Clomipramine | Side Effects, Dosage, Uses & More

Generic Name:

clomipramine, Oral capsule

All Brands

  • Anafranil
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Highlights for clomipramine

Oral capsule
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Clomipramine is used to treat the excessive and repetitive ideas, thoughts and impulses of obsessive-compulsive disorder.

2

This drug comes in a capsule that you take by mouth.

3

This drug is available as the brand-name drug Anafranil. It’s also available as a generic drug.

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The more common side effects of this drug include dry mouth, constipation, nausea, drowsiness, loss of appetite, dizziness, decreased sexual desire in men and women, and impotence and problems with ejaculation in men.

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This drug may put you at an increased risk for suicidal thoughts or behavior. Talk to your doctor about this side effect and how you will be monitored while taking clomipramine.

IMPORTANT INFORMATION

FDA warning

This drug has a black box warning. This is the most serious warning from the Food and Drug Administration (FDA). A black box warning alerts doctors and patients about drug effects that may be dangerous.

Suicidal behavior warning. You may be at greater risk for suicidal behavior or thoughts if you are a child or young adult and you take this drug. Your doctor will monitor you for behavior changes and worsening of your disorder while you are taking this drug.

Serotonin syndrome

While taking this drug, you may be at risk for a life-threatening condition called serotonin syndrome. This condition occurs when the level of serotonin in your body is too high. It can result in agitation, delirium, coma, muscle rigidity, tremor, and seizures. It can also result in nausea, vomiting, diarrhea, and sometimes death.

Seizures

This drug may increase your risk of seizures. Your risk of seizures is higher if you have a history of seizures, alcoholism, or another disorder that increases your risk of seizures. If you have any of these conditions, talk to your doctor about your risk of seizures while taking this drug.

Sexual dysfunction

This drug can cause sexual problems in both men and women, including decreased sexual desire and ability to have an orgasm. In men it can also cause problems with ejaculation (painful or delayed ejaculation) and impotence (troubling getting an erection) in males. Talk to your doctor if you experience these problems while taking this drug.

Drug features

This drug is a prescription drug. It’s available as a capsule you take by mouth. 

This drug is also available as a generic drug. Generic drugs usually cost less. In some cases, they may not be available in every strength or form as the brand-name version.

Why it's used

This drug is used to treat the excessive and repetitive ideas, thoughts and impulses of obsessive-compulsive disorder. It’s most often used when obsessions and compulsions cause you major distress and interfere with your work or social life.

How it works

This drug belongs to a class of drugs called antidepressants and works as an antiobsessional agent. A class of drugs is a group of medications that work in a similar way.

More Details

How it works

This drug belongs to a class of drugs called antidepressants and works as an antiobsessional agent. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

This drug works by reducing obsessions and compulsions. It’s not entirely clear how the drug does this. It’s thought that it does this by increasing the activity of certain chemicals in your brain called norepinephrine and serotonin. These chemicals are believed to help regulate mood and behavior.

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clomipramine Side Effects

Oral capsule

More Common Side Effects

The more common side effects of clomipramine can include:

  • dry mouth

  • constipation

  • nausea

  • heartburn

  • loss of appetite

  • drowsiness

  • tremor

  • dizziness

  • nervousness

  • problems with ejaculation (in men)

  • impotence (in men)

  • decreased sexual desire (in men and women)

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious Side Effects

Call your doctor right away if you have serious side effects. Call 9-1-1 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

  • New or worsening depression, anxiety, or irritability

  • Panic attacks

  • Acting on dangerous impulses

  • Extreme increases in activity or talking (manic episode)

  • Thoughts of suicide

  • Suicide attempts

  • Serotonin syndrome. Symptoms can include:

    • agitation
    • hallucinations
    • coma
    • rapid heart rate
    • sweating
    • feeling hot
    • muscle rigidity
    • tremor
    • nausea
    • vomiting
    • diarrhea
  • Eye disorders. Symptoms can include:

    • eye pain
    • vision changes, such as blurred vision and trouble seeing
    • swelling around your eyes
Pharmacist's Advice
Healthline Pharmacist Editorial Team

This drug may cause drowsiness. Also, this drug can cause suicidal thoughts or behaviors. Tell your doctor right away if you notice changes in your mood or thoughts, especially when starting or stopping this drug or when your dose is adjusted. 

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.
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clomipramine May Interact with Other Medications

Oral capsule

Clomipramine can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Alcohol interaction

The use of drinks that contain alcohol can increase your risk of drowsiness and seizures from clomipramine. If you drink alcohol, talk to your doctor. You may need to be monitored for signs of bleeding.

Medications that might interact with this drug

Drugs that should not be used with clomipramine

You should not take certain drugs with clomipramine. When used with clomipramine, these drugs can cause dangerous effects in the body. Examples of these drugs include:

  • Monoamine oxidase inhibitors such as selegiline, and drugs such as linezolid, methylene blue fentanyl, tramadol, lithium, buspirone, and St. John’s wort. When used with clomipramine, these drugs can increase your risk of developing serotonin syndrome. This can lead to agitation, delirium, coma, muscle rigidity, tremor, and seizures. It can also lead to nausea, vomiting, diarrhea, and sometimes death. You should not use clomipramine and these drugs within 14 days of each other.

Drugs that increase the risk of side effects

Taking clomipramine with certain drugs raises your risk of side effects from those drugs.  Examples of these drugs include: 

  • Thyroid drugs such as levothyroxine and liothyronine. When used with clomipramine, these drugs can cause heart trouble, such as irregular and rapid heart rate, trouble breathing, and fatigue.
  • Warfarin and digoxin. Taking these drugs with clomipramine can increase your risk of bleeding, confusion, fast or irregular heart rate, nausea, and vomiting.
  • Phenobarbital and lorazepam. Increased side effects can include drowsiness.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.

People who have recently had a heart attack

You should not use this drug. This drug can increase your risk of having another heart attack.

People with major depressive disorder

This drug may make your depression worse. If you have major depressive disorder and you’re taking this drug, let your doctor know if your depression gets worse.

People with bipolar disorder

If you have bipolar disorder, taking this drug without taking other drugs to help treat your bipolar disorder may make your condition worse.

People with hyperthyroidism

If you have hyperthyroidism that isn’t treated, taking this drug could cause heart problems.

People with glaucoma

This drug may increase the pressure in your eye and cause your pupils to dilate. If you have glaucoma, taking this drug can make your condition worse.

People with urinary retention

This drug can cause urinary retention. If you already have urinary retention, taking this drug can make your condition worse.

Pregnant women

This drug is a category C pregnancy drug. That means two things: 

  1. Research in animals has shown adverse effects to the fetus when the mother takes the drug.
  2. There haven’t been enough studies done in humans to be certain how the drug might affect the fetus. 

Talk to your doctor if you’re pregnant or planning to become pregnant. This drug should only be used if the potential benefit justifies the potential risk to the fetus.

Women who are breast-feeding

This drug may pass into breast milk and may cause side effects in a child who is breast-fed.

Talk to your doctor if you breast-feed your child. You may need to decide whether to stop breast-feeding or stop taking this medication.

For seniors

The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This raises your risk of side effects.

For children

This drug has not been studied in people younger than 10 years. 

When to call the doctor

Call your doctor if you have any new or sudden changes in mood, behaviors, thoughts, or feelings. Watch for these changes especially when starting this drug or when your dosage is changed.

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How to Take clomipramine (Dosage)

Oral capsule

All possible dosages and drug forms may not be included here. Your dosage, drug form, and how often you take the drug will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

What are you taking this medication for?

Obsessive-compulsive disorder

Generic: clomipramine

Form: Oral capsule
Strengths: 25 mg, 50 mg, 75 mg

Brand: Anafranil

Form: Oral capsule
Strengths: 25 mg, 50 mg, 75 mg
Adult dosage (ages 18–64 years)
  • The typical starting dose is 25 mg per day.
  • Your doctor will slowly increase your dose to 100 mg per day. You should take it in evenly divided doses, usually once in the morning and once in the evening, during the first 2 weeks. This will lower your risk of nausea and upset stomach.  
  • The maximum dose is 250 mg per day. You should take these doses at bedtime to lessen drowsiness during the day.
Child dosage (ages 10–17 years)
  • The typical starting dose is 25 mg per day.
  • Your doctor may slowly increase your dose to 100 mg per day or 3 mg/kg/day (whichever is less). You should take it in evenly divided doses, usually once in the morning and once in the evening,  during the first 2 weeks. This will lower your risk of nausea and upset stomach.
  • The maximum dose is 200 mg per day or 3 mg/kg (whichever is less). You should take these doses at bedtime to lessen drowsiness during the day.
Child dosage (ages 0–9 years)

Use of this drug by people younger than 10 years has not been confirmed to be safe and effective.

Senior dosage (ages 65 years and older)

The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This raises your risk of side effects.

Your doctor may start you on a lower dose or a different dosing schedule. This can help keep levels of this drug from building up too much in your body.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.
Pharmacist's Advice
Healthline Pharmacist Editorial Team

This drug comes with risks if you don’t take it as prescribed.

If you stop taking the drug suddenly or don’t take it at all

Your obsessions or compulsions will not be controlled, and you may experience mood swings if you stop taking this drug suddenly.

If you miss doses or don’t take the drug on schedule

Your medication may not work as well or may stop working completely. For this drug to work well, a certain amount needs to be in your body at all times.

If you take too much

You could have dangerous levels of the drug in your body. Symptoms of an overdose of this drug can include:

  • drowsiness
  • restlessness
  • agitation
  • delirium
  • severe sweating
  • fast heart beat
  • fainting
  • seizures
  • coma

If you think you’ve taken too much of this drug, call your doctor or local poison control center. If your symptoms are severe, call 9-1-1 or go to the nearest emergency room right away.   

What to do if you miss a dose

Take your dose as soon as you remember. But if you remember just a few hours before your next scheduled dose, take only one dose. Never try to catch up by taking two doses at once. This could result in dangerous side effects.

How to tell if the drug is working

The symptoms of your obsessive-compulsive disorder should get better. This may take 2–3 weeks. If you don’t notice an improvement in your symptoms, don’t stop taking this drug without talking to your doctor first.

This drug is used for long-term treatment.

Important considerations for taking this drug
Take this drug with food Take this drug with food, especially when starting it. This can help to reduce upset stomach
timing Take this drug at the time(s) recommended by your doctor See Details
storage Store this drug carefully See Details
medication is refillable A prescription for this medication is refillable See Details
Travel Travel See Details
Clinical monitoring Clinical monitoring See Details
Sun sensitivity Sun sensitivity See Details
not usually stocked Not every pharmacy stocks this drug. When filling your prescription, be sure to call ahead

Take this drug at the time(s) recommended by your doctor

If you are taking this drug once per day, take it at bedtime to lessen drowsiness during the day.

Store this drug carefully

  • Store this drug at room temperature between 68°F and 77°F (20°C and 25°C). Keep it away from light.
  • Don’t store this medication in moist or damp areas, such as bathrooms.

A prescription for this medication is refillable

You should not need a new prescription for this medication to be refilled. Your doctor will write the number of refills authorized on your prescription.

Travel

When traveling with your medication:

  • Always carry your medication with you. When flying, never put it into a checked bag. Keep it in your carry-on bag.
  • Don’t worry about airport x-ray machines. They can’t hurt your medication.
  • You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled box with you.
  • Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

Clinical monitoring

Your doctor should monitor you for any changes in your behavior. 

Sun sensitivity

This drug can make your skin more sensitive to the sun, although this is rare. This increases your risk of sunburn. Avoid the sun if you can. If you can’t, be sure to wear protective clothing and apply sunscreen.

Are there any alternatives?

There are other drugs available to treat your condition. Some may be better suited for you than others. Talk to your doctor about other drug options that may work for you.

What does the pill look like?

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How Much Does clomipramine Cost?

Oral capsule

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Lowest price for clomipramine

Walgreens $261.30
Rite-Aid $277.31
Walmart $349.85
These prices represent the lowest priced national pharmacies for clomipramine on GoodRx. They may be lower than your insurance.

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These prices represent the lowest priced national pharmacies for clomipramine on GoodRx. They may be lower than your insurance.

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Content developed in collaboration with University of Illinois-Chicago, Drug Information Group

Medically reviewed by Creighton University, Center for Drug Information and Evidence-Based Practice on December 15, 2015

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
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