Drug interactions
Clomipramine + Remifentanil
Severity: Moderate
Clomipramine and Remifentanil: 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 is a strongly serotonergic tricyclic and adds to opioid sedation and respiratory depression. Serotonin syndrome is a concern, although remifentanil itself has weak serotonergic activity.
What this interaction means in plain words
Clomipramine and Remifentanil 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; Remifentanil belongs to Musculoskeletal.
Why it happens
Additive CNS depression, with possible additive serotonergic effects.
What to do
Use the lowest effective remifentanil dose and monitor sedation, respiratory rate and serotonin toxicity signs such as clonus and hyperthermia.
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 Remifentanil
- Alvimopan + Remifentanil Contraindicated
- Isocarboxazid + Remifentanil Contraindicated
- Olanzapine / samidorphan + Remifentanil Contraindicated
- Phenelzine + Remifentanil Contraindicated
- Benzhydrocodone / acetaminophen + Remifentanil Major
- Brexanolone + Remifentanil Major
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 Remifentanil?
MediHelp rates the interaction as moderate. Clomipramine and Remifentanil 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 is a strongly serotonergic tricyclic and adds to opioid sedation and respiratory depression. Serotonin syndrome is a concern, although remifentanil itself has weak serotonergic activity.
How serious is the interaction between Clomipramine and Remifentanil?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use the lowest effective remifentanil dose and monitor sedation, respiratory rate and serotonin toxicity signs such as clonus and hyperthermia.
What other medicines interact with Remifentanil?
MediHelp also lists interactions of Remifentanil with, for example, Alvimopan, Isocarboxazid, Olanzapine / samidorphan. The full list is on the Remifentanil page.
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