Unknown.repaglinideclomipramine increases effects of repaglinide by pharmacodynamic synergism. Minor/Significance Unknown.rosiglitazoneclomipramine increases effects of rosiglitazone by pharmacodynamic synergism. Minor/Significance Unknown.rufinamiderufinamide will decrease the level or effect of clomipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.sageclomipramine and sage both increase sedation. Minor/Significance Unknown.saxagliptinclomipramine increases effects of saxagliptin by pharmacodynamic synergism. Minor/Significance Unknown.secobarbitalsecobarbital, 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.serdexmethylphenidate/dexmethylphenidateserdexmethylphenidate/dexmethylphenidate increases effects of clomipramine by decreasing metabolism. Minor/Significance Unknown.sevofluranesevoflurane, clomipramine. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.sitagliptinclomipramine increases effects of sitagliptin by pharmacodynamic synergism. Minor/Significance Unknown.sulfamethoxazolesulfamethoxazole decreases levels of clomipramine by unspecified interaction mechanism. Minor/Significance Unknown.thioridazineclomipramine, 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.tolazamideclomipramine increases effects of tolazamide by pharmacodynamic synergism. Minor/Significance Unknown.tolbutamideclomipramine increases effects of tolbutamide by pharmacodynamic synergism. Minor/Significance Unknown.topiramatetopiramate will decrease the level or effect of clomipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.trifluoperazineclomipramine, 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.vasopressinclomipramine increases effects of vasopressin by pharmacodynamic synergism. Minor/Significance Unknown.verapamilverapamil 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.vildagliptinclomipramine increases effects of vildagliptin by pharmacodynamic synergism. Minor/Significance Unknown.voriconazolevoriconazole will increase the level or effect of clomipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.zafirlukastzafirlukast will increase the level or effect of clomipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.zolpidemzolpidem, clomipramine. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive CNS depression.5-HTPMonitor Closely (1)clomipramine and 5-HTP both increase serotonin levels. Modify Therapy/Monitor Closely.abametapirSerious - Use Alternative (1)abametapir will increase the level or effect of clomipramine by affecting hepatic enzyme CYP1A2 metabolism. Avoid or Use Alternate Drug. For 2 weeks after abametapir application, avoid taking drugs that are CYP1A2 substrates. If not feasible, avoid use of abametapir.abirateroneMonitor Closely (1)abiraterone 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.abobotulinumtoxinAMonitor Closely (1)abobotulinumtoxinA 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. .acarboseMinor (1)clomipramine increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.aceclofenacMonitor Closely (1)clomipramine, 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.acemetacinMonitor Closely (1)clomipramine, 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.aclidiniumMonitor Closely (1)aclidinium and clomipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.acrivastineMonitor Closely (1)acrivastine and clomipramine both increase sedation. Use Caution/Monitor.adagrasibSerious - Use Alternative (1)adagrasib, clomipramine. Either increases effects of the other by QTc interval. Avoid or Use Alternate Drug. Each drug prolongs the QTc interval, which may increased the risk of Torsade de pointes, other serious arryhthmias, and sudden death. If coadministration unavoidable, more frequent monitoring is recommended for such patients.albuterolMonitor Closely (1)clomipramine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)clomipramine, albuterol. 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.alfentanilMonitor Closely (1)alfentanil and clomipramine both increase sedation. Use Caution/Monitor.alfuzosinMonitor Closely (1)clomipramine and alfuzosin both increase QTc interval. Use Caution/Monitor.almotriptanMonitor Closely (1)almotriptan and clomipramine both increase serotonin levels. Modify Therapy/Monitor Closely.alprazolamMonitor Closely (1)alprazolam and clomipramine both increase sedation. Use Caution/Monitor.amifampridineMonitor Closely (1)clomipramine 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.amiodaroneMonitor Closely (1)amiodarone will increase the level or effect of clomipramine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.Serious - Use Alternative (1)clomipramine and amiodarone both increase QTc interval. Avoid or Use Alternate Drug.amisulprideMonitor Closely (1)clomipramine and amisulpride both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended if coadministered.amitriptylineMonitor Closely (2)amitriptyline and clomipramine both decrease cholinergic effects/transmission. Use Caution/Monitor. amitriptyline and clomipramine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (2)amitriptyline and clomipramine both increase QTc interval. Avoid or Use Alternate Drug. amitriptyline and clomipramine both increase serotonin levels. Avoid or Use Alternate Drug.amobarbitalMonitor Closely (3)amobarbital 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.Minor (1)amobarbital, 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.amoxapineMonitor Closely (2)amoxapine and clomipramine both decrease cholinergic effects/transmission. Use Caution/Monitor. amoxapine and clomipramine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (2)amoxapine and clomipramine both increase QTc interval. Avoid or Use Alternate Drug. amoxapine and clomipramine both increase serotonin levels. Avoid or Use Alternate Drug.anagrelideMonitor Closely (1)anagrelide and clomipramine both increase QTc interval. Use Caution/Monitor.anticholinergic/sedative combosMonitor Closely (1)anticholinergic/sedative combos and clomipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.apalutamideSerious - Use Alternative (1)apalutamide will decrease the level or effect of clomipramine by affecting hepatic enzyme CYP2C19 metabolism. Avoid or Use Alternate Drug. Coadministration of apalutamide, a strong CYP2C19 inducer, with drugs that are CYP2C19 substrates can result in lower exposure to these medications. Avoid or substitute another drug for these medications when possible. Evaluate for loss of therapeutic effect if medication must be coadministered.apomorphineMonitor Closely (1)clomipramine and apomorphine both increase sedation. Use Caution/Monitor.aprepitantMonitor Closely (1)aprepitant will increase the level or effect of clomipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.arformoterolMonitor Closely (1)clomipramine increases and arformoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)clomipramine, arformoterol. 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.aripiprazoleMonitor Closely (2)aripiprazole and clomipramine both increase sedation. Use Caution/Monitor. aripiprazole and clomipramine both increase QTc interval. Use Caution/Monitor.armodafinilMonitor Closely (2)armodafinil 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.Minor (1)armodafinil will decrease the level or effect of clomipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.arsenic trioxideSerious - Use Alternative (1)clomipramine and arsenic trioxide both increase QTc interval. Avoid or Use Alternate Drug.artemether/lumefantrineContraindicated (1)artemether/lumefantrine will increase the level or effect of clomipramine by affecting hepatic enzyme CYP2D6 metabolism. Contraindicated.Serious - Use Alternative (1)clomipramine and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.Minor (1)artemether/lumefantrine will decrease the level or effect of clomipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.asenapineMonitor Closely (3)asenapine will increase the level or effect of clomipramine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. asenapine and clomipramine both increase sedation. Use Caution/Monitor. asenapine and clomipramine both increase QTc interval. Use Caution/Monitor.asenapine transdermalMonitor Closely (2)asenapine transdermal and clomipramine both increase sedation. Use Caution/Monitor. asenapine transdermal and clomipramine both increase QTc interval. Use Caution/Monitor.aspirinMonitor Closely (1)clomipramine, 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 rectalMonitor Closely (1)clomipramine, 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 bicarbonateMonitor Closely (1)clomipramine, 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.atazanavirMonitor Closely (2)atazanavir increases levels of clomipramine by unspecified interaction mechanism. Use Caution/Monitor. atazanavir will increase the level or effect of clomipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.atomoxetineMonitor Closely (2)clomipramine increases levels of atomoxetine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. atomoxetine and clomipramine both increase QTc interval. Use Caution/Monitor.atracuriumMonitor Closely (1)atracurium and clomipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.atropineMonitor Closely (1)atropine and clomipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.Minor (1)clomipramine increases levels of atropine by unknown mechanism. Minor/Significance Unknown.atropine IV/IMMonitor Closely (1)atropine IV/IM and clomipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.Minor (1)clomipramine increases levels of atropine IV/IM by unknown mechanism. Minor/Significance Unknown.avapritinibMonitor Closely (1)avapritinib and clomipramine both increase sedation. Use Caution/Monitor.azelastineMonitor Closely (1)azelastine and clomipramine both increase sedation. Use Caution/Monitor.azithromycinMonitor Closely (1)clomipramine and azithromycin both increase QTc interval. Use Caution/Monitor.baclofenMonitor Closely (1)baclofen and clomipramine both increase sedation. Use Caution/Monitor.bazedoxifene/conjugated estrogensMinor (1)bazedoxifene/conjugated estrogens, clomipramine. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.bedaquilineMonitor Closely (1)clomipramine and bedaquiline both increase QTc interval. Modify Therapy/Monitor Closely. ECG should be monitored closelybelladonna alkaloidsMonitor Closely (1)belladonna alkaloids and clomipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.belladonna and opiumMonitor Closely (2)belladonna and opium and clomipramine both decrease cholinergic effects/transmission. Use Caution/Monitor. belladonna and opium and clomipramine both increase sedation. Use Caution/Monitor.benazeprilMonitor Closely (1)clomipramine, benazepril. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Increases risk of hypotension.benperidolMonitor Closely (1)benperidol and clomipramine both increase sedation. Use Caution/Monitor.benzhydrocodone/acetaminophenMonitor Closely (1)benzhydrocodone/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.Serious - Use Alternative (1)benzhydrocodone/acetaminophen and clomipramine both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequatebenzphetamineMonitor Closely (1)clomipramine increases and benzphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)clomipramine, benzphetamine. 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.benztropineMonitor Closely (1)benztropine and clomipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.bethanecholMonitor Closely (1)bethanechol increases and clomipramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.bosentanMinor (1)bosentan will decrease the level or effect of clomipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.brexpiprazoleMonitor Closely (2)brexpiprazole and clomipramine both increase sedation. Use Caution/Monitor. clomipramine 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. brimonidineMonitor Closely (1)brimonidine and clomipramine both increase sedation. Use Caution/Monitor.Minor (1)clomipramine decreases effects of brimonidine by pharmacodynamic antagonism. Minor/Significance Unknown.brivaracetamMonitor Closely (1)brivaracetam and clomipramine both increase sedation. Use Caution/Monitor.brompheniramineMonitor Closely (1)brompheniramine and clomipramine both increase sedation. Use Caution/Monitor.budesonideMinor (1)budesonide will decrease the level or effect of clomipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.buprenorphineMonitor Closely (1)buprenorphine and clomipramine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)buprenorphine and clomipramine both increase QTc interval. Avoid or Use Alternate Drug.buprenorphine buccalMonitor Closely (1)buprenorphine buccal and clomipramine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)buprenorphine buccal and clomipramine both increase QTc interval. Avoid or Use Alternate Drug.buprenorphine subdermal implantMonitor Closely (1)clomipramine, 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.Serious - Use Alternative (2)buprenorphine subdermal implant and clomipramine both increase QTc interval. Avoid or Use Alternate Drug. buprenorphine subdermal implant and clomipramine both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequatebuprenorphine transdermalSerious - Use Alternative (2)buprenorphine transdermal and clomipramine both increase QTc interval. Avoid or Use Alternate Drug. buprenorphine transdermal and clomipramine both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequatebuprenorphine, long-acting injectionMonitor