Drug interactions
Clomipramine + Terbinafine
Severity: Moderate
Clomipramine and Terbinafine: 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
Terbinafine inhibits CYP2D6 and can raise concentrations of clomipramine and its active metabolite desmethylclomipramine. This increases the risk of anticholinergic effects, sedation, seizures, serotonergic effects and cardiac conduction abnormalities.
What this interaction means in plain words
Clomipramine and Terbinafine 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; Terbinafine belongs to Anti Fungals.
Why it happens
CYP2D6 inhibition by terbinafine reduces hydroxylation of clomipramine and its metabolite.
What to do
Monitor for tricyclic toxicity, consider an ECG and reduce the clomipramine dose or check plasma levels if available.
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 Terbinafine
- Terbinafine + Thioridazine Contraindicated
- Desipramine + Terbinafine Major
- Eliglustat + Terbinafine Major
- Flecainide + Terbinafine Major
- Imipramine + Terbinafine Major
- Maprotiline + Terbinafine 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 Terbinafine?
MediHelp rates the interaction as moderate. Clomipramine and Terbinafine 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. Terbinafine inhibits CYP2D6 and can raise concentrations of clomipramine and its active metabolite desmethylclomipramine. This increases the risk of anticholinergic effects, sedation, seizures, serotonergic effects and cardiac conduction abnormalities.
How serious is the interaction between Clomipramine and Terbinafine?
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 for tricyclic toxicity, consider an ECG and reduce the clomipramine dose or check plasma levels if available.
What other medicines interact with Terbinafine?
MediHelp also lists interactions of Terbinafine with, for example, Thioridazine, Desipramine, Eliglustat. The full list is on the Terbinafine page.
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