III. Mechanism

  1. See Tricyclic Antidepressant
  2. Very strong Serotonin uptake blockade
  3. Primarily blocks Serotonin uptake

IV. Safety

  1. Pregnancy Category C
  2. Safe in Lactation

V. Dosing

  1. Adult
    1. Start 25 mg orally at bedtime
    2. Titrate to 100 mg/day in divided doses with meals over 2 to 4 week period
    3. Max: 250 mg/day
      1. May consolidate divided doses into one nightly dose after titration
  2. Child (over age 10 years)
    1. Start 25 mg orally at bedtime
    2. Titrate to 3 mg/kg/day (up to 100 mg/day) in divided doses with meals over 2 to 4 week period
    3. Max: 3 mg/kg/day (up to 200 mg/day)
      1. May consolidate divided doses into one nightly dose after titration

VI. Adverse Effects

  1. See Tricyclic Antidepressant
  2. Very sedating

VII. Pharmacokinetics

  1. Half-Life: 20-35 hours

IX. References

  1. Olson (2020) Clinical Pharmacology, Medmaster Miami, p. 38-9
  2. Hamilton (2020) Tarascon Pocket Pharmacopoeia

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Related Studies

Cost: Medications

clomipramine (on 11/23/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
CLOMIPRAMINE 25 MG CAPSULE Generic $0.27 each
CLOMIPRAMINE 50 MG CAPSULE Generic $0.37 each
CLOMIPRAMINE 75 MG CAPSULE Generic $0.50 each

Ontology: Anafranil (C0002752)

Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH D002997
English anafranil, Anafranil

Ontology: Clomipramine (C0009010)

Definition (NCI) A tricyclic antidepressant that acts by reducing the re-uptake of norepinephrine and serotonin in the central nervous system, thereby enhancing the effects of these neurotransmitters. This drug also binds to alpha-adrenergic, histaminergic, and cholinergic receptors which are responsible for the many side effects seen with this agent.
Definition (MSH) A tricyclic antidepressant similar to IMIPRAMINE that selectively inhibits the uptake of serotonin in the brain. It is readily absorbed from the gastrointestinal tract and demethylated in the liver to form its primary active metabolite, desmethylclomipramine.
Definition (CSP) tricyclic antidepressant that selectively inhibits the uptake of serotonin in the brain; readily absorbed from the gastrointestinal tract and demethylated in the liver to form its primary active metabolite, desmethylclomipramine.
Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH D002997
SnomedCT 349855006, 96209002, 372903001
LNC LP16083-5, MTHU004252
English Chlomipramine, Chlorimipramine, Clomipramine, 5H-Dibenz(b,f)azepine-5-propanamine, 3-chloro-10,11-dihydro-N,N-dimethyl-, 3-Chloro-5-(3-(dimethylamino)propyl)-10,11-dihydro-5H-dibenz(b,f)azepine, Clomipramine [Chemical/Ingredient], chlomipramine, chlorimipramine, clomiPRAMINE, clomipramine, CLOMIPRAMINE, Clomipramine (product), Clomipramine (substance)
Swedish Klomipramin
Czech klomipramin
Finnish Klomipramiini
Russian KLOMIPRAMINA GIDROKHLORID, KLOMIPRAMIN, KHLORIMIPRAMIN, КЛОМИПРАМИН, КЛОМИПРАМИНА ГИДРОХЛОРИД, ХЛОРИМИПРАМИН
Japanese クロルイミプラミン, クロミプラミン, 塩酸クロミプラミン
Italian Clorimipramina, Clomipramina
Polish Klomipramina, Chlorimipramina
Spanish clomipramina (producto), clomipramina (sustancia), clomipramina, clorimipramina, Clomipramina, Clorimipramina
French Clomipramine
German Clomipramin, Clorimipramin
Portuguese Clomipramina, Clorimipromina