Drug interactions
Clomipramine + Primidone
Severity: Moderate
Clomipramine and Primidone: 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
Primidone is metabolized to phenobarbital, an enzyme inducer that can lower clomipramine concentrations and weaken antidepressant effect. Additive sedation occurs, and tricyclics may lower seizure threshold in epilepsy patients.
What this interaction means in plain words
Clomipramine and Primidone 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; Primidone belongs to Central Nervous System.
Why it happens
Induction of hepatic CYP enzymes (CYP1A2, CYP3A4) by primidone and its phenobarbital metabolite, plus additive CNS depression.
What to do
Monitor depressive symptoms and seizure control, and adjust clomipramine dosing using plasma levels if possible. Counsel about additive drowsiness.
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
Other interactions of Primidone
- Lorlatinib + Primidone Contraindicated
- Lurasidone + Primidone Contraindicated
- Primidone + Ranolazine Contraindicated
- Primidone + Sofosbuvir-velpatasvir-voxilaprevir Contraindicated
- Primidone + Voriconazole Contraindicated
- Abiraterone + Primidone Major
Frequently asked questions
Can I take Clomipramine with Primidone?
MediHelp rates the interaction as moderate. Clomipramine and Primidone 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. Primidone is metabolized to phenobarbital, an enzyme inducer that can lower clomipramine concentrations and weaken antidepressant effect. Additive sedation occurs, and tricyclics may lower seizure threshold in epilepsy patients.
How serious is the interaction between Clomipramine and Primidone?
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 depressive symptoms and seizure control, and adjust clomipramine dosing using plasma levels if possible. Counsel about additive drowsiness.
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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