Drug interactions
Clomipramine + Sertraline
Severity: Major
Clomipramine and Sertraline: major interaction.
Last updated Sources: US FDA label
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
Sertraline can moderately inhibit CYP2D6 and raise clomipramine levels, and both drugs are serotonergic with some QT effect. This raises the risk of serotonin syndrome and tricyclic toxicity.
What this interaction means in plain words
Clomipramine and Sertraline can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Clomipramine belongs to Central Nervous System; Sertraline belongs to Central Nervous System.
Why it happens
Additive serotonergic activity and CYP2D6 inhibition by sertraline increasing clomipramine exposure.
What to do
Avoid if possible; if combined, use low clomipramine doses, check plasma levels and ECG, and monitor for serotonin syndrome.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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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
Other interactions of Sertraline
- Isocarboxazid + Sertraline Contraindicated
- Methylene blue + Sertraline Contraindicated
- Phenelzine + Sertraline Contraindicated
- Pimozide + Sertraline Contraindicated
- Selegiline transdermal + Sertraline Contraindicated
- Selegiline + Sertraline Contraindicated
Frequently asked questions
Can I take Clomipramine with Sertraline?
MediHelp rates the interaction as major. Clomipramine and Sertraline can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Sertraline can moderately inhibit CYP2D6 and raise clomipramine levels, and both drugs are serotonergic with some QT effect. This raises the risk of serotonin syndrome and tricyclic toxicity.
How serious is the interaction between Clomipramine and Sertraline?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid if possible; if combined, use low clomipramine doses, check plasma levels and ECG, and monitor for serotonin syndrome.
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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