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Anafranil (Generic Clomipramine)

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Clinical research found that a tiny number of kids, teenagers, and young adults (up to 24 years old) who used antidepressants (sometimes known as “mood lifters”) like clomipramine experienced suicide thoughts (thinking about harming or killing oneself or planning or trying to do so). Children, teenagers, and young adults who take antidepressants to treat depression or other mental diseases may have a higher risk of committing suicide than those who do not take these medications. However, experts disagree on how significant this risk is and how much it has to be taken into account when determining whether or not a kid or adolescent should take an antidepressant.Clomipramine is typically not recommended for use in children under the age of 18, however in some circumstances, a doctor may determine that it is the best treatment option for a child’s illness.

Even if you are an adult above the age of 24, you should be aware that taking clomipramine or other antidepressants may cause unanticipated changes in your mental health. Suicidal thoughts may come to mind, especially at the start of treatment and whenever your dose is changed. Any of the following symptoms should prompt you, your family, or your carer to call your doctor immediately away: Depression that is either new or getting worse, thoughts of self-harm or suicide, plans or attempts to do so, excessive worry, agitation, panic attacks, trouble falling or staying asleep, aggressive behaviour, irritability, acting without thinking, extreme restlessness, and frenzied abnormal excitement. Make sure your family or carer is aware of any symptoms that could be significant so they can contact the doctor on your behalf if you are unable to call for help.

While you are taking clomipramine, your doctor will want to visit you frequently, especially at the start of your treatment. Be sure to show up for all of your doctor’s appointment times.

When you start taking clomipramine for therapy, your doctor or pharmacist will provide you the medication guide (patient information sheet) from the manufacturer. If you have any questions, carefully read the material and contact your doctor or pharmacist. The FDA website also has the medication guide available.

No of your age, you, your parent, or your carer should discuss the advantages and disadvantages of treating your disease with an antidepressant or with alternative treatments with your doctor before starting an antidepressant. The dangers and advantages of not treating your ailment should also be discussed. You should be aware that your chance of committing suicide is significantly increased if you suffer from depression or any mental disorder. This risk is increased if you or a family member currently has, or previously had, bipolar disorder (depression followed by periods of extreme excitement) or mania (frenzied, abnormally excited mood), or if you have ever considered or tried suicide. Discuss your ailment, symptoms, and personal and family medical history with your doctor. What kind of treatment is best for you will be decided by both you and your doctor.

Why is this medication prescribed?

Obsessive-compulsive disorder is treated with clomipramine (a condition that causes repeated unwanted thoughts and the need to perform certain behaviours over and over). Clomipramine is a member of the tricyclic antidepressant class of drugs. It functions by raising the brain’s natural chemical serotonin levels, which are necessary for maintaining mental equilibrium.

How should this medicine be used?

To be swallowed whole, clomipramine capsules are available. Clomipramine is typically started as a three-time daily dose with meals while the body becomes used to the medicine. Once daily at bedtime after a few weeks of therapy, clomipramine is often given. Ask your doctor or pharmacist to explain any instructions on your prescription label that you are unsure about following. Follow the clomipramine directions exactly. Never take it in larger or less amounts or more frequently than directed by your doctor.

Your doctor might prescribe you a low dose of clomipramine and then gradually raise it.

You could need a few weeks or more to experience the full benefits of clomipramine. Even if you feel good, keep taking clomipramine. Without consulting your doctor, do not stop taking clomipramine. If you stop taking clomipramine abruptly, you can have agitation, fever, headache, weakness, nausea, vomiting, dizziness, and other withdrawal symptoms. Your dose will likely be gradually reduced by your doctor.

What special precautions should I follow?

Before taking clomipramine,

  • Inform your physician and pharmacist if you have any allergies to clomipramine, other tricyclic antidepressants like amitriptyline (Elavil), amoxapine (Asendin), desipramine (Norpramin), doxepin (Adapin, Sinequan), imipramine (Tofranil), nortriptyline (Aventyl, Pamelor), protriptyline (Vivactil), and trimipramine ( You can obtain a list of the inactive ingredients by asking your doctor or pharmacist.
  • Inform your doctor if you are currently using an MAO inhibitor, such as isocarboxazid (Marplan), linezolid (Zyvox), methylene blue, phenelzine (Nardil), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate), or if you have just discontinued taking one. Most likely, your doctor will advise against using clomipramine. You should wait at least 14 days after stopping clomipramine before starting an MAO inhibitor.
  • Inform your doctor and pharmacist about all prescription and over-the-counter drugs, vitamins, dietary supplements, and herbal products that you are now taking or intend to use. Incorporate any of the following: Warfarin (Coumadin, Jantoven), benztropine (Cogentin), cimetidine (Tagamet), clonidine (Catapres), dicyclomine (Bentyl), digoxin (Lanoxin), and disulfiram are examples of anticoagulants (sometimes known as “blood thinners”). Methylphenidate (Concerta, Metadate, Ritalin), oral contraceptives, phenobarbital, phenytoin, propafenone (Rythmol), quinidine, secobarbital (Seconal), and secobarbital (Seconal) are all examples of drugs for nausea, dizziness, or mental disease. Guanethidine (Ismelin), haloperidol (HaldoI); trihexyphenidyl (Artane), tranquillizers, and selective serotonin reuptake inhibitors (SSRIs) as fluoxetine (Prozac, Sarafem), sertraline (Zoloft), and paroxetine (Paxil). Your medicine doses could need to be adjusted, or your doctor might need to keep a closer eye out for any side effects. If you haven’t used fluoxetine for the past five weeks, your doctor might advise against taking clomipramine.
  • If you’ve suffered a heart attack recently, let your doctor know. Your physician might advise against taking clomipramine.
  • Tell your doctor if you have seizures, brain damage, issues with your urinary system or prostate (a male reproductive organ), an irregular heartbeat, issues with your blood pressure, thyroid issues, heart, kidney, or liver disease. Also mention if you are receiving electroshock therapy, a procedure that involves giving small electric shocks to the brain to treat some mental illnesses.
  • If you are breastfeeding a child or intend to become pregnant, let your doctor know. Call your doctor if you get pregnant while taking clomipramine.
  • If you are 65 years of age or older, discuss the advantages and disadvantages of taking clomipramine with your doctor. Clomipramine is typically not recommended for usage by older adults since it is less reliable and less efficient than alternative drugs that can be used to treat the same disease.
  • Inform your doctor or dentist that you are taking clomipramine if you are undergoing surgery, including dental surgery.
  • You should be aware that taking this medication could make you sleepy and raise your risk of having a seizure. Until you are certain of how this drug affects you, avoid operating machinery, climbing, swimming, or driving a car.
    Keep in mind that drinking alcohol can increase the drowsiness brought on by this drug.
  • If you use tobacco products, let your doctor know. Smoking cigarettes may make this medication less effective.
  • Angle-closure glaucoma may be brought on by clomipramine, so you should be aware of this (a condition where the fluid is suddenly blocked and unable to flow out of the eye causing a quick, severe increase in eye pressure which may lead to a loss of vision). Ask your doctor if you should get your eyes checked before beginning this medicine. Call your doctor or get emergency medical attention right away if you are experiencing nausea, eye pain, changes in your vision, such as seeing coloured rings around lights, or swelling or redness in or around your eyes.

What special dietary instructions should I follow?

Maintain your normal diet unless your doctor instructs you otherwise.

What should I do if I forget a dose?

If you miss a dosage, take it as soon as you recall. If your next dose is approaching, skip the missed one and carry on with your regular dosing regimen. To make up for a missing dose, do not take a second one.

What side effects can this medication cause?

There can be negative effects from clomipramine. If any of these symptoms are severe or do not go away, let your doctor know right once:

  • Drowsiness
  • Mouth ache
  • Nausea
  • Vomiting
  • Diarrhea
  • Constipation
  • Nervousness
  • Reduced sexual capacity
  • Decreased concentration or memory
  • Headache
  • Clogged nose
  • Alterations in weight or appetite

There could be some severe negative effects. Call your doctor right away or seek emergency medical attention if you experience any of the following symptoms or those noted in the IMPORTANT WARNING or SPECIAL PRECAUTIONS sections:

  • Uncontrollable trembling of a body part Seizures
  • A hammering, rapid, or inconsistent heartbeat
  • Inability to control one’s bladder or difficulty urinating
  • Believing incorrect information
  • Hallucinations (seeing things or hearing sounds and voices that do not exist) Shakiness
  • Breathing difficulties or rapid breathing
  • Extremely tight muscles
  • Unusual weakness or fatigue
  • Fever, a sore throat, and other symptoms of infection

You or your doctor can submit a report to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting programme online or by phone if you have a serious side event (1-800-332-1088).

What should I know about storage and disposal of this medication?

Keep this medication tightly closed in the original container and out of the reach of children. Store it away from excessive heat and moisture at room temperature (not in the bathroom).

As many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and are simple for young children to open, it is crucial to keep all medications out of sight and out of reach of children. Always lock safety caps and promptly stash medication up and away from young children where it is out of their sight and reach to prevent poisoning.

Unused prescriptions must be disposed of carefully to prevent pets, kids, and other people from ingesting them. You should not, however, dispose of this medication in the toilet. Instead, utilising a medicine take-back programme is the easiest approach to get rid of your medication. To find out about take-back programmes in your area, speak with your pharmacist or the garbage/recycling department in your city. If you do not have access to a take-back programme, see the FDA’s Safe Disposal of Medicines website at for additional information.

In case of emergency/overdose

Call the poison control hotline at 1-800-222-1222 in the event of an overdose. Additionally, information can be found online at Call 911 right once if the person has collapsed, experienced a seizure, is having difficulty breathing, or cannot be roused.

Overdose symptoms could include:

  • Seizures
  • Coma (loss of consciousness for a period of time)
  • Drowsiness
  • Restlessness
  • Inability to coordinate
  • Sweating
  • Rigid muscles
  • Unusual motion
  • Rapid heart rate
  • Breathing more slowly
  • Skin colouring that is blue
  • Fever
  • Widening eyes (dark circles in the centre of the eye)
  • Less urinations

What other information should I know?

Keep all of your doctor’s appointments.

No one else should take your medication. Any queries you may have regarding medication refills should be directed to your pharmacist.

You should keep a written record of every medication you take, including any over-the-counter (OTC) items, prescription drugs, and dietary supplements like vitamins and minerals. This list should be brought with you whenever you see a doctor or are admitted to the hospital. You should always have this information with you in case of emergencies.

Brand names

  • Anafranil®
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