Drug interactions
Clomipramine + Posaconazole
Severity: Major
Clomipramine and Posaconazole: major 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
Both agents can prolong the QT interval, which increases the risk of torsades de pointes. Posaconazole may also increase clomipramine levels through CYP3A4 inhibition, adding to cardiac and anticholinergic toxicity.
What this interaction means in plain words
Clomipramine and Posaconazole 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; Posaconazole belongs to Anti Fungals.
Why it happens
Additive QT prolongation, with possible CYP3A4 inhibition raising clomipramine concentrations.
What to do
Obtain a baseline and follow-up ECG and correct potassium and magnesium. Consider an alternative agent if the QTc rises significantly or other QT risk factors exist.
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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Other interactions of Posaconazole
- Artemether + Posaconazole Contraindicated
- Avanafil + Posaconazole Contraindicated
- Cobimetinib + Posaconazole Contraindicated
- Conivaptan + Posaconazole Contraindicated
- Dihydroergotamine intranasal + Posaconazole Contraindicated
- Dihydroergotamine + Posaconazole Contraindicated
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 Posaconazole?
MediHelp rates the interaction as major. Clomipramine and Posaconazole 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 agents can prolong the QT interval, which increases the risk of torsades de pointes. Posaconazole may also increase clomipramine levels through CYP3A4 inhibition, adding to cardiac and anticholinergic toxicity.
How serious is the interaction between Clomipramine and Posaconazole?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Obtain a baseline and follow-up ECG and correct potassium and magnesium. Consider an alternative agent if the QTc rises significantly or other QT risk factors exist.
What other medicines interact with Posaconazole?
MediHelp also lists interactions of Posaconazole with, for example, Artemether, Avanafil, Cobimetinib. The full list is on the Posaconazole page.
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