Drug interactions
Clomipramine + Perphenazine
Severity: Major
Clomipramine and Perphenazine: 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
Both drugs can prolong the QT interval, and perphenazine is a CYP2D6 substrate and inhibitor that can raise clomipramine levels. This increases arrhythmia risk and also adds sedation and anticholinergic effects.
What this interaction means in plain words
Clomipramine and Perphenazine 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; Perphenazine belongs to Central Nervous System.
Why it happens
Additive QT prolongation with CYP2D6 competition increasing tricyclic exposure.
What to do
Avoid if possible; if combined, obtain baseline and follow-up ECGs, correct electrolytes, and use the lowest effective doses.
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 Clomipramine
- Arsenic trioxide + Clomipramine Contraindicated
- Clomipramine + Dofetilide Contraindicated
- Clomipramine + Droperidol Contraindicated
- Clomipramine + Isocarboxazid Contraindicated
- Clomipramine + Methylene blue Contraindicated
- Clomipramine + Pentamidine Contraindicated
Other interactions of Perphenazine
- Ibutilide + Perphenazine Contraindicated
- Perphenazine + Pimozide Contraindicated
- Perphenazine + Thioridazine Contraindicated
- Adagrasib + Perphenazine Major
- Alfentanil + Perphenazine Major
- Amiodarone + Perphenazine Major
Frequently asked questions
Can I take Clomipramine with Perphenazine?
MediHelp rates the interaction as major. Clomipramine and Perphenazine 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. Both drugs can prolong the QT interval, and perphenazine is a CYP2D6 substrate and inhibitor that can raise clomipramine levels. This increases arrhythmia risk and also adds sedation and anticholinergic effects.
How serious is the interaction between Clomipramine and Perphenazine?
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 if possible; if combined, obtain baseline and follow-up ECGs, correct electrolytes, and use the lowest effective doses.
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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