of euphoria, postural hypot'n when switching from clomipramine to milnacipran.Serious - Use Alternative (1)milnacipran and clomipramine both increase serotonin levels. Avoid or Use Alternate Drug.mirabegronMonitor Closely (1)mirabegron will increase the level or effect of clomipramine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.mirtazapineMonitor Closely (2)clomipramine and mirtazapine both increase serotonin levels. Modify Therapy/Monitor Closely. clomipramine and mirtazapine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)mirtazapine and clomipramine both increase QTc interval. Avoid or Use Alternate Drug.mobocertinibSerious - Use Alternative (1)mobocertinib and clomipramine both increase QTc interval. Avoid or Use Alternate Drug. If coadministration unavoidable, reduce mobocertinib dose and monitor QTc interval more frequently.modafinilMonitor Closely (2)modafinil will decrease the level or effect of clomipramine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor. clomipramine increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.morphineMonitor Closely (2)clomipramine and morphine both increase serotonin levels. Modify Therapy/Monitor Closely. morphine and clomipramine both increase sedation. Use Caution/Monitor.motherwortMonitor Closely (1)clomipramine and motherwort both increase sedation. Use Caution/Monitor.moxifloxacinSerious - Use Alternative (1)clomipramine and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.moxonidineMonitor Closely (1)clomipramine and moxonidine both increase sedation. Use Caution/Monitor.nabiloneMonitor Closely (1)clomipramine and nabilone both increase sedation. Use Caution/Monitor.nabumetoneMonitor Closely (1)clomipramine, nabumetone. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. Clomipramine inhib. serotonin uptake by platelets.nalbuphineMonitor Closely (1)nalbuphine and clomipramine both increase sedation. Use Caution/Monitor.naproxenMonitor Closely (1)clomipramine, naproxen. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. Clomipramine inhib. serotonin uptake by platelets.naratriptanMonitor Closely (1)naratriptan and clomipramine both increase serotonin levels. Modify Therapy/Monitor Closely.nateglinideMinor (1)clomipramine increases effects of nateglinide by pharmacodynamic synergism. Minor/Significance Unknown.nefazodoneSerious - Use Alternative (2)nefazodone and clomipramine both increase serotonin levels. Avoid or Use Alternate Drug. nefazodone will increase the level or effect of clomipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.nefopamMonitor Closely (1)nefopam, clomipramine. Mechanism: unspecified interaction mechanism. Use Caution/Monitor. Use combination with caution.nelfinavirMonitor Closely (1)nelfinavir will increase the level or effect of clomipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.neostigmineMonitor Closely (1)neostigmine increases and clomipramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.netupitant/palonosetronSerious - Use Alternative (1)netupitant/palonosetron, clomipramine. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.nevirapineMinor (1)nevirapine will decrease the level or effect of clomipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.nifedipineMinor (1)nifedipine will increase the level or effect of clomipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.nilotinibMonitor Closely (1)nilotinib will increase the level or effect of clomipramine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.Serious - Use Alternative (1)clomipramine and nilotinib both increase QTc interval. Avoid or Use Alternate Drug.Minor (1)nilotinib will increase the level or effect of clomipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.norepinephrineMonitor Closely (2)clomipramine increases effects of norepinephrine by unknown mechanism. Use Caution/Monitor. clomipramine increases and norepinephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)clomipramine, norepinephrine. 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.nortriptylineMonitor Closely (2)clomipramine and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor. clomipramine and nortriptyline both increase sedation. Use Caution/Monitor.Serious - Use Alternative (2)clomipramine and nortriptyline both increase QTc interval. Avoid or Use Alternate Drug. clomipramine and nortriptyline both increase serotonin levels. Avoid or Use Alternate Drug.octreotideSerious - Use Alternative (1)clomipramine and octreotide both increase QTc interval. Avoid or Use Alternate Drug.octreotide (Antidote)Serious - Use Alternative (1)clomipramine and octreotide (Antidote) both increase QTc interval. Avoid or Use Alternate Drug.ofloxacinMonitor Closely (1)clomipramine and ofloxacin both increase QTc interval. Modify Therapy/Monitor Closely.olanzapineMonitor Closely (2)olanzapine and clomipramine both increase sedation. Use Caution/Monitor. olanzapine and clomipramine both increase QTc interval. Use Caution/Monitor.oliceridineMonitor Closely (3)clomipramine will increase the level or effect of oliceridine by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. If concomitant use is necessary, may require less frequent oliceridine dosing. Closely monitor for respiratory depression and sedation and titrate subsequent doses accordingly. If inhibitor is discontinued, consider increase oliceridine dosage until stable drug effects are achieved. Monitor for signs of opioid withdrawal. clomipramine, oliceridine. Either increases effects of the other by serotonin levels. Modify Therapy/Monitor Closely. clomipramine increases toxicity of oliceridine by Other (see comment). Modify Therapy/Monitor Closely. Comment: Anticholinergic drugs may increase risk of urinary retention and/or severe constipation, which may lead to paralytic ileus. Monitor for signs of urinary retention or reduced gastric motility if oliceridine is coadministered with anticholinergics.olodaterol inhaledMonitor Closely (1)clomipramine and olodaterol inhaled both increase QTc interval. Use Caution/Monitor. TCAs prolong the QTc interval and may potentiate the effects of beta2 agonists on the cardiovascular system; increased risk of ventricular arrhythmiasolopatadine intranasalSerious - Use Alternative (1)clomipramine and olopatadine intranasal both increase sedation. Avoid or Use Alternate Drug. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment. omeprazoleMinor (1)omeprazole will increase the level or effect of clomipramine by affecting hepatic enzyme CYP2C19 metabolism. Minor/Significance Unknown.onabotulinumtoxinAMonitor Closely (1)onabotulinumtoxinA and clomipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.ondansetronSerious - Use Alternative (2)clomipramine and ondansetron both increase QTc interval. Avoid or Use Alternate Drug. Avoid with congenital long QT syndrome; ECG monitoring recommended with concomitant medications that prolong QT interval, electrolyte abnormalities, CHF, or bradyarrhythmias. ondansetron, clomipramine. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.opium tinctureMonitor Closely (1)opium tincture and clomipramine both increase sedation. Use Caution/Monitor.orphenadrineMonitor Closely (2)clomipramine and orphenadrine both decrease cholinergic effects/transmission. Use Caution/Monitor. orphenadrine and clomipramine both increase sedation. Use Caution/Monitor.osimertinibMonitor Closely (1)osimertinib and clomipramine both increase QTc interval. Use Caution/Monitor. Conduct periodic monitoring with ECGs and electrolytes in patients taking drugs known to prolong the QTc interval.oxaprozinMonitor Closely (1)clomipramine, oxaprozin. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. Clomipramine inhib. serotonin uptake by platelets.oxazepamMonitor Closely (1)oxazepam and clomipramine both increase sedation. Use Caution/Monitor.oxcarbazepineMinor (1)oxcarbazepine will decrease the level or effect of clomipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.oxybutyninMonitor Closely (1)oxybutynin and clomipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.oxybutynin topicalMonitor Closely (1)oxybutynin topical and clomipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.oxybutynin transdermalMonitor Closely (1)oxybutynin transdermal and clomipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.oxycodoneMonitor Closely (1)oxycodone and clomipramine both increase sedation. Use Caution/Monitor.oxymetazoline intranasalMonitor Closely (1)clomipramine increases effects of oxymetazoline intranasal by pharmacodynamic synergism. Use Caution/Monitor. TCAs inhibit norepinephrine uptake in adrenergic neurons, thereby increasing synaptic norepinephrine levels. Coadministration with alpha1 agonists may cause increased adrenergic receptor stimulation. When oxymetazoline is combined with intranasal tetracaine for dental anesthesia, avoid or use alternant anesthetic in patients taking TCAs.oxymorphoneMonitor Closely (1)oxymorphone and clomipramine both increase sedation. Use Caution/Monitor.ozanimodMonitor Closely (1)ozanimod and clomipramine both increase QTc interval. Modify Therapy/Monitor Closely. The potential additive effects on heart rate, treatment with ozanimod should generally not be initiated in patients who are concurrently treated with QT prolonging drugs with known arrhythmogenic properties.Serious - Use Alternative (1)ozanimod increases toxicity of clomipramine by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Avoid or Use Alternate Drug. Because the active metabolite of ozanimod inhibits MAO-B in vitro, there is a potential for serious adverse reactions, including hypertensive crisis. Therefore, coadministration of ozanimod with drugs that can increase norepinephrine or serotonin is not recommended. Monitor for hypertension with concomitant use.paliperidoneMonitor Closely (2)clomipramine and paliperidone both increase QTc interval. Modify Therapy/Monitor Closely. paliperidone and clomipramine both increase sedation. Use Caution/Monitor.palonosetronSerious - Use Alternative (1)palonosetron, clomipramine. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.panax ginsengMinor (1)panax ginseng increases effects of clomipramine by pharmacodynamic synergism. Minor/Significance Unknown.pancuroniumMonitor Closely (1)pancuronium and clomipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.papaveretumMonitor Closely (1)papaveretum and clomipramine both increase sedation. Use Caution/Monitor.papaverineMonitor Closely (1)clomipramine and papaverine both increase sedation. Use Caution/Monitor.parecoxibMonitor Closely (2)parecoxib will increase the level or effect of clomipramine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. clomipramine, parecoxib. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. Clomipramine inhib. serotonin uptake by platelets.paroxetineMonitor Closely (1)clomipramine and paroxetine both increase QTc interval. Modify Therapy/Monitor Closely.Serious - Use Alternative (2)paroxetine and clomipramine both increase serotonin levels. Avoid or Use Alternate Drug. paroxetine will increase the level or effect of clomipramine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.pasireotideMonitor Closely (1)clomipramine and pasireotide both increase QTc interval. Modify Therapy/Monitor Closely.pazopanibMonitor Closely (1)clomipramine and pazopanib both increase QTc interval. Use Caution/Monitor.pefloxacinSerious - Use Alternative (1)pefloxacin will increase the level or effect of clomipramine by affecting hepatic enzyme CYP1A2 metabolism. Avoid or Use Alternate Drug.peginterferon alfa 2aMonitor Closely (1)peginterferon alfa 2a will increase the level or effect of clomipramine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.peginterferon alfa 2bMonitor Closely (1)peginterferon alfa 2b, clomipramine. Other (see comment). Use Caution/Monitor. Comment: When patients are administered peginterferon alpha-2b with CYP2D6 substrates, the therapeutic effect of these drugs may be altered. Peginterferon alpha-2b may increase or decrease levels of CYP2D6 substrate.pentamidineContraindicated (1)clomipramine and pentamidine both increase QTc interval. Contraindicated.pentazocineMonitor Closely (2)clomipramine and pentazocine both increase serotonin levels. Modify Therapy/Monitor Closely. pentazocine and clomipramine both increase sedation. Use Caution/Monitor.pentobarbitalMonitor Closely (3)pentobarbital will decrease the level or effect of clomipramine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor. pentobarbital will decrease the level or effect of clomipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. pentobarbital and clomipramine both increase sedation. Use Caution/Monitor.Minor (1)pentobarbital, clomipramine. Other (see comment). Minor/Significance Unknown. Comment: Barbiturates may increase adverse effects, including respiratory depression, produced by toxic doses of TCAs. With therapeutic doses of TCAs, barbiturates increase metabolism and decrease blood concentrations of TCAs.perphenazineMonitor Closely (2)perphenazine will increase the level or effect of clomipramine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. perphenazine and clomipramine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)perphenazine and clomipramine both increase QTc interval. Avoid or Use Alternate Drug.Minor (2)clomipramine, perphenazine. Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects. clomipramine, perphenazine. Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.phendimetrazineMonitor Closely (1)clomipramine increases and phendimetrazine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)clomipramine, phendimetrazine. 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.phenelzineContraindicated (1)phenelzine and clomipramine both increase serotonin levels. Contraindicated.phenobarbitalMonitor Closely (3)phenobarbital will decrease the level or effect of clomipramine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor. phenobarbital will decrease the level or effect of clomipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. phenobarbital and clomipramine both increase sedation. Use Caution/Monitor.Minor (1)phenobarbital, clomipramine. Other (see comment). Minor/Significance Unknown. Comment: Barbiturates may increase adverse effects, including respiratory depression, produced by toxic doses of TCAs. With therapeutic doses of TCAs, barbiturates increase metabolism and decrease blood concentrations of TCAs.phentermineMonitor Closely (1)clomipramine increases and phentermine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)clomipramine, phentermine. 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.phenylephrineMonitor Closely (1)clomipramine increases and phenylephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)clomipramine, phenylephrine. 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.phenylephrine ophthalmicMonitor Closely (1)clomipramine, phenylephrine ophthalmic. Other (see comment). Use Caution/Monitor. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.phenylephrine POMonitor Closely (1)clomipramine increases and phenylephrine PO decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. .Serious - Use Alternative (1)clomipramine, phenylephrine PO. 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.phenytoinMonitor Closely (1)phenytoin will decrease the level or effect of clomipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.pholcodineMonitor Closely (1)clomipramine and pholcodine both