Drug interactions
Clomipramine + Propafenone
Severity: Moderate
Clomipramine and Propafenone: 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
Propafenone inhibits CYP2D6, which is involved in clearing clomipramine and its active metabolite. Plasma tricyclic concentrations may rise, increasing anticholinergic effects, sedation, seizure risk and cardiac conduction effects. Both drugs also slow cardiac conduction, so additive proarrhythmic effects are possible.
What this interaction means in plain words
Clomipramine and Propafenone 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; Propafenone belongs to Cardiovascular.
Why it happens
Propafenone inhibits CYP2D6-mediated metabolism of clomipramine, with additive effects on cardiac conduction.
What to do
Start clomipramine at a low dose and titrate against response and tolerability, considering plasma level monitoring. Obtain an ECG if doses are increased or symptoms of toxicity appear.
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 Propafenone
- Dofetilide + Propafenone Contraindicated
- Dronedarone + Propafenone Contraindicated
- Nilotinib + Propafenone Contraindicated
- Nirmatrelvir / ritonavir + Propafenone Contraindicated
- Nirmatrelvir + Propafenone Contraindicated
- Pimozide + Propafenone 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 Propafenone?
MediHelp rates the interaction as moderate. Clomipramine and Propafenone 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. Propafenone inhibits CYP2D6, which is involved in clearing clomipramine and its active metabolite. Plasma tricyclic concentrations may rise, increasing anticholinergic effects, sedation, seizure risk and cardiac conduction effects. Both drugs also slow cardiac conduction, so additive proarrhythmic effects are possible.
How serious is the interaction between Clomipramine and Propafenone?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Start clomipramine at a low dose and titrate against response and tolerability, considering plasma level monitoring. Obtain an ECG if doses are increased or symptoms of toxicity appear.
What other medicines interact with Propafenone?
MediHelp also lists interactions of Propafenone with, for example, Dofetilide, Dronedarone, Nilotinib. The full list is on the Propafenone page.
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