Clomipramine

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Clomipramine
Adult Indications & Dosage
Pediatric Indications & Dosage
Contraindications
Warnings & Precautions
Adverse Reactions
Drug Interactions
Use in Specific Populations
Administration & Monitoring
Overdosage
Pharmacology
Clinical Studies
How Supplied
Images
Patient Counseling Information
Precautions with Alcohol
Brand Names
Look-Alike Names

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Pratik Bahekar, MBBS [2]

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Overview

Clomipramine is a Tricyclic antidepressant that is FDA approved for the {{{indicationType}}} of obsessive-compulsive disorder. Common adverse reactions include diaphoresis, weight increased, constipation, diarrhea, indigestion, loss of appetite, nausea, xerostomia, myalgia, dizziness, feeling nervous, headache, insomnia, myoclonus, somnolence, tremor, abnormal vision, disorder of the urinary system, disorder of ejaculation, impotence, pharyngitis fatigue..

Adult Indications and Dosage

FDA-Labeled Indications and Dosage (Adult)

Obsessive-compulsive disorder

  • Monotherapy
  • Maximum, 250 mg/day[1]
  • Combination Therapy
  • Initial dose, 25 mg/day; weekly titration up to 75 mg/day; mean dose, 55 mg/day) plus fluoxetine (maximum dose, 40 mg/day), quetiapine initial dose, 50 mg/day; weekly titration up to 200 mg/day; mean dose, 142 mg/day

Off-Label Use and Dosage (Adult)

Guideline-Supported Use

Condition 1

  • Developed by: (Organization)
  • Class of Recommendation: (Class) (Link)
  • Strength of Evidence: (Category A/B/C) (Link)
  • Dosing Information/Recommendation
  • (Dosage)

Non–Guideline-Supported Use

Delusional disorder

  • Initial, 25 mg/day ORALLY, may increase dosage to 100 mg/day during the first 2 weeks (MAX dose 250 mg/day, mean dose 140 mg/day)

Depression

  • Initial, 75 mg/day ORALLY (3 divided doses); may increase dosage slowly as needed and tolerated to a range of 100-250 mg/day (3 divided doses)

Disorder of ejaculation

Obsessive-compulsive disorder, Intravenous therapy

  • Initial, 25 mg/day ORALLY, may increase dosage to 100 mg/day ORALLY during the first 2 weeks; MAX dose 250 mg/day

Pain, chronic

Panic disorder

  • 25-75 mg/day ORALLY

Pervasive developmental disorder

  • There is limited information about Off-Label Non–Guideline-Supported Use of Clomipramine in adult patients.

Pediatric Indications and Dosage

FDA-Labeled Indications and Dosage (Pediatric)

Obsessive-compulsive disorder

  • 10 years and older, initial, 25 mg/day ORALLY, may increase dosage to 3 mg/kg or 100 mg/day (whichever is less) ORALLY during the first 2 weeks; MAX dose 200 mg/day OR 3 mg/kg/day (whichever is less)

Off-Label Use and Dosage (Pediatric)

Guideline-Supported Use

Condition 1

  • Developed by: (Organization)
  • Class of Recommendation: (Class) (Link)
  • Strength of Evidence: (Category A/B/C) (Link)
  • Dosing Information/Recommendation
  • (Dosage)

Non–Guideline-Supported Use

Depression

  • Safety and effectiveness in children less than 10 years of age have not been established
  • 20-30 mg/day ORALLY; may increase dosage by 10 mg/day at 4-5 day intervals as needed and tolerated
  • There is limited information about Off-Label Non–Guideline-Supported Use of Clomipramine in pediatric patients.

Contraindications

  • Condition 1
  • Condition 2
  • Condition 3
  • Condition 4
  • Condition 5

Warnings

Conidition 1

Adverse Reactions

Clinical Trials Experience

Central Nervous System

(list/description of adverse reactions)

Cardiovascular

(list/description of adverse reactions)

Respiratory

(list/description of adverse reactions)

Gastrointestinal

(list/description of adverse reactions)

Hypersensitive Reactions

(list/description of adverse reactions)

Miscellaneous

(list/description of adverse reactions)

Postmarketing Experience

Central Nervous System

(list/description of adverse reactions)

Cardiovascular

(list/description of adverse reactions)

Respiratory

(list/description of adverse reactions)

Gastrointestinal

(list/description of adverse reactions)

Hypersensitive Reactions

(list/description of adverse reactions)

Miscellaneous

(list/description of adverse reactions)

Drug Interactions

  • (Drug 1)
  • (Description)
  • (Drug 2)
  • (Description)
  • (Drug 3)
  • (Description)

Use in Specific Populations

Pregnancy

Pregnancy Category (FDA): There is no FDA guidance on usage of Clomipramine in women who are pregnant.
Pregnancy Category (AUS): There is no Australian Drug Evaluation Committee (ADEC) guidance on usage of Clomipramine in women who are pregnant.

Labor and Delivery

There is no FDA guidance on use of Clomipramine during labor and delivery.

Nursing Mothers

There is no FDA guidance on the use of Clomipramine in women who are nursing.

Pediatric Use

There is no FDA guidance on the use of Clomipramine in pediatric settings.

Geriatic Use

There is no FDA guidance on the use of Clomipramine in geriatric settings.

Gender

There is no FDA guidance on the use of Clomipramine with respect to specific gender populations.

Race

There is no FDA guidance on the use of Clomipramine with respect to specific racial populations.

Renal Impairment

There is no FDA guidance on the use of Clomipramine in patients with renal impairment.

Hepatic Impairment

There is no FDA guidance on the use of Clomipramine in patients with hepatic impairment.

Females of Reproductive Potential and Males

There is no FDA guidance on the use of Clomipramine in women of reproductive potentials and males.

Immunocompromised Patients

There is no FDA guidance one the use of Clomipramine in patients who are immunocompromised.

Administration and Monitoring

Administration

There is limited information regarding Clomipramine Administration in the drug label.

Monitoring

There is limited information regarding Clomipramine Monitoring in the drug label.

IV Compatibility

There is limited information regarding the compatibility of Clomipramine and IV administrations.

Overdosage

There is limited information regarding Clomipramine overdosage. If you suspect drug poisoning or overdose, please contact the National Poison Help hotline (1-800-222-1222) immediately.

Pharmacology

Template:Px
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Clomipramine
Systematic (IUPAC) name
3-(3-chloro-10,11-dihydro-5H-dibenzo[b,f]azepin-5-yl)-N,N-dimethylpropan-1-amine
Identifiers
CAS number 303-49-1
ATC code N06AA04
PubChem 2801
DrugBank DB01242
Chemical data
Formula Template:OrganicBox atomTemplate:OrganicBox atomTemplate:OrganicBoxTemplate:OrganicBoxTemplate:OrganicBoxTemplate:OrganicBoxTemplate:OrganicBox atomTemplate:OrganicBoxTemplate:OrganicBoxTemplate:OrganicBoxTemplate:OrganicBoxTemplate:OrganicBoxTemplate:OrganicBoxTemplate:OrganicBox atomTemplate:OrganicBoxTemplate:OrganicBoxTemplate:OrganicBoxTemplate:OrganicBoxTemplate:OrganicBoxTemplate:OrganicBoxTemplate:OrganicBoxTemplate:OrganicBoxTemplate:OrganicBox 
Mol. mass 314.9 g/mol
SMILES eMolecules & PubChem
Pharmacokinetic data
Bioavailability 50%
Protein binding 97-98%
Metabolism Hepatic (CYP2D6-mediated)
Half life 32 hr (69 hr for active metabolite)
Excretion Renal (60%), faeces (32%)
Therapeutic considerations
Licence data

US

Pregnancy cat.

C(AU) C(US)

Legal status

Prescription Only (S4)(AU) ?(CA) POM(UK) [[Prescription drug|Template:Unicode-only]](US)

Routes Oral, IV[2]

Mechanism of Action

There is limited information regarding Clomipramine Mechanism of Action in the drug label.

Structure

Pharmacodynamics

There is limited information regarding Clomipramine Pharmacodynamics in the drug label.

Pharmacokinetics

There is limited information regarding Clomipramine Pharmacokinetics in the drug label.

Nonclinical Toxicology

There is limited information regarding Clomipramine Nonclinical Toxicology in the drug label.

Clinical Studies

There is limited information regarding Clomipramine Clinical Studies in the drug label.

How Supplied

There is limited information regarding Clomipramine How Supplied in the drug label.

Storage

There is limited information regarding Clomipramine Storage in the drug label.

Images

Drug Images

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Package and Label Display Panel

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Patient Counseling Information

There is limited information regarding Clomipramine Patient Counseling Information in the drug label.

Precautions with Alcohol

Alcohol-Clomipramine interaction has not been established. Talk to your doctor about the effects of taking alcohol with this medication.

Brand Names

There is limited information regarding Clomipramine Brand Names in the drug label.

Look-Alike Drug Names

There is limited information regarding Clomipramine Look-Alike Drug Names in the drug label.

Drug Shortage Status

Price

References

The contents of this FDA label are provided by the National Library of Medicine.

  1. Flament MF, Rapoport JL, Berg CJ, Sceery W, Kilts C, Mellström B et al. (1985) Clomipramine treatment of childhood obsessive-compulsive disorder. A double-blind controlled study. Arch Gen Psychiatry 42 (10):977-83. PMID: 3899048
  2. Template:Cite isbn

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