Drug interactions
Clomipramine + Stiripentol
Severity: Major
Clomipramine and Stiripentol: major 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
Stiripentol inhibits several CYP enzymes including CYP2C19, CYP1A2 and CYP2D6, so clomipramine concentrations may rise, increasing anticholinergic, sedative and cardiac effects. Clomipramine also lowers the seizure threshold, which is undesirable in patients treated with stiripentol for epilepsy.
What this interaction means in plain words
Clomipramine and Stiripentol 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; Stiripentol belongs to Central Nervous System.
Why it happens
Stiripentol inhibits CYP2C19, CYP1A2 and CYP2D6, reducing clomipramine clearance (with mixed induction effects on CYP1A2).
What to do
Start clomipramine at a low dose and titrate slowly, monitoring for toxicity, ECG changes and seizure control. Reduce the clomipramine dose or consider an alternative antidepressant if adverse effects occur.
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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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 Stiripentol
- Apalutamide + Stiripentol Major
- Ergotamine + Stiripentol Major
- Flibanserin + Stiripentol Major
- Lorlatinib + Stiripentol Major
- Midazolam + Stiripentol Major
- Phenytoin + Stiripentol Major
Frequently asked questions
Can I take Clomipramine with Stiripentol?
MediHelp rates the interaction as major. Clomipramine and Stiripentol 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. Stiripentol inhibits several CYP enzymes including CYP2C19, CYP1A2 and CYP2D6, so clomipramine concentrations may rise, increasing anticholinergic, sedative and cardiac effects. Clomipramine also lowers the seizure threshold, which is undesirable in patients treated with stiripentol for epilepsy.
How serious is the interaction between Clomipramine and Stiripentol?
MediHelp rates it major, 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 slowly, monitoring for toxicity, ECG changes and seizure control. Reduce the clomipramine dose or consider an alternative antidepressant if adverse effects occur.
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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