Interactions

Drug-Drug

• May cause hypotension and tachycardia when used with MAO inhibitors (concurrent use not recommended)

• Wait 2 wks before initiating clomipramine after MAO Inhibitors are stopped

• Wait 2 wks before initiating MAO Inhibitors after clomipramine is stopped

• May prevent the therapeutic response to antihypertensives

• Use with clonidine may result in hypertensive crisis (avoid concurrent use)

• CNS depression with other CNS depressants including alcohol, antihistamines, opioids, and sedative/hypnotics

• Adrenergic and anticholinergic side effects may be with other agents having adrenergic/anticholinergic properties

• Effects and toxicity may be by concurrent use with SSRI antidepressants (wait several weeks after stopping SSRIs to start clomipiramine; up to 5 weeks for fluoxetine), phenothiazines, cimetidine, or oral contraceptives

• Nicotine may metabolism and effectiveness

• Transient delirium may occur with disulfiram

Drug-Natural Products

• Increased risk of serotonergic side effects including serotonin syndrome with St. John's wort and SAMe

• Kava, valerian, or chamomile can increase CNS depression

Drug-Food
Grapefruit juice serum levels and effect

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