine?
MediHelp also lists interactions of Pentazocine with, for example, Calcium / magnesium / potassium / sodium oxybates, Olanzapine / samidorphan, Phenelzine. The full list is on the Pentazocine page.
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