Drug interactions
Clomipramine + Venlafaxine
Severity: Major
Clomipramine and Venlafaxine: 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 drugs increase serotonergic and noradrenergic activity, raising the risk of serotonin syndrome. Clomipramine can also increase venlafaxine exposure via CYP2D6 competition, and blood pressure and heart rate may rise.
What this interaction means in plain words
Clomipramine and Venlafaxine 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; Venlafaxine belongs to Central Nervous System.
Why it happens
Additive serotonin and norepinephrine reuptake inhibition with CYP2D6-related pharmacokinetic effects.
What to do
Avoid if possible; if combined, use low doses, titrate slowly, and monitor blood pressure, ECG and signs of serotonin toxicity.
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 Venlafaxine
- Isocarboxazid + Venlafaxine Contraindicated
- Methylene blue + Venlafaxine Contraindicated
- Phenelzine + Venlafaxine Contraindicated
- Procarbazine + Venlafaxine Contraindicated
- Rasagiline + Venlafaxine Contraindicated
- Safinamide + Venlafaxine Contraindicated
Frequently asked questions
Can I take Clomipramine with Venlafaxine?
MediHelp rates the interaction as major. Clomipramine and Venlafaxine 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 drugs increase serotonergic and noradrenergic activity, raising the risk of serotonin syndrome. Clomipramine can also increase venlafaxine exposure via CYP2D6 competition, and blood pressure and heart rate may rise.
How serious is the interaction between Clomipramine and Venlafaxine?
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 doses, titrate slowly, and monitor blood pressure, ECG and signs of serotonin toxicity.
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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