Generic name: Clomipramine

Why is this medication prescribed?
Clomipramine is used to treat patients with obsessive-compulsive disorder.

This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

How should this medicine be used?
Clomipramine comes as a capsule to take by mouth. It usually is taken one to three times a day with meals or once a day at bedtime. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take clomipramine exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Continue to take clomipramine even if you feel well. Do not stop taking clomipramine without talking to your doctor, especially if you have taken large doses for a long time. Your doctor probably will decrease your dose gradually. This drug must be taken regularly for a few weeks before its full effect is felt.

What special precautions should I follow?
Before taking clomipramine,

• tell your doctor and pharmacist if you are allergic to clomipramine or any other drugs.
• tell your doctor and pharmacist what prescription and nonprescription medications you are taking, especially MAO inhibitors [phenelzine (Nardil) or tranylcypromine (Parnate)], even if you stopped taking them in the last 2 weeks; anticoagulants ('blood thinners') such as warfarin (Coumadin); benztropine (Cogentin); cimetidine (Tagamet); clonidine (Catapres); dicyclomine (Bentyl); digoxin (Lanoxin); disulfiram; flecainide (Tambocor); guanethidine (Ismelin); haloperidol (Haldol); levodopa (Sinemet, Dopar); medications for nausea, dizziness, or schizophrenia; oral contraceptives; propafenone (Rythmol); quinidine (Quinidex); secobarbital (Seconal); sedatives; selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine (Prozac, Sarafem), sertraline (Zoloft), and paroxetine (Paxil); tranquilizers; trihexyphenidyl (Artane); and vitamins. You must wait at least 5 weeks after stopping to take fluoxetine before beginning to take clomipramine.
• tell your doctor if you have or have ever had a heart attack, seizures, problems with your urinary system or prostate, glaucoma, irregular heartbeat, problems with your blood pressure, thyroid problems, or heart, kidney, or liver disease.
• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking clomipramine, call your doctor.
• if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking clomipramine.
• you should know that this drug may make you drowsy. Do not drive a car or operate machinery until you know how this drug affects you.
• remember that alcohol can add to the drowsiness caused by this drug.
• tell your doctor if you use tobacco products. Cigarette smoking may decrease the effectiveness of this drug.
• plan to avoid unnecessary or prolonged exposure to sunlight and to wear protective clothing, sunglasses, and sunscreen. Clomipramine may make your skin sensitive to sunlight.

What special dietary instructions should I follow?
Clomipramine may cause an upset stomach. Take clomipramine with food or milk.

What should I do if I forget a dose?
If you take clomipramine several times a day, take the missed dose as soon as you remember it and take any remaining doses for that day at evenly spaced intervals. However, if you remember a missed dose when it is almost time for your next scheduled dose, skip the missed dose.

If you take clomipramine once a day at bedtime and do not remember it until the next morning, skip the missed dose. Do not take a double dose to make up for a missed one.

What side effects can this medication cause?
Although side effects from clomipramine are not common, they can occur. Tell your doctor if any of these symptoms are severe or do not go away:

• drowsiness
• dry mouth
• upset stomach
• vomiting
• diarrhea
• constipation
• nervousness
• decreased sexual ability
• decreased memory or concentration
• headache
• stuffy nose
• change in appetite or weight

If you experience any of the following symptoms, call your doctor immediately:

• tremor
• seizures
• fast, irregular, or pounding heartbeat
• difficulty urinating or loss of bladder control
• depression
• delusions or hallucinations
• eye pain
• shakiness
• difficulty breathing or fast breathing
• severe muscle stiffness
• unusual tiredness or weakness

What storage conditions are needed for this medicine?
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

In case of emergency/overdose
In case of overdose, call your local poison controlcenter at 1-800-222-1222. If the victim has collapsedor is not breathing, call local emergency services at911.

What other information should I know?
Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your response to clomipramine.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.