Drug interactions
Clomipramine + Tetrabenazine
Severity: Major
Clomipramine and Tetrabenazine: 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
Both clomipramine and tetrabenazine can prolong the QT interval, so the combination may increase the risk of torsades de pointes. Clomipramine may also raise tetrabenazine exposure by inhibiting CYP2D6, and the combination can add to sedation and depression-related concerns.
What this interaction means in plain words
Clomipramine and Tetrabenazine 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; Tetrabenazine belongs to Central Nervous System.
Why it happens
Additive QT prolongation, with CYP2D6 inhibition by clomipramine possibly raising tetrabenazine active metabolite levels.
What to do
Obtain a baseline ECG and correct potassium and magnesium; repeat the ECG after dose changes. Avoid the combination in patients with long QT or other QT-prolonging drugs, and consider limiting the tetrabenazine dose.
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 Tetrabenazine
- Dronedarone + Tetrabenazine Contraindicated
- Isocarboxazid + Tetrabenazine Contraindicated
- Linezolid + Tetrabenazine Contraindicated
- Phenelzine + Tetrabenazine Contraindicated
- Pimozide + Tetrabenazine Contraindicated
- Procarbazine + Tetrabenazine Contraindicated
Frequently asked questions
Can I take Clomipramine with Tetrabenazine?
MediHelp rates the interaction as major. Clomipramine and Tetrabenazine 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. Both clomipramine and tetrabenazine can prolong the QT interval, so the combination may increase the risk of torsades de pointes. Clomipramine may also raise tetrabenazine exposure by inhibiting CYP2D6, and the combination can add to sedation and depression-related concerns.
How serious is the interaction between Clomipramine and Tetrabenazine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Obtain a baseline ECG and correct potassium and magnesium; repeat the ECG after dose changes. Avoid the combination in patients with long QT or other QT-prolonging drugs, and consider limiting the tetrabenazine dose.
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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