Anafranil (Clomipramine)

Common Use

Anafranil is a drug used to treat obsessive-compulsive disorder (OCD). This is a nervous condition where a person has recurring thoughts or ideas or does repetitive things because they are anxious. Clomipramine works on the central nervous system (CNS) and helps to relieve the symptoms of OCD. This medication belongs to a class of so-called tricyclic antidepressants. It helps to restore the balance of certain natural substances (serotonin, among others) in the brain. This medication is also used to treat panic attacks, depression, and ongoing pain.

Dosage and Direction

Take the drug only as prescribed because dosage and schedule may vary based on your condition and other factors. It is advised to follow the doctor's instructions carefully and not to take more or less medication than prescribed. It is advised not to eat grapefruit or drink grapefruit juice (it influences the level of cyclosporin in your blood). Also, limit alcoholic beverages. Do not suddenly stop taking this medication as your condition may become worse. It may take 2 to 3 weeks or longer before you notice the effects of this medication. Inform your doctor about your condition.

Precautions

Before you start taking Clomipramine, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. Inform your doctor or pharmacist if you have certain heart problems (heart failure, slow heartbeat, QT prolongation in the EKG). You may feel dizzy or drowsy or have temporary blurred vision. Avoid driving, using machinery, or doing any activity that requires alertness. Aged people may be more sensitive to the side effects of the drug. During pregnancy, this medication should be used only when strongly needed. Consult your doctor about the risks. This medicine passes into breast milk so it may have undesirable effects on a nursing infant. It is better to stop breast-feeding while using this drug.

Possible Side Effects

The most common side effects are dizziness, dry mouth, drowsiness, constipation, stomach upset, nausea, vomiting, sweating, etc. Anxiety symptoms may temporarily worsen when you first start using Clomipramine. A serious allergic reaction to this drug is very rare, but seek immediate medical help if it occurs. Many people using this medicine do not have serious side effects. In case you notice any side effects not listed above, contact your doctor or pharmacist.

Drug Interaction

Tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use before using this medication. Avoid taking Clomipramine with:

• MAO inhibitors: Furazolidone, Isocarboxazid, Linezolid, Moclobemide, Tranylcypromine, etc.
• Anti-arrhythmic medication: Propafenone, Quinidine, etc.
• Selective Serotonin Reuptake Inhibitors (SSRIs): Citalopram, Dapoxetine, Fluoxetine, Fluvoxamine, Paroxetine, etc.
• Antipsychotics: Fluphenazine, etc.
• H2-receptor antagonists: Cimetidine, Ranitidine, Famotidine, Nizatidine, etc.

Nicotine decreases blood levels of this medication. Inform your doctor if you smoke or if you have recently stopped smoking. Try not to eat grapefruit or drink grapefruit juice while being treated with this medication. Consult your doctor or pharmacist for more details.

Missed Dose

If you have missed your dose, take it as soon as you remember. If it is almost time for the next dose, skip the missed dose and resume your usual dosing schedule. Do not take the dose twice.

Overdose

If you think you have used too much of this medicine, seek emergency medical attention right away. The symptoms of overdose usually include chest pain, nausea, irregular heartbeat, and feeling light-headed or fainting.

Storage

Store your medicines at room temperature between 68-77 degrees F (20-25 degrees C) away from light and moisture. Do not store the drugs in the bathroom. Keep all drugs out of reach of children and pets.