clomipramine hydrochloride at a glance
Medicine class
Tricyclic antidepressant with a particularly strong effect on serotonin reuptake.
Licensed uses
Depressive illness, obsessional and phobic states, and adjunctive treatment of cataplexy in adults.
Stopping treatment
Do not stop suddenly; withdrawal can cause nausea, abdominal symptoms, insomnia, headache, nervousness or anxiety.
Driving
Drowsiness, blurred vision, confusion or poor attention can make driving unsafe.
What is clomipramine hydrochloride used for?
The selected UK product is licensed for adults for:
Symptoms of depressive illness, particularly when sedation is required.
Obsessional and phobic states.
Adjunctive treatment of cataplexy associated with narcolepsy.
How does clomipramine hydrochloride work?
Clomipramine reduces reuptake of serotonin and noradrenaline, leaving more of these chemical messengers available between nerve cells. Its effect on serotonin reuptake is especially prominent. Other actions contribute to dry mouth, constipation, drowsiness and postural dizziness.
clomipramine hydrochloride preparations and strengths
Capsule
Route: Oral
Strengths: 10 mg, 25 mg, 50 mg
How to take clomipramine hydrochloride
Take clomipramine exactly as directed by the prescriber.
Swallow hard capsules whole with water.
Food does not substantially alter overall absorption, although it may delay peak absorption.
Do not stop treatment abruptly without discussing a gradual withdrawal plan.
Do not drive or operate machinery if sleepy, confused, visually impaired or unable to concentrate.
clomipramine hydrochloride side effects
Common or expected effects
- Dry mouth, constipation or nausea.
- Sleepiness, tiredness, dizziness or headache.
- Blurred vision, sweating or tremor.
- Increased appetite or weight gain.
- Restlessness, sleep disturbance or anxiety.
- Sexual difficulties.
- Palpitations or light-headedness when standing.
Get urgent medical advice
- Suicidal thoughts or marked worsening of mood or behaviour.
- Seizure, collapse, fainting or an irregular heartbeat.
- Severe allergic reaction with swelling or breathing difficulty.
- Agitation or confusion with fever, sweating, diarrhoea, rapid heartbeat or muscle jerking.
- High fever with muscle rigidity and altered mental state.
- Inability to pass urine or sudden painful visual disturbance.
- Jaundice, dark urine or other signs of liver injury.
- Fever, sore throat or mouth ulcers suggesting a blood-cell disorder.
clomipramine hydrochloride in pregnancy
Speak to the prescriber when planning pregnancy or as soon as pregnancy is known; do not stop clomipramine suddenly. The selected product information does not recommend routine use in pregnancy and reports a registry signal for cardiac defects. Tricyclic antidepressants may still be used when clinically necessary; exposure near delivery can cause temporary newborn feeding, sleeping, breathing or withdrawal symptoms.
clomipramine hydrochloride while breastfeeding
The selected product information advises stopping either clomipramine or breastfeeding. Cautious use may be possible for a full-term, healthy infant, although imipramine or nortriptyline are preferred. Monitor for drowsiness, poor feeding, inadequate weight gain, irritability, constipation or reduced wet nappies. Specialist assessment is important for premature or unwell infants.
clomipramine hydrochloride interactions
Check prescribed, over-the-counter and herbal products before starting or stopping them. Important examples include:
Monoamine oxidase inhibitors, including moclobemide
The combination is contraindicated because severe serotonin toxicity, seizures, extreme fever or blood-pressure changes can occur.
SSRIs, SNRIs, lithium and other serotonergic antidepressants
These may increase clomipramine exposure or add serotonin effects, raising toxicity risk.
Buprenorphine and other opioids
Combining them with clomipramine may cause potentially life-threatening serotonin syndrome.
Common questions about clomipramine hydrochloride
Answers are fully visible for fast scanning and source review.
Can clomipramine hydrochloride make me sleepy?
Yes. Sleepiness, tiredness, dizziness, blurred vision and impaired attention are recognised effects, especially when treatment begins or other sedatives are used.
Can I drive while taking clomipramine hydrochloride?
Do not drive until you know its effects. Driving is unsafe if it causes sleepiness, blurred vision, confusion, dizziness or poor concentration.
Why should clomipramine hydrochloride not be stopped suddenly?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.