Drug interactions
Clomipramine + Procainamide
Severity: Contraindicated
Clomipramine and Procainamide: contraindicated interaction.
Last updated Sources: UK SmPC
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
Procainamide is a class Ia antiarrhythmic that lengthens the QT interval, and clomipramine also slows cardiac conduction and repolarization. Together they increase the risk of torsades de pointes and conduction block.
What this interaction means in plain words
Clomipramine and Procainamide are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.
Why it happens
Additive sodium channel blockade and QT prolongation, with possible CYP2D6 competition.
What to do
Avoid the combination and choose an alternative antiarrhythmic or antidepressant. If it cannot be avoided, monitor ECG continuously and correct electrolytes.
What to ask your pharmacist
- Is there an alternative to one of these two medicines for me?
- If both are essential, who is monitoring me and how often?
- Which symptoms mean I should stop and seek help straight away?
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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
Frequently asked questions
Can I take Clomipramine with Procainamide?
MediHelp rates the interaction as contraindicated. Clomipramine and Procainamide are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Procainamide is a class Ia antiarrhythmic that lengthens the QT interval, and clomipramine also slows cardiac conduction and repolarization. Together they increase the risk of torsades de pointes and conduction block.
How serious is the interaction between Clomipramine and Procainamide?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination and choose an alternative antiarrhythmic or antidepressant. If it cannot be avoided, monitor ECG continuously and correct electrolytes.
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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