and St John's Wort both increase serotonin levels. Avoid or Use Alternate Drug.tedizolidtedizolid, clomipramine. Either increases effects of the other by Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. both increase serotonin levels; increased risk of serotonin syndrome.terbutalineclomipramine, terbutaline. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.thioridazinethioridazine and clomipramine both increase QTc interval. Avoid or Use Alternate Drug.toremifeneclomipramine and toremifene both increase QTc interval. Avoid or Use Alternate Drug. Concurrent use of toremifene with agents causing QT prolongation should be avoided. If concomitant use is required it's recommended that toremifene be interrupted. If interruption not possible, patients requiring therapy with a drug that prolongs QT should be closely monitored. ECGs should be obtained for high risk patients.trazodoneclomipramine and trazodone both increase QTc interval. Avoid or Use Alternate Drug.trazodone and clomipramine both increase serotonin levels. Avoid or Use Alternate Drug.trifluoperazinetrifluoperazine and clomipramine both increase QTc interval. Avoid or Use Alternate Drug.trimipramineclomipramine and trimipramine both increase QTc interval. Avoid or Use Alternate Drug.clomipramine and trimipramine both increase serotonin levels. Avoid or Use Alternate Drug.umeclidinium bromide/vilanterol inhaledclomipramine increases toxicity of umeclidinium bromide/vilanterol inhaled by QTc interval. Avoid or Use Alternate Drug. Exercise extreme caution when vilanterol coadministered with drugs that prolong QTc interval; adrenergic agonist effects on the cardiovascular system may be potentiated.clomipramine and umeclidinium bromide/vilanterol inhaled both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Avoid or Use Alternate Drug. Exercise extreme caution if vilanterol coadministered with MAOIs or TCAs, or within 2 weeks of discontinuation of these drugs; adrenergic agonist effects on the cardiovascular system may be potentiatedvandetanibclomipramine, vandetanib. Either increases toxicity of the other by QTc interval. Avoid or Use Alternate Drug. Avoid coadministration with drugs known to prolong QT interval; if a drug known to prolong QT interval must be used, more frequent ECG monitoring is recommended.vemurafenibvemurafenib and clomipramine both increase QTc interval. Avoid or Use Alternate Drug. Concomitant use of vemurafenib with drugs that prolong QT interval is not recommended.venlafaxinevenlafaxine and clomipramine both increase serotonin levels. Avoid or Use Alternate Drug.vilanterol/fluticasone furoate inhaledclomipramine and vilanterol/fluticasone furoate inhaled both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Avoid or Use Alternate Drug. Exercise extreme caution if vilanterol coadministered with MAOIs or TCAs, or within 2 weeks of discontinuation of these drugs; adrenergic agonist effects on the cardiovascular system may be potentiatedclomipramine increases toxicity of vilanterol/fluticasone furoate inhaled by QTc interval. Avoid or Use Alternate Drug. Exercise extreme caution when vilanterol coadministered with drugs that prolong QTc interval; adrenergic agonist effects on the cardiovascular system may be potentiated.vilazodoneclomipramine, vilazodone. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug. Concomitant therapy should be discontinued immediately if signs or symptoms of serotonin syndrome emerge and supportive symptomatic treatment should be initiated. .vortioxetineclomipramine, vortioxetine. Either increases effects of the other by serotonin levels. Avoid or Use Alternate Drug.xylometazolineclomipramine, xylometazoline. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.yohimbeyohimbe, clomipramine. Mechanism: unspecified interaction mechanism. Contraindicated. May cause increase or decrease in blood pressure.yohimbineclomipramine, yohimbine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.ziprasidoneclomipramine and ziprasidone both increase QTc interval. Avoid or Use Alternate Drug.Monitor Closely (448)5-HTPclomipramine and 5-HTP both increase serotonin levels. Modify Therapy/Monitor Closely.abirateroneabiraterone increases levels of clomipramine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Avoid coadministration of abiraterone with substrates of CYP2D6. If alternative therapy cannot be used, exercise caution and consider a dose reduction of the CYP2D6 substrate.abobotulinumtoxinAabobotulinumtoxinA increases effects of clomipramine by pharmacodynamic synergism. Use Caution/Monitor. Use of anticholinergic drugs after administration of botulinum toxin-containing products may potentiate systemic anticholinergic effects. .aceclofenacclomipramine, aceclofenac. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. Clomipramine inhib. serotonin uptake by platelets.acemetacinclomipramine, acemetacin. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. Clomipramine inhib. serotonin uptake by platelets.aclidiniumaclidinium and clomipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.acrivastineacrivastine and clomipramine both increase sedation. Use Caution/Monitor.albuterolclomipramine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.alfentanilalfentanil and clomipramine both increase sedation. Use Caution/Monitor.alfuzosinclomipramine and alfuzosin both increase QTc interval. Use Caution/Monitor.almotriptanalmotriptan and clomipramine both increase serotonin levels. Modify Therapy/Monitor Closely.alprazolamalprazolam and clomipramine both increase sedation. Use Caution/Monitor.amifampridineclomipramine increases toxicity of amifampridine by Other (see comment). Modify Therapy/Monitor Closely. Comment: Amifampridine can cause seizures. Coadministration with drugs that lower seizure threshold may increase this risk.amiodaroneamiodarone will increase the level or effect of clomipramine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.amisulprideclomipramine and amisulpride both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended if coadministered.amitriptylineamitriptyline and clomipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.amitriptyline and clomipramine both increase sedation. Use Caution/Monitor.amobarbitalamobarbital will decrease the level or effect of clomipramine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.amobarbital will decrease the level or effect of clomipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.amobarbital and clomipramine both increase sedation. Use Caution/Monitor.amoxapineamoxapine and clomipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.amoxapine and clomipramine both increase sedation. Use Caution/Monitor.anagrelideanagrelide and clomipramine both increase QTc interval. Use Caution/Monitor.anticholinergic/sedative combosanticholinergic/sedative combos and clomipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.apomorphineclomipramine and apomorphine both increase sedation. Use Caution/Monitor.aprepitantaprepitant will increase the level or effect of clomipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.arformoterolclomipramine increases and arformoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.aripiprazolearipiprazole and clomipramine both increase sedation. Use Caution/Monitor.aripiprazole and clomipramine both increase QTc interval. Use Caution/Monitor.armodafinilarmodafinil will decrease the level or effect of clomipramine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.clomipramine increases and armodafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.asenapineasenapine will increase the level or effect of clomipramine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.asenapine and clomipramine both increase QTc interval. Use Caution/Monitor.asenapine and clomipramine both increase sedation. Use Caution/Monitor.asenapine transdermalasenapine transdermal and clomipramine both increase QTc interval. Use Caution/Monitor.asenapine transdermal and clomipramine both increase sedation. Use Caution/Monitor.aspirinclomipramine, aspirin. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. Clomipramine inhib. serotonin uptake by platelets.aspirin rectalclomipramine, aspirin rectal. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. Clomipramine inhib. serotonin uptake by platelets.aspirin/citric acid/sodium bicarbonateclomipramine, aspirin/citric acid/sodium bicarbonate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. Clomipramine inhib. serotonin uptake by platelets.atazanaviratazanavir will increase the level or effect of clomipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.atazanavir increases levels of clomipramine by unspecified interaction mechanism. Use Caution/Monitor.atomoxetineclomipramine increases levels of atomoxetine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.atomoxetine and clomipramine both increase QTc interval. Use Caution/Monitor.atracuriumatracurium and clomipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.atropineatropine and clomipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.atropine IV/IMatropine IV/IM and clomipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.avapritinibavapritinib and clomipramine both increase sedation. Use Caution/Monitor.azelastineazelastine and clomipramine both increase sedation. Use Caution/Monitor.azithromycinclomipramine and azithromycin both increase QTc interval. Use Caution/Monitor.baclofenbaclofen and clomipramine both increase sedation. Use Caution/Monitor.bedaquilineclomipramine and bedaquiline both increase QTc interval. Modify Therapy/Monitor Closely. ECG should be monitored closelybelladonna alkaloidsbelladonna alkaloids and clomipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.belladonna and opiumbelladonna and opium and clomipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.belladonna and opium and clomipramine both increase sedation. Use Caution/Monitor.benazeprilclomipramine, benazepril. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Increases risk of hypotension.benperidolbenperidol and clomipramine both increase sedation. Use Caution/Monitor.benzhydrocodone/acetaminophenbenzhydrocodone/acetaminophen, clomipramine. Either increases effects of the other by serotonin levels. Use Caution/Monitor. Coadministration of drugs that affect the serotonergic neurotransmitter system may result in serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation and dose adjustment.benzphetamineclomipramine increases and benzphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.benztropinebenztropine and clomipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.bethanecholbethanechol increases and clomipramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.brexpiprazoleclomipramine will increase the level or effect of brexpiprazole by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. Administer a quarter of brexpiprazole dose if coadministered with a moderate CYP2D6 inhibitor PLUS a strong/moderate CYP3A4 inhibitor. brexpiprazole and clomipramine both increase sedation. Use Caution/Monitor.brimonidinebrimonidine and clomipramine both increase sedation. Use Caution/Monitor.brivaracetambrivaracetam and clomipramine both increase sedation. Use Caution/Monitor.brompheniraminebrompheniramine and clomipramine both increase sedation. Use Caution/Monitor.buprenorphinebuprenorphine and clomipramine both increase sedation. Use Caution/Monitor.buprenorphine buccalbuprenorphine buccal and clomipramine both increase sedation. Use Caution/Monitor.buprenorphine subdermal implantclomipramine, buprenorphine subdermal implant. Either increases toxicity of the other by serotonin levels. Use Caution/Monitor. Concomitant use could result in life-threatening serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation, and during dose adjustment of the serotonergic drug. Discontinue buprenorphine if serotonin syndrome is suspected.buprenorphine, long-acting injectionclomipramine, buprenorphine, long-acting injection. Either increases toxicity of the other by serotonin levels. Use Caution/Monitor. Concomitant use could result in life-threatening serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation, and during dose adjustment of the serotonergic drug. Discontinue buprenorphine if serotonin syndrome is suspected.bupropionclomipramine increases toxicity of bupropion by unspecified interaction mechanism. Use Caution/Monitor. May lower seizure threshold; keep bupropion dose as low as possible.butabarbitalbutabarbital will decrease the level or effect of clomipramine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.butabarbital will decrease the level or effect of clomipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.butabarbital and clomipramine both increase sedation. Use Caution/Monitor.butalbitalbutalbital will decrease the level or effect of clomipramine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.butalbital will decrease the level or effect of clomipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.butalbital and clomipramine both increase sedation. Use Caution/Monitor.butorphanolbutorphanol and clomipramine both increase sedation. Use Caution/Monitor.caffeineclomipramine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.cannabidiolcannabidiol will increase the level or effect of clomipramine by affecting hepatic enzyme CYP2C19 metabolism. Modify Therapy/Monitor Closely. Consider reducing the dose of sensitive CYP2C19 substrates, as clinically appropriate, when coadministered with cannabidiol. captoprilclomipramine, captopril. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Both drugs lower blood pressure. Monitor blood pressure.carbacholcarbachol increases and clomipramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.carbamazepinecarbamazepine will decrease the level or effect of clomipramine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.carbamazepine will decrease the level or effect of clomipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.carbinoxaminecarbinoxamine and clomipramine both increase sedation. Use Caution/Monitor.carisoprodolcarisoprodol and clomipramine both increase sedation. Use Caution/Monitor.celecoxibcelecoxib will increase the level or effect of clomipramine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.clomipramine, celecoxib. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. Clomipramine inhib. serotonin uptake by platelets.cenobamatecenobamate, clomipramine. Either increases effects of the other by sedation. Use Caution/Monitor.ceritinibceritinib and clomipramine both increase QTc interval. Use Caution/Monitor.cevimelinecevimeline increases and clomipramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.chloral hydratechloral hydrate and clomipramine both increase sedation. Use Caution/Monitor.chlordiazepoxidechlordiazepoxide and clomipramine both increase sedation. Use Caution/Monitor.chloroquinechloroquine will increase the level or effect of clomipramine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.chloroquine increases toxicity of clomipramine by QTc interval. Use Caution/Monitor.chlorpheniraminechlorpheniramine and clomipramine both increase sedation. Use Caution/Monitor.chlorpromazinechlorpromazine and clomipramine both increase sedation. Use Caution/Monitor.chlorzoxazonechlorzoxazone and clomipramine both increase sedation. Use Caution/Monitor.choline magnesium trisalicylateclomipramine, choline magnesium trisalicylate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. Clomipramine inhib. serotonin uptake by platelets.cigarette smokingcigarette smoking will decrease the level or effect of clomipramine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.cimetidinecimetidine will increase the level or effect of clomipramine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.cimetidine will increase the level or effect of clomipramine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.cimetidine will increase the level or effect of clomipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.cinnarizinecinnarizine and clomipramine both increase sedation. Use Caution/Monitor.cisatracuriumcisatracurium and clomipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.clemastineclemastine and