Drug interactions
Clomipramine + Rivastigmine
Severity: Moderate
Clomipramine and Rivastigmine: 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
The anticholinergic action of clomipramine opposes the cholinesterase inhibition of rivastigmine, which may reduce its benefit in dementia. Cognition may worsen with the combination.
What this interaction means in plain words
Clomipramine and Rivastigmine 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; Rivastigmine belongs to Central Nervous System.
Why it happens
Pharmacodynamic antagonism between anticholinergic and cholinesterase-inhibitor effects.
What to do
Avoid anticholinergic tricyclics in patients on rivastigmine where possible and choose an antidepressant with low anticholinergic activity. If combined, monitor cognitive function.
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 Rivastigmine
Frequently asked questions
Can I take Clomipramine with Rivastigmine?
MediHelp rates the interaction as moderate. Clomipramine and Rivastigmine 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. The anticholinergic action of clomipramine opposes the cholinesterase inhibition of rivastigmine, which may reduce its benefit in dementia. Cognition may worsen with the combination.
How serious is the interaction between Clomipramine and Rivastigmine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid anticholinergic tricyclics in patients on rivastigmine where possible and choose an antidepressant with low anticholinergic activity. If combined, monitor cognitive function.
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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