Clomipramine (kloe-MIP-ra-meen)

Treats obsessive-compulsive disorder (OCD).

Brand Name(s):

Anafranil

When This Medicine Should Not Be Used:

How to Use This Medicine:

Capsule, Tablet

• Take your medicine as directed. Your dose may need to be changed several times to find what works best for you.
• Your doctor may tell you to take the medicine at bedtime to prevent drowsiness during the day.
• It is best to take this medicine with food or milk.
• This medicine should come with a Medication Guide. Ask your pharmacist for a copy if you do not have one.
• Missed dose: Take a dose as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose. Do not take extra medicine to make up for a missed dose.
• Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.

Drugs and Foods to Avoid:

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Do not use this medicine if you are using or have used an MAO inhibitor (MAOI), within the past 14 days.
• Some medicines can affect how clomipramine works. Tell your doctor if you are using any of the following:
  • Buspirone, cimetidine, clonidine, digoxin, fentanyl, guanethidine, haloperidol, lithium, methylphenidate, St John's wort, tramadol, tryptophan
  • Blood thinner (including warfarin)
  • Diuretic (water pill)
  • Electroconvulsive treatment
  • Medicine to treat depression (including fluoxetine, fluvoxamine, paroxetine, sertraline)
  • Medicine to treat heart rhythm problems (including flecainide, propafenone, quinidine)
  • Medicine to treat mental illness (including chlorpromazine, perphenazine, prochlorperazine, promethazine, thioridazine)
  • Medicine to treat seizures (including phenobarbital, phenytoin)
  • Thyroid medicine
  • Triptan medicine for migraine headaches
• Do not drink alcohol while you are using this medicine.
• Tell your doctor if you use anything else that makes you sleepy. Some examples are allergy medicine, narcotic pain medicine, and alcohol.

Warnings While Using This Medicine:

• Tell your doctor if you are pregnant or breastfeeding, or if you have kidney disease, liver disease, heart or blood vessel disease, an adrenal gland tumor (including neuroblastoma), glaucoma, depression, mood or mental problems (including bipolar disorder, schizophrenia, mania), thyroid problems, trouble urinating, or a history of seizures or brain damage. Tell your doctor if you drink alcohol.
• This medicine may cause the following problems:
  • Serotonin syndrome (may be life-threatening when used with certain other medicines)
  • Increased risk of seizures
  • Drug reaction with eosinophilia and systemic symptoms (DRESS), which can damage organs, including the liver, kidney, or heart
  • Liver problems
  • Problems with sex (in males)
• For some children, teenagers, and young adults, this medicine may increase mental or emotional problems. This may lead to thoughts of suicide and violence. Talk with your doctor right away if you have any thoughts or behavior changes that concern you. Tell your doctor if you or anyone in your family has a history of bipolar disorder or suicide attempts.
• This medicine may make you dizzy or drowsy. Do not drive or do anything else that could be dangerous until you know how this medicine affects you.
• This medicine may make it more difficult for your body to cool itself down. Use care not to become overheated during exercise or hot weather since overheating may result in heat stroke.
• This medicine may make you bleed, bruise, or get infections more easily. Take precautions to prevent illness and injury. Wash your hands often.
• Do not stop using this medicine suddenly. Your doctor will need to slowly decrease your dose before you stop it completely.
• Tell any doctor or dentist who treats you that you are using this medicine. You may need to stop using this medicine several days before you have surgery or medical tests.
• Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.
• Keep all medicine out of the reach of children. Never share your medicine with anyone.

Possible Side Effects While Using This Medicine:

Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Agitation, confusion, depression, irritability, memory problems
• Anxiety, restlessness, fever, sweating, muscle spasms, nausea, vomiting, diarrhea, seeing or hearing things that are not there
• Chest pain, fast or pounding heartbeat
• Confusion, weakness, muscle twitching
• Dark urine, pale stools, nausea, vomiting, loss of appetite, stomach pain, yellow skin or eyes
• Fast breathing, pale, clammy skin, high fever or body temperature, increased thirst
• Feeling more excited or energetic than usual, racing thoughts, trouble sleeping
• Lightheadedness, dizziness, fainting
• Seizures or tremors
• Swollen, painful, or tender lymph glands in the neck, armpit, or groin
• Thoughts of hurting others or yourself, unusual behavior
• Unusual bleeding, bruising, or weakness

If you notice these less serious side effects, talk with your doctor:

• Cough, sore throat, runny or stuffy nose
• Dry mouth, diarrhea, constipation
• Eye pain, vision changes, seeing halos around lights
• Headache
• Increased sweating, warmth or redness in your face, neck, arms, or upper chest
• Problems with ejaculation or decreased sexual performance
• Weight gain or loss

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088