Clomipramine Pharmacology

Clomipramine

About Clomipramine
Tricyclic Antidepressant (Tertiary Amine), Antiobsessional.
Mechanism of Action of Clomipramine
Clomipramine acts by inhibiting the re-uptake of Noradrenaline, and Serotonin (5 HT) in the CNS nerve terminals.This will result in an increased concentration of neurotransmitters in the synaptic cleft and produces antidepressant effect. Clomipramine more selectively inhibits the reuptake of Serotonin than Noradrenaline. Clomipramine also possesses anticholinergic, weak antiserotonin and antihistamine activities.
Pharmacokinets of Clomipramine
Absorption: Clomipramine is rapidly absorbed after oral administration but bioavailability is less (about 50 %) due to its first pass metabolism. Distribution: It is widely distributed in the body in protein bound form Metabolism: Clomipramine is metabolised to active metabolites in the liver. Excretion: Drug is excreted mainly through urine. Some is excreted through faeces also.
Onset of Action for Clomipramine
4 weeks
Duration of Action for Clomipramine
2 week
Half Life of Clomipramine
32 - 70 hours
Side Effects of Clomipramine
1.Drowsiness
2.Dizziness
3 Nausea
4.Vomiting
5.Blurred vision
6.Difficulty in micturition
7.Tachycardia
8.Hypotension
9.Arrhythmia
10. Dryness of mouth
11.Constipation
12.Confusion
13.Headache
14.Sedation
15.Agranulocytosis
16.Urticaria
17.Rash
18.Jaundice
19.Anorexia
20. Impotence
21.Loss of libido
22.Galactorrhea
23.Gynecomastia
Contra-indications of Clomipramine
1.Hypersensitivity to Clomipramine
2.Myocardial infarction
3.Epilepsy
4.Severe liver disease.
Special Precautions while taking Clomipramine
1.Hepatic impairment
2.Cardiac arrhythmia
3.Myocardial infarction
4.Renal impairment
5.Heart failure
6.Strokes
7.Angle closure glaucoma
8.History of urine retention
9.Hyperthyroidism
10.Alcoholics
11.Slowly withdraw the drug with caution
12.Patient should be cautioned against driving vehicle, operating machine and activities requiring mental alertness or judgment
13.Tachycardia
Pregnancy Related Information
Contraindicated.
Old Age Related Information
Use with caution
Breast Feeding Related Information
Contraindicated.
Children Related Information
Contraindicated
NEONATES: contraindicated
Indications for Clomipramine
1.Depression,
2.Obsessive compulsive disorder,
3.Adjunctive treatment of cataplexy associated with narcolepsy.
Interactions for Clomipramine
Anticholinergics: Enhanced effect of anticholinergics may occur.
Barbiturates: Serum level of imipramine decreased; additive respiratory depressant effect.
Clonidine: Hypertensive crisis.
Dicoumarol: Increase in anticoagulation effects.
Disulfiram: Acute organic brain syndrome.
Fluoxetine & Haloperidol: Potentiate action of Clomipramine.
Levodopa: Its bioavailability is reduced, hypertensive episodes.
MAOIs, Furazolidone: Seizures, sweating, coma, hyperexcitability, hyperthermia, tachycardia, mydriasis, confusion, DIC (Disseminated Intravascular Coagulation) and death.
Oral Contraceptives and Phenothiazines: Increase plasma levels of Clomipramine.
Smoking: Increases metabolic bio-transformation.
Alcohol: Sedative effect of alcohol potentiated.
Typical Dosage for Clomipramine
Adult:
Depression: Initial dose: 10 mg at night. Dose can be gradually increased to 150 mg / day at night or in 3 - 4 divided doses.
Maintenance dose: 30 - 50 mg daily
Maximum dose: 250 mg / day
Obsessive compulsive disorder:
Initial dose: 25 mg at night. Dose can be gradually increased to 150 mg / day at night or in 3 - 4 divided doses.
Schedule of Clomipramine
H
Storage Requirements for Clomipramine
Store in a cool place in a tightly closed container. Keep out of the reach of children.
Effects of Missed Dosage of Clomipramine
Take the missed dose as soon as noticed and if it is the time to take the next dose then skip the missed dose.
Effects of Overdose of Clomipramine
Give supportive measures and treatment. Remove the drug from the body by gastric lavage. Seizure can be treated with Diazepam and shock with IV fluids or plasma expanders.

Home Delivery for Clomipramine in Your City

Medicine India is just a publishing medium for medicine related information and does not provide services or sales of medicines including clomipramine.

However, we do publish a comprehensive directory of Pharmacies, Chemists and Druggists in cities all over India. You can use this directory to find the medicine stores in your city (or area) that provide home delivery services for clomipramine and other medicines and health products. Home delivery services for clomipramine may be free or they may cost you depending on the pharmacy and the minimum order requirements. It would be best to get this clarified while placing the order.

Please be aware that you should take clomipramine only if a doctor has recommended or prescribed it. Some or all pharmacies who provide a home delivery service for medicines might insist on a prescription for clomipramine before they complete the sale. You can get this information while placing the order for clomipramine with the pharmacy.

Clomipramine is a generic medicine name and there are several brands available for it. Some of the brands for clomipramine might be better known than clomipramine itself. If the pharmacy that's willing to deliver medicines to your home doesn't have clomipramine in stock, you can ask for one of the branded alternatives for clomipramine.