Anafranil

What side effects are possible with this medication?

A side effect is an unwanted response to a medication when it is taken in normal doses. A side effect may be mild or severe, temporary or permanent, but does not occur in everyone. The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away over time. If you develop any of these side effects (or any other side effects not listed here) or they change in intensity, speak to your doctor or pharmacist for advice on managing them and on the risks and benefits of the medication.

blurred vision confusion or delirium constipation decreased sexual drive and ability diarrhea difficulty sleeping dizziness drowsiness dryness of mouth fast or irregular heartbeat headache

heartburn increased or decreased appetite increased sweating loss of balance control nausea problems with urinating shakiness or trembling tiredness or weakness unpleasant taste sensation vomiting weight gain

Click here to learn about serious side effects that can potentially occur with any medication. These examples are provided for information purposes only and are not meant to be exhaustive. Always consult your doctor for sound medical advice specific to your particular medication and treatment.

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Drowsiness/reduced alertness: Since clomipramine may cause drowsiness, especially at the beginning of treatment, caution should be used when engaging in activities requiring mental alertness, judgment, and physical coordination.

Medical conditions: Clomipramine should be taken with caution by people with:

• a history of heart disease
• a history of liver disease
• narrow-angle glaucoma
• pheochromocytoma (tumor of the adrenal glands)
• problems with urination
• severe kidney disease
• thyroid disorders

Orthostatic hypotension (dizziness upon arising): Move slowly when rising from a sitting or lying position as clomipramine can cause sudden temporary low blood pressure resulting in dizziness.

Risk of suicide for children, adolescents, and adults: Antidepressants may increase the risk of suicidal thinking and behavior in children, adolescents, and young adults who have major depression or other mental health conditions. It is not known if this risk also applies to adults over age 24. Adults and children taking this medication may feel agitated (restless, anxious, aggressive, emotional, and feeling not like themselves), or they may want to hurt themselves or others. These symptoms may occur within several weeks after people start taking this medication. People should be closely monitored by their doctor for emotional and behavioral changes.

Seizures: Clomipramine should be used with extreme caution by anyone with a history of seizures or conditions that lower the seizure threshold (such as alcoholism or withdrawal from alcohol).

Surgery: People undergoing surgery and require general anesthetics should tell the doctor about this medication. Clomipramine will need to be stopped several days prior to the planned surgery date.

Withdrawal: Withdrawal symptoms such as dizziness, nausea, headache, and sleep disturbance have occurred when clomipramine therapy is discontinued suddenly. This is not a sign of addiction. Check with your doctor before stopping this medication on your own.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: This medication passes into breast milk. If you are a breast-feeding mother and are taking clomipramine, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of this medication have not been established for children less than 10 years of age.

What other drugs could interact with this medication?

There may be an interaction between clomipramine and any of the following:

• alcohol
• antiarrhythmic drugs (e.g., flecainide, propafenone, quinidine)
• anticholinergic medications (e.g., atropine, benztropine)
• barbiturates (e.g., phenobarbital)
• benzodiazepines (e.g., diazepam, lorazepam)
• carbamazepine
• cimetidine
• cisapride
• clonidine
• digoxin
• haloperidol
• MAO inhibitors (e.g., phenelzine, moclobemide)
• phenothiazines (e.g., chlorpromazine, thioridazine)
• phenytoin
• SSRI antidepressants (e.g., fluoxetine, fluvoxamine)
• sympathomimetics (e.g., amphetamine, methylphenidate, ephedrine)
• thyroid medications (e.g., levothyroxine)
• warfarin

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.