dose of magnesium sulfate together with drugs that lower the seizure threshold.sodium sulfate/potassium chloride/magnesium sulfate/polyethylene glycolMonitor Closely (1)clomipramine, sodium sulfate/potassium chloride/magnesium sulfate/polyethylene glycol. Other (see comment). Use Caution/Monitor. Comment: Caution when bowel preps are used with drugs that cause SIADH or NSAIDs; increased risk for water retention or electrolyte imbalance.sodium sulfate/potassium sulfate/magnesium sulfateMonitor Closely (1)sodium sulfate/potassium sulfate/magnesium sulfate increases effects of clomipramine by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of seizures when using higher dose of magnesium sulfate together with drugs that lower the seizure threshold.solifenacinMonitor Closely (2)solifenacin and clomipramine both decrease cholinergic effects/transmission. Use Caution/Monitor. solifenacin and clomipramine both increase QTc interval. Use Caution/Monitor.somapacitanMonitor Closely (1)somapacitan will decrease the level or effect of clomipramine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor. Limited published data indicate that growth hormone treatment increases cytochrome P450 (CYP450)-mediated antipyrine clearance. Caution with sensitive CYP substratessomatrogonMonitor Closely (1)somatrogon will decrease the level or effect of clomipramine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor. Limited published data indicate that growth hormone treatment increases cytochrome P450 (CYP450)-mediated antipyrine clearance. Caution with sensitive CYP substratessomatropinMonitor Closely (1)somatropin will decrease the level or effect of clomipramine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor. Limited published data indicate that growth hormone treatment increases cytochrome P450 (CYP450)-mediated antipyrine clearance. Caution with sensitive CYP substratessorafenibMonitor Closely (1)sorafenib and clomipramine both increase QTc interval. Use Caution/Monitor.sotalolContraindicated (1)clomipramine and sotalol both increase QTc interval. Contraindicated.sparsentanMonitor Closely (1)sparsentan will decrease the level or effect of clomipramine by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. Sparsentan (a CYP2C19 inducer) decreases exposure of CYP2C19 substrates and reduces efficacy related to these substrates. St John's WortMonitor Closely (1)St John's Wort will decrease the level or effect of clomipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.Serious - Use Alternative (1)clomipramine and St John's Wort both increase serotonin levels. Avoid or Use Alternate Drug.stiripentolMonitor Closely (3)stiripentol, clomipramine. Either increases effects of the other by sedation. Use Caution/Monitor. Concomitant use stiripentol with other CNS depressants, including alcohol, may increase the risk of sedation and somnolence. stiripentol, clomipramine. affecting hepatic enzyme CYP1A2 metabolism. Modify Therapy/Monitor Closely. Stiripentol is a CYP1A2 inhibitor and inducer. Monitor CYP1A2 substrates coadministered with stiripentol for increased or decreased effects. CYP1A2 substrates may require dosage adjustment. stiripentol will decrease the level or effect of clomipramine by affecting hepatic enzyme CYP2C19 metabolism. Modify Therapy/Monitor Closely. Consider reducing the dose of CYP2C19 substrates, if adverse reactions are experienced when administered concomitantly with stiripentol.succinylcholineMonitor Closely (1)succinylcholine increases and clomipramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.sufentanilMonitor Closely (1)sufentanil and clomipramine both increase sedation. Use Caution/Monitor.sufentanil SLMonitor Closely (1)sufentanil SL, 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.sulfamethoxazoleMonitor Closely (1)clomipramine and sulfamethoxazole both increase QTc interval. Modify Therapy/Monitor Closely.Minor (1)sulfamethoxazole decreases levels of clomipramine by unspecified interaction mechanism. Minor/Significance Unknown.sulfasalazineMonitor Closely (1)clomipramine, sulfasalazine. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. Clomipramine inhib. serotonin uptake by platelets.sulindacMonitor Closely (1)clomipramine, sulindac. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. Clomipramine inhib. serotonin uptake by platelets.sumatriptanMonitor Closely (1)sumatriptan and clomipramine both increase serotonin levels. Modify Therapy/Monitor Closely.sumatriptan intranasalMonitor Closely (1)sumatriptan intranasal and clomipramine both increase serotonin levels. Modify Therapy/Monitor Closely.suvorexantMonitor Closely (1)suvorexant and clomipramine both increase sedation. Modify Therapy/Monitor Closely. Dosage adjustments of suvorexant and concomitant CNS depressants may be necessarytacrolimusMonitor Closely (1)tacrolimus and clomipramine both increase QTc interval. Use Caution/Monitor.tamsulosinMonitor Closely (1)clomipramine increases levels of tamsulosin by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.tapentadolMonitor Closely (2)clomipramine and tapentadol both increase serotonin levels. Modify Therapy/Monitor Closely. tapentadol and clomipramine both increase sedation. Use Caution/Monitor.tecovirimatMonitor Closely (1)tecovirimat will increase the level or effect of clomipramine by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. Tecovirimat is a weak inhibitor of CYP2C8 and CYP2C19. Monitor for adverse effects if coadministered with sensitive substrates of these enzymes.tedizolidSerious - Use Alternative (1)tedizolid, 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.telavancinMonitor Closely (1)clomipramine and telavancin both increase QTc interval. Modify Therapy/Monitor Closely.temazepamMonitor Closely (1)temazepam and clomipramine both increase sedation. Use Caution/Monitor.terbinafineMonitor Closely (1)terbinafine will increase the level or effect of clomipramine by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. Assess need to reduce dose of CYP2D6-metabolized drug.terbutalineMonitor Closely (1)clomipramine increases and terbutaline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)clomipramine, 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.teriflunomideMonitor Closely (1)teriflunomide decreases levels of clomipramine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.tetrabenazineMonitor Closely (1)tetrabenazine and clomipramine both increase QTc interval. Use Caution/Monitor.thioridazineContraindicated (1)thioridazine will increase the level or effect of clomipramine by affecting hepatic enzyme CYP2D6 metabolism. Contraindicated.Monitor Closely (1)thioridazine and clomipramine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)thioridazine and clomipramine both increase QTc interval. Avoid or Use Alternate Drug.Minor (2)clomipramine, thioridazine. Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects. clomipramine, thioridazine. Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.thiothixeneMonitor Closely (1)thiothixene and clomipramine both increase sedation. Use Caution/Monitor.thyroid desiccatedMonitor Closely (1)thyroid desiccated increases effects of clomipramine by Other (see comment). Use Caution/Monitor. Comment: Increased catecholamine receptor sensitivity; may increase CNS and cardiovascular effects, including arrhythmias.tiotropiumMonitor Closely (1)tiotropium and clomipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.tipranavirMonitor Closely (1)tipranavir will increase the level or effect of clomipramine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.tobacco useMonitor Closely (1)tobacco use will decrease the level or effect of clomipramine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.tolazamideMinor (1)clomipramine increases effects of tolazamide by pharmacodynamic synergism. Minor/Significance Unknown.tolbutamideMinor (1)clomipramine increases effects of tolbutamide by pharmacodynamic synergism. Minor/Significance Unknown.tolfenamic acidMonitor Closely (1)clomipramine, tolfenamic acid. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. Clomipramine inhib. serotonin uptake by platelets.tolmetinMonitor Closely (1)clomipramine, tolmetin. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. Clomipramine inhib. serotonin uptake by platelets.tolterodineMonitor Closely (1)tolterodine and clomipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.topiramateMonitor Closely (1)clomipramine and topiramate both increase sedation. Modify Therapy/Monitor Closely.Minor (1)topiramate will decrease the level or effect of clomipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.toremifeneSerious - Use Alternative (1)clomipramine 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.tramadolMonitor Closely (2)clomipramine and tramadol both increase serotonin levels. Modify Therapy/Monitor Closely. tramadol and clomipramine both increase sedation. Use Caution/Monitor.tranylcypromineContraindicated (1)tranylcypromine and clomipramine both increase serotonin levels. Contraindicated.trazodoneMonitor Closely (2)clomipramine and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor. clomipramine and trazodone both increase sedation. Use Caution/Monitor.Serious - Use Alternative (2)clomipramine and trazodone both increase QTc interval. Avoid or Use Alternate Drug. trazodone and clomipramine both increase serotonin levels. Avoid or Use Alternate Drug.triazolamMonitor Closely (1)triazolam and clomipramine both increase sedation. Use Caution/Monitor.triclabendazoleMonitor Closely (1)triclabendazole will increase the level or effect of clomipramine by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. If plasma concentrations of the CYP2C19 substrates are elevated during triclabendazole, recheck plasma concentration of the CYP2C19 substrates after discontinuation of triclabendazole. triclofosMonitor Closely (1)triclofos and clomipramine both increase sedation. Use Caution/Monitor.trifluoperazineMonitor Closely (1)trifluoperazine and clomipramine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)trifluoperazine and clomipramine both increase QTc interval. Avoid or Use Alternate Drug.Minor (2)clomipramine, trifluoperazine. Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects. clomipramine, trifluoperazine. Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.trihexyphenidylMonitor Closely (1)trihexyphenidyl and clomipramine both decrease cholinergic effects/transmission. Use Caution/Monitor. Potential for additive anticholinergic effects.trimethoprimMonitor Closely (1)clomipramine and trimethoprim both increase QTc interval. Modify Therapy/Monitor Closely.trimipramineMonitor Closely (2)clomipramine and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor. clomipramine and trimipramine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (2)clomipramine and trimipramine both increase QTc interval. Avoid or Use Alternate Drug. clomipramine and trimipramine both increase serotonin levels. Avoid or Use Alternate Drug.triprolidineMonitor Closely (1)triprolidine and clomipramine both increase sedation. Use Caution/Monitor.tropisetronMonitor Closely (1)clomipramine and tropisetron both increase QTc interval. Modify Therapy/Monitor Closely.trospium chlorideMonitor Closely (1)trospium chloride and clomipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.umeclidinium bromide/vilanterol inhaledSerious - Use Alternative (2)clomipramine 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 potentiatedvalbenazineMonitor Closely (1)valbenazine and clomipramine both increase QTc interval. Use Caution/Monitor.valerianMonitor Closely (1)valerian and clomipramine both increase sedation. Use Caution/Monitor.vandetanibSerious - Use Alternative (1)clomipramine, 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.vasopressinMinor (1)clomipramine increases effects of vasopressin by pharmacodynamic synergism. Minor/Significance Unknown.vecuroniumMonitor Closely (1)vecuronium and clomipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.vemurafenibSerious - Use Alternative (1)vemurafenib and clomipramine both increase QTc interval. Avoid or Use Alternate Drug. Concomitant use of vemurafenib with drugs that prolong QT interval is not recommended.venlafaxineMonitor Closely (2)venlafaxine will increase the level or effect of clomipramine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. clomipramine and venlafaxine both increase QTc interval. Modify Therapy/Monitor Closely.Serious - Use Alternative (1)venlafaxine and clomipramine both increase serotonin levels. Avoid or Use Alternate Drug.verapamilMonitor Closely (1)verapamil will increase the level or effect of clomipramine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.Minor (2)verapamil will increase the level or effect of clomipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown. verapamil increases levels of clomipramine by decreasing metabolism. Minor/Significance Unknown.vilanterol/fluticasone furoate inhaledSerious - Use Alternative (2)clomipramine 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 potentiated clomipramine 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.vilazodoneSerious - Use Alternative (1)clomipramine, 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. .vildagliptinMinor (1)clomipramine increases effects of vildagliptin by pharmacodynamic synergism. Minor/Significance Unknown.voclosporinMonitor Closely (1)voclosporin, clomipramine. Either increases effects of the other by QTc interval. Use Caution/Monitor.voriconazoleMonitor Closely (1)clomipramine and voriconazole both increase QTc interval. Modify Therapy/Monitor Closely.Minor (1)voriconazole will increase the level or effect of clomipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.vortioxetineSerious - Use Alternative (1)clomipramine, vortioxetine. Either increases effects of the other by serotonin levels. Avoid or Use Alternate Drug.xylometazolineMonitor Closely (1)clomipramine increases and xylometazoline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)clomipramine, 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.yohimbeSerious - Use Alternative (1)yohimbe, clomipramine. Mechanism: unspecified interaction mechanism. Contraindicated. May cause increase or decrease in blood pressure.yohimbineMonitor Closely (1)clomipramine increases and yohimbine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative