Drug interactions
Clomipramine + Pyridostigmine
Severity: Moderate
Clomipramine and Pyridostigmine: 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
Clomipramine has marked anticholinergic activity that opposes the cholinesterase inhibition produced by pyridostigmine. This may reduce the benefit of pyridostigmine, for example on muscle strength in myasthenia gravis.
What this interaction means in plain words
Clomipramine and Pyridostigmine 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; Pyridostigmine belongs to Central Nervous System.
Why it happens
Pharmacodynamic antagonism between the anticholinergic effects of a tricyclic antidepressant and a cholinesterase inhibitor.
What to do
Monitor muscle strength and cholinergic symptoms when starting or stopping clomipramine, and adjust the pyridostigmine dose as needed. Consider a less anticholinergic antidepressant if control worsens.
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 Pyridostigmine
Frequently asked questions
Can I take Clomipramine with Pyridostigmine?
MediHelp rates the interaction as moderate. Clomipramine and Pyridostigmine 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 has marked anticholinergic activity that opposes the cholinesterase inhibition produced by pyridostigmine. This may reduce the benefit of pyridostigmine, for example on muscle strength in myasthenia gravis.
How serious is the interaction between Clomipramine and Pyridostigmine?
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 muscle strength and cholinergic symptoms when starting or stopping clomipramine, and adjust the pyridostigmine dose as needed. Consider a less anticholinergic antidepressant if control worsens.
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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