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Interazioni tra farmaci

Clomipramine + Cocaine

Gravità: Maggiore

Clomipramine and Cocaine: major interaction.

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Sintesi

Cocaine blocks reuptake of norepinephrine, dopamine and serotonin, and clomipramine has similar actions on serotonin and norepinephrine. The combination can increase sympathomimetic and serotonergic effects, including hypertension, arrhythmias and serotonin toxicity. Topical use at a clinical dose has lower systemic exposure, but significant absorption can occur from mucosal use.

Cosa significa questa interazione in parole semplici

Clomipramine and Cocaine 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; Cocaine belongs to Central Nervous System.

Livello di evidenza: Moderate

Perché avviene

Additive monoamine reuptake inhibition, with potentiated adrenergic effects and arrhythmia risk.

Cosa fare

Avoid cocaine, including recreational use, in patients taking clomipramine. If topical cocaine is required, use the minimum dose and monitor blood pressure and ECG.

Cosa chiedere al farmacista

  • 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?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Domande frequenti

Can I take Clomipramine with Cocaine?

MediHelp rates the interaction as major. Clomipramine and Cocaine 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. Cocaine blocks reuptake of norepinephrine, dopamine and serotonin, and clomipramine has similar actions on serotonin and norepinephrine. The combination can increase sympathomimetic and serotonergic effects, including hypertension, arrhythmias and serotonin toxicity. Topical use at a clinical dose has lower systemic exposure, but significant absorption can occur from mucosal use.

How serious is the interaction between Clomipramine and Cocaine?

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 cocaine, including recreational use, in patients taking clomipramine. If topical cocaine is required, use the minimum dose and monitor blood pressure and ECG.

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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