Closely (1)clomipramine, 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.Serious - Use Alternative (2)buprenorphine, long-acting injection and clomipramine both increase QTc interval. Avoid or Use Alternate Drug. buprenorphine, long-acting injection and clomipramine both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequatebupropionMonitor Closely (1)clomipramine increases toxicity of bupropion by unspecified interaction mechanism. Use Caution/Monitor. May lower seizure threshold; keep bupropion dose as low as possible.Serious - Use Alternative (1)bupropion will increase the level or effect of clomipramine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.buspironeSerious - Use Alternative (1)clomipramine and buspirone both increase serotonin levels. Avoid or Use Alternate Drug.butabarbitalMonitor Closely (3)butabarbital 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.Minor (1)butabarbital, 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.butalbitalMonitor Closely (3)butalbital 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.Minor (1)butalbital, 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.butorphanolMonitor Closely (1)butorphanol and clomipramine both increase sedation. Use Caution/Monitor.caffeineMonitor Closely (1)clomipramine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.calcium/magnesium/potassium/sodium oxybatesSerious - Use Alternative (1)clomipramine, calcium/magnesium/potassium/sodium oxybates. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.cannabidiolMonitor Closely (1)cannabidiol 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. captoprilMonitor Closely (1)clomipramine, captopril. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Both drugs lower blood pressure. Monitor blood pressure.carbacholMonitor Closely (1)carbachol increases and clomipramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.carbamazepineMonitor Closely (2)carbamazepine 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.Minor (1)carbamazepine decreases levels of clomipramine by increasing metabolism. Minor/Significance Unknown.carbinoxamineMonitor Closely (1)carbinoxamine and clomipramine both increase sedation. Use Caution/Monitor.carisoprodolMonitor Closely (1)carisoprodol and clomipramine both increase sedation. Use Caution/Monitor.celecoxibMonitor Closely (2)celecoxib 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.cenobamateMonitor Closely (1)cenobamate, clomipramine. Either increases effects of the other by sedation. Use Caution/Monitor.ceritinibMonitor Closely (1)ceritinib and clomipramine both increase QTc interval. Use Caution/Monitor.cevimelineMonitor Closely (1)cevimeline increases and clomipramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.chloral hydrateMonitor Closely (1)chloral hydrate and clomipramine both increase sedation. Use Caution/Monitor.chlordiazepoxideMonitor Closely (1)chlordiazepoxide and clomipramine both increase sedation. Use Caution/Monitor.chloroquineMonitor Closely (2)chloroquine 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.chlorpheniramineMonitor Closely (1)chlorpheniramine and clomipramine both increase sedation. Use Caution/Monitor.chlorpromazineMonitor Closely (1)chlorpromazine and clomipramine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)chlorpromazine and clomipramine both increase QTc interval. Avoid or Use Alternate Drug.Minor (2)clomipramine, chlorpromazine. Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects. clomipramine, chlorpromazine. Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.chlorpropamideMinor (1)clomipramine increases effects of chlorpropamide by pharmacodynamic synergism. Minor/Significance Unknown.chlorzoxazoneMonitor Closely (1)chlorzoxazone and clomipramine both increase sedation. Use Caution/Monitor.choline magnesium trisalicylateMonitor Closely (1)clomipramine, 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 smokingMonitor Closely (1)cigarette smoking will decrease the level or effect of clomipramine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.cimetidineMonitor Closely (3)cimetidine 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.cinnarizineMonitor Closely (1)cinnarizine and clomipramine both increase sedation. Use Caution/Monitor.ciprofloxacinSerious - Use Alternative (1)ciprofloxacin will increase the level or effect of clomipramine by affecting hepatic enzyme CYP1A2 metabolism. Avoid or Use Alternate Drug. Concurrent use of drugs that can cause QT interval prolongation may result in additive effects and increased risk of ventricular arrhythmias. It is important to monitor therapy carefully.cisatracuriumMonitor Closely (1)cisatracurium and clomipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.citalopramSerious - Use Alternative (2)citalopram and clomipramine both increase serotonin levels. Avoid or Use Alternate Drug. Citalopram may increase TCA levels. Increased risk of serotonin syndrome or neuroleptic malignant syndrome. Potential risk for QT prolongation. ECG monitoring is recommended. citalopram and clomipramine both increase QTc interval. Avoid or Use Alternate Drug.clarithromycinSerious - Use Alternative (2)clomipramine and clarithromycin both increase QTc interval. Avoid or Use Alternate Drug. clarithromycin will increase the level or effect of clomipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.clemastineMonitor Closely (1)clemastine and clomipramine both increase sedation. Use Caution/Monitor.clobazamMonitor Closely (2)clobazam will increase the level or effect of clomipramine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Lower doses of drugs metabolized by CYP2D6 may be required when used concomitantly. clomipramine, clobazam. Other (see comment). Use Caution/Monitor. Comment: Concomitant administration can increase the potential for CNS effects (e.g., increased sedation or respiratory depression).clonazepamMonitor Closely (1)clonazepam and clomipramine both increase sedation. Use Caution/Monitor.clonidineSerious - Use Alternative (1)clomipramine decreases effects of clonidine by Other (see comment). Avoid or Use Alternate Drug. Comment: Inhibition of uptake by adrenergic neurons.clorazepateMonitor Closely (1)clorazepate and clomipramine both increase sedation. Use Caution/Monitor.clozapineMonitor Closely (1)clozapine and clomipramine both increase sedation. Use Caution/Monitor.cobicistatMonitor Closely (2)cobicistat will increase the level or effect of clomipramine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Carefully titrate antidepressant to the desired effect, including using the lowest feasible initial or maintenance dose, and monitoring for antidepressant response cobicistat will increase the level or effect of clomipramine by Other (see comment). Use Caution/Monitor. Carefully titrate dose of the antidepressant to the desired effect, including using the lowest feasible initial or maintenance dose, and monitor its response during coadministration with TCAs and cobicistat. cocaine topicalMonitor Closely (1)clomipramine and cocaine topical both increase serotonin levels. Modify Therapy/Monitor Closely.codeineMonitor Closely (2)codeine and clomipramine both increase sedation. Use Caution/Monitor. clomipramine decreases effects of codeine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Prevents conversion of codeine to its active metabolite morphine.conivaptanMonitor Closely (1)conivaptan will increase the level or effect of clomipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.conjugated estrogensMinor (1)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.conjugated estrogens, vaginalMinor (1)conjugated estrogens, vaginal, clomipramine. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.cortisoneMinor (1)cortisone will decrease the level or effect of clomipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.crizotinibMonitor Closely (1)crizotinib and clomipramine both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.cyclizineMonitor Closely (2)cyclizine and clomipramine both decrease cholinergic effects/transmission. Use Caution/Monitor. cyclizine and clomipramine both increase sedation. Use Caution/Monitor.cyclobenzaprineMonitor Closely (2)cyclobenzaprine and clomipramine both decrease cholinergic effects/transmission. Use Caution/Monitor. cyclobenzaprine and clomipramine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)clomipramine and cyclobenzaprine both increase serotonin levels. Avoid or Use Alternate Drug.cyclosporineMonitor Closely (1)cyclosporine will increase the level or effect of clomipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.cyproheptadineMonitor Closely (1)cyproheptadine and clomipramine both increase sedation. Use Caution/Monitor.dacomitinibSerious - Use Alternative (1)dacomitinib will increase the level or effect of clomipramine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug. Avoid use with CYP2D6 substrates where minimal increases in concentration of the CYP2D6 substrate may lead to serious or life-threatening toxicities. dantroleneMonitor Closely (1)dantrolene and clomipramine both increase sedation. Use Caution/Monitor.daridorexantMonitor Closely (1)clomipramine and daridorexant both increase sedation. Modify Therapy/Monitor Closely. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment. darifenacinMonitor Closely (3)darifenacin and clomipramine both decrease cholinergic effects/transmission. Use Caution/Monitor. darifenacin will increase the level or effect of clomipramine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. darifenacin will increase the level or effect of clomipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.darunavirMonitor Closely (1)darunavir will increase the level or effect of clomipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.dasatinibMonitor Closely (1)clomipramine and dasatinib both increase QTc interval. Modify Therapy/Monitor Closely.Serious - Use Alternative (1)dasatinib will increase the level or effect of clomipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.debrisoquineMonitor Closely (1)clomipramine decreases effects of debrisoquine by Other (see comment). Use Caution/Monitor. Comment: Inhibition of uptake by adrenergic neurons.deferasiroxMonitor Closely (1)deferasirox increases levels of clomipramine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.degarelixSerious - Use Alternative (1)degarelix and clomipramine both increase QTc interval. Avoid or Use Alternate Drug.desfluraneMonitor Closely (2)desflurane and clomipramine both increase sedation. Use Caution/Monitor. desflurane and clomipramine both increase QTc interval. Use Caution/Monitor.Minor (1)desflurane, clomipramine. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.desipramineMonitor Closely (2)clomipramine and desipramine both decrease cholinergic effects/transmission. Use Caution/Monitor. clomipramine and desipramine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (2)clomipramine and desipramine both increase QTc interval. Avoid or Use Alternate Drug. clomipramine and desipramine both increase serotonin levels. Avoid or Use Alternate Drug.desvenlafaxineMonitor Closely (1)desvenlafaxine will increase the level or effect of clomipramine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Desvenlafaxine inhibits CYP2D6; with higher desvenlafaxine doses (ie, 400 mg) decrease the CYP2D6 substrate dose by up to 50%; no dosage adjustment needed with desvenlafaxine doses <100 mgSerious - Use Alternative (1)clomipramine and desvenlafaxine both increase serotonin levels. Avoid or Use Alternate Drug.deutetrabenazineMonitor Closely (2)clomipramine and deutetrabenazine both increase sedation. Use Caution/Monitor. deutetrabenazine and clomipramine both increase QTc interval. Use Caution/Monitor. At the maximum recommended dose, deutetrabenazine does not prolong QT interval to a clinically relevant extent. Certain circumstances may increase risk of torsade de pointes and/or sudden death in association with drugs that prolong the QTc interval (eg, bradycardia, hypokalemia or hypomagnesemia, coadministration with other drugs that prolong QTc interval, presence of congenital QT prolongation).dexamethasoneMinor (1)dexamethasone will decrease the level or effect of clomipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.dexchlorpheniramineMonitor Closely (1)dexchlorpheniramine and clomipramine both increase sedation. Use Caution/Monitor.dexfenfluramineMonitor Closely (2)clomipramine and dexfenfluramine both increase serotonin levels. Modify Therapy/Monitor Closely. clomipramine increases and dexfenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)clomipramine, dexfenfluramine. 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.dexmedetomidineMonitor Closely (1)dexmedetomidine and clomipramine both increase sedation. Use Caution/Monitor.dexmethylphenidateMonitor Closely (1)clomipramine increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)clomipramine, dexmethylphenidate. 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.Minor (1)dexmethylphenidate increases effects of clomipramine by decreasing metabolism. Minor/Significance Unknown.dextroamphetamineMonitor