ClomiPRAMINE Hydrochloride(kloe mi’ pra meen)
Anafranil, Apo-Clomipramine (CAN), Co Clomipramine (CAN), Gen-Clomipramine (CAN)
PREGNANCY CATEGORY C
Drug Classes
TCA (tertiary amine)
Therapeutic Actions
Mechanism unknown; inhibits the presynaptic reuptake of the neurotransmitters norepinephrine and serotonin; anticholinergic at CNS and peripheral receptors.
Indications
Treatment of obsessions and compulsions in patients with OCD, whose obsessions or compulsions cause marked distress, are time-consuming, or interfere with social or occupational functioning
Unlabeled uses: Panic disorders, PMS, prevention of migraine, stuttering
Contraindications and Cautions
Contraindicated with hypersensitivity to any tricyclic drug, concomitant therapy with an MAOI, patients in the acute recovery phase following MI, myelography within previous 24 hr or scheduled within 48 hr, lactation.
Use cautiously with allergy to dibenzazepines, ECT, preexisting CV disorders (eg, severe coronary heart disease, progressive heart failure, angina pectoris, paroxysmal tachycardia); angle-closure glaucoma, increased IOP, urinary retention, ureteral or urethral spasm; seizure disorders; hyperthyroidism; impaired hepatic, renal function; psychiatric patients (schizophrenic or paranoid patients may exhibit a worsening of psychosis with TCA therapy); patients with bipolar disorder; elective surgery; pregnancy; lactation.
Available Forms
Capsules—25, 50, 75 mg
Dosages
Adults
Initial treatment: 25 mg PO daily; gradually increase as tolerated to approximately 100 mg during the first 2 wk. Then increase gradually over the next several weeks to a maximum dose of 250 mg/day. At maximum dose, give once a day at bedtime to minimize sedation.
Maintenance therapy: Adjust to maintain the lowest effective dosage, and periodically assess need for treatment. Effectiveness after 10 wk has not been documented.
Pediatric patients
Initial treatment: 25 mg PO daily; gradually increase as tolerated during the first 2 wk to a maximum of 3 mg/kg or 100 mg, whichever is smaller. Administer in divided doses with meals to reduce GI side effects. Then increase dosage to a daily maximum of 3 mg/kg or 200 mg, whichever is smaller. At maximum, give once a day at bedtime to minimize sedation.
Pharmacokinetics
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