WARNING

Anafranil (generic Clomipramine) is a tricyclic antidepressant primarily used to treat obsessive-compulsive disorder (OCD). While it can be effective, it carries several risks:

• Side Effects: Common side effects include dry mouth, drowsiness, dizziness, constipation, blurred vision, and weight gain. Severe side effects can include irregular heartbeat, severe dizziness, fainting, and seizures.
• Mental Health Risks: It may increase the risk of suicidal thoughts or behavior, particularly in young people under 25 years old, especially when starting the medication or changing the dose.
• Cardiovascular Risks: Clomipramine may cause heart problems, especially in people with preexisting heart conditions, and it can affect heart rhythm (QT prolongation).
• Serotonin Syndrome: There is a risk of serotonin syndrome, a potentially life-threatening condition, especially if taken with other serotonergic drugs.
• Withdrawal Symptoms: Abrupt discontinuation can cause withdrawal symptoms, including mood swings, irritability, dizziness, and sleep disturbances.
• Contraindications and Interactions: People with a history of bipolar disorder, glaucoma, urinary retention, or those taking certain medications (like MAO inhibitors) should avoid Anafranil due to potential severe interactions.

Consult a healthcare professional for a comprehensive assessment of risks based on individual health conditions.

Why is this medication prescribed?

Anafranil (Generic Clomipramine) is primarily prescribed to treat obsessive-compulsive disorder (OCD). It belongs to a class of medications called tricyclic antidepressants, which work by affecting the balance of certain natural chemicals (neurotransmitters) in the brain.

How should this medicine be used?

Anafranil (Generic Clomipramine) should be used according to the following guidelines:

• Dosage Instructions: Take Anafranil exactly as prescribed by your doctor. It is usually taken once daily at bedtime or in divided doses throughout the day. The dosage will typically start low and gradually increase to minimize side effects.
• Taking the Medication: You can take Anafranil with or without food. Swallow the capsule whole with a full glass of water. Do not crush or chew it, as this may release the drug too quickly, increasing side effects.
• Duration of Use: Continue taking Anafranil even if you feel well, as it may take several weeks to experience the full benefit. Do not stop taking Anafranil suddenly without consulting your healthcare provider, as this may cause withdrawal symptoms.
• Missed Dose: If you miss a dose, take it as soon as you remember. If it is almost time for the next dose, skip the missed dose. Do not take a double dose to make up for a missed one.
• Special Considerations: Avoid alcohol while taking Anafranil, as it can enhance certain side effects. Follow any special dietary instructions your doctor provides.

If you have any concerns or experience side effects, contact your healthcare provider for guidance.

Other uses for this medicine

While Anafranil is primarily prescribed for obsessive-compulsive disorder (OCD), it may also be used for:

• Depression: To manage symptoms of major depressive disorder.
• Panic Disorder: To reduce the frequency and severity of panic attacks.
• Chronic Pain: To help manage certain types of chronic pain, such as neuropathic pain.

What special precautions should I follow?

Special Precautions for Anafranil

• Medical History: Inform your doctor if you have a history of heart disease, glaucoma, seizures, liver problems, thyroid issues, or a history of bipolar disorder or suicidal thoughts.
• Allergies: Notify your doctor of any allergies to clomipramine or other tricyclic antidepressants, as well as any other allergies (e.g., food, dyes, preservatives).
• Interactions with Other Medications: Discuss all medications you are currently taking, including over-the-counter drugs, vitamins, and herbal supplements. Anafranil can interact with other antidepressants, MAO inhibitors, anticholinergic drugs, and certain blood pressure medications.
• Risk of Drowsiness and Dizziness: Anafranil can cause drowsiness, dizziness, or blurred vision. Avoid driving, operating heavy machinery, or engaging in activities requiring alertness until you know how the medication affects you.
• Alcohol and Other Substances: Avoid alcohol, as it can increase some side effects, such as drowsiness and dizziness.
• Pregnancy and Breastfeeding: Inform your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. Anafranil may pose risks to an unborn baby or nursing infant.
• Sun Sensitivity: Anafranil can make your skin more sensitive to sunlight. Use sunscreen and wear protective clothing when outdoors.
• Surgery: If you are scheduled for surgery, including dental procedures, inform the doctor or dentist that you are taking Anafranil.
• Suicidal Thoughts: Be aware of the potential for increased risk of suicidal thoughts or behavior, especially in young adults. Monitor mood changes and seek medical help if you experience any worsening symptoms.

If you have specific concerns or questions about using Anafranil, your healthcare provider is the best source of personalized advice.

What special dietary instructions should I follow?

• General Dietary Considerations: There are no specific dietary restrictions with Anafranil; however, it is important to maintain a balanced diet.
• Caffeine: Limit caffeine intake (found in coffee, tea, cola, and chocolate), as Anafranil can increase its effects, leading to nervousness, irritability, or sleep disturbances.
• Alcohol: Avoid alcohol, as it may enhance the sedative effects of Anafranil and increase the risk of side effects.

What should I do if I forget a dose?

• If you miss a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose. Do not take a double dose to make up for the missed one.
• Try to take Anafranil at the same time each day to help remember your doses.

What side effects can this medication cause?

Anafranil can cause various side effects, ranging from mild to serious. It’s important to be aware of them and consult your doctor if they become severe or persistent.

Common Side Effects: These are usually mild and may go away as your body adjusts to the medication:

• Drowsiness or dizziness
• Dry mouth
• Constipation
• Nausea or vomiting
• Increased sweating
• Weight gain or loss
• Blurred vision
• Tremors or shakiness
• Difficulty urinating
• Increased appetite

Serious Side Effects: If you experience any of these, contact your doctor immediately:

• Changes in heart rate: Fast, pounding, or irregular heartbeat.
• Severe dizziness or fainting: Could indicate blood pressure changes.
• Mood changes: Agitation, confusion, hallucinations, or worsening depression.
• Seizures
• Eye pain or vision changes: Could be signs of glaucoma.
• Muscle stiffness: Especially along with a high fever and sweating, which could indicate a serious condition called neuroleptic malignant syndrome (NMS).
• Tingling or numbness: Tingling or numbness in hands or feet.
• Yellowing of the skin or eyes: Signs of liver problems.
• Unusual bleeding or bruising: Might indicate blood disorders.
• Difficulty breathing or swallowing: May signal a severe allergic reaction.
• Serotonin Syndrome: Symptoms include agitation, hallucinations, fast heartbeat, fever, excessive sweating, muscle twitching, loss of coordination, nausea, vomiting, or diarrhea.
• Severe Allergic Reaction: Rash, itching, swelling (especially of the face/tongue/throat), severe dizziness, or trouble breathing.

Stopping Anafranil suddenly can cause withdrawal symptoms such as headache, nausea, vomiting, sleep problems, irritability, or flu-like symptoms. Tapering off the medication slowly under medical supervision is usually recommended.

If you experience any other unusual symptoms while taking Anafranil, it’s important to report them to your healthcare provider.

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

Storage and Disposal of Anafranil:

• Storage:
  • Store Anafranil at room temperature, away from direct light, heat, and moisture. Avoid storing it in the bathroom where humidity can affect the medication.
  • Keep the medication in its original container, tightly closed, and out of reach of children and pets.
  • Do not freeze or refrigerate unless directed by your healthcare provider.
• Disposal:
  • Do not flush Anafranil down the toilet or pour it into a drain unless instructed to do so.
  • Use a medication take-back program if available, or consult your pharmacist or local waste disposal company about safe disposal options.
  • If no take-back programs are available, mix the unused medication with an undesirable substance (like coffee grounds or cat litter), place it in a sealed plastic bag, and throw it away in the household trash.

In case of emergency/overdose

• Symptoms of Overdose:
  • Confusion, restlessness, hallucinations
  • Extreme drowsiness or coma
  • Fast or irregular heartbeat
  • Seizures or convulsions
  • Severe dizziness, fainting
  • Trouble breathing
• Immediate Actions:
  • If you suspect an overdose, call your local emergency services (911 in the U.S.) immediately.
  • You can also contact a poison control center at 1-800-222-1222 in the U.S.
  • Do not attempt to make the person vomit unless instructed by a healthcare professional.

What other information should I know?

• Regular Medical Monitoring: Regular follow-ups with your doctor are essential to monitor your progress and adjust your dosage if necessary.
• Laboratory Tests: Your doctor may recommend periodic blood tests, liver function tests, and heart monitoring (like EKG) to check for any potential side effects.
• Medication List: Keep an updated list of all medications you are taking (including prescription, over-the-counter, and supplements) and share it with every healthcare provider you visit.
• Do Not Share: Anafranil is prescribed for your specific condition; do not share it with others, even if they have similar symptoms.
• Store Information Safely: Carry a medical alert card or bracelet indicating that you are taking Anafranil, especially if you have a history of severe reactions or conditions that may require emergency care.

If you have any more specific questions or concerns, consult your healthcare provider for tailored advice.