Anafranil

The recommended adult dose of Anafranil (Clomipramine) ranges from 25 mg to 200 mg daily in divided doses, or as a single dose at bedtime. The dose depends on individual circumstances, but is usually started low and increased gradually as required and as prescribed by the doctor. Anafranil (Clomipramine) may be taken with or without food. Taking it with food may decrease the chance of stomach upset.

Children and adolescents (10 to 17 years old) usually begin with a dose of 25 mg daily, increasing the dose by 25 mg every 3 to 4 days as prescribed by the doctor.

When discontinuing the medication, the dosage should be reduced gradually to prevent withdrawal effects.

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take Anafranil (Clomipramine) exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store Anafranil (Clomipramine) at room temperature and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

In addition to its desired action, this medication may cause some adverse effects, notably: it may cause dryness of the mouth; it may cause constipation - to prevent this, drink plenty of water or juice, and eat more dietary fibre; it may cause drowsiness or dizziness - use caution when getting up from a lying or sitting position and use caution if driving; it may cause nausea or, rarely, vomiting; it may make your skin more sensitive to UV rays (e.g., sunlight, tanning lamps) - avoid exposure to UV rays as much as possible and protect yourself when out in the sun; it may cause weight gain, mostly with prolonged use. Each person may react differently to a treatment. If you think this medication may be causing adverse effects (including those described here, or others), talk to your health care professional. He or she can help you to determine whether or not the medication is the source of the problem.

10 mg
Each pale yellow, triangular, biconvex, film-coated tablet, engraved with "10" on one side and "CP" on the other side, contains 10 mg of Anafranil (Clomipramine). Nonmedicinal ingredients: carnauba wax, colloidal silicon dioxide, croscarmellose sodium, ferric oxide yellow, hydroxypropyl methylcellulose, lactose monohydrate, magnesium stearate, microcrystalline cellulose, polyethylene glycol, and titanium dioxide.

25 mg
Each pale yellow, round, biconvex, film-coated tablet, engraved with "25" on one side and "CP" on the other side, contains 25 mg of Anafranil (Clomipramine). Nonmedicinal ingredients: carnauba wax, colloidal silicon dioxide, croscarmellose sodium, ferric oxide yellow, hydroxypropyl methylcellulose, lactose monohydrate, magnesium stearate, microcrystalline cellulose, polyethylene glycol, and titanium dioxide.

50 mg
Each white, round, biconvex, film-coated tablet, engraved with "CP" over "50" on one side, plain on the other side, contains 50 mg of Anafranil (Clomipramine). Nonmedicinal ingredients: carnauba wax, colloidal silicon dioxide, croscarmellose sodium, hydroxypropyl methylcellulose, lactose monohydrate, magnesium stearate, microcrystalline cellulose, polyethylene glycol, and titanium dioxide.

Do not take Anafranil (Clomipramine) if you:

• are allergic to Anafranil (Clomipramine) or any ingredients of the medication
• have acute Congestive Heart Failure
• have certain blood disorders
• have Glaucoma
• have kidney or liver damage
• have recently had a Heart Attack
• have taken a MAO inhibitor such as Moclobemide or Phenelzine within 14 days

There may be an interaction between Anafranil (Clomipramine) and any of the following:

• Abiraterone acetate
• acetylsalicylic acid (Asa)
• aclidinium
• alcohol
• Alfuzosin
• Aliskiren
• alpha agonists (e.g., Clonidine, methyldopa)
• Amiodarone
• Amlodipine
• amphetamines (e.g., Dextroamphetamine, Lisdexamfetamine)
• antihistamines (e.g., cetirizine, doxylamine, Diphenhydramine, Hydroxyzine, Loratadine)
• antipsychotics (e.g., Chlorpromazine, Clozapine, Haloperidol, Olanzapine, Quetiapine, Risperidone)
• asunaprevir
• Atomoxetine
• atropine
• azelastine
• "azole" antifungals (e.g., fluconazole, itraconazole, ketoconazole)
• barbiturates (e.g., butalbital, pentobarbital, Phenobarbital)
• belladonna
• benzodiazepines (e.g., Diazepam, Lorazepam)
• Benztropine
• beta-2 agonists (e.g., salbutamol, formoterol, terbutaline)
• blood pressure medications
• botulinum toxin
• brimonidine
• Bromocriptine
• Buprenorphine
• Bupropion
• Buspirone
• Cabergoline
• Captopril
• Carvedilol
• Celecoxib
• chloral hydrate
• chloroquine
• Cinacalcet
• clonidine
• Cobicistat
• Cyproterone
• Dabrafenib
• Darifenacin
• Deferasirox
• Desmopressin
• Dextromethorphan
• Disopyramide
• dofetilide
• Domperidone
• Donepezil
• Dronedarone
• efavirenz
• Entacapone
• Enzalutamide
• Epinephrine
• ergot alkaloids (e.g., ergotamine, Dihydroergotamine)
• Flavoxate
• Flecainide
• Galantamine
• general anesthetics (medications used to put people to sleep before surgery)
• Glucagon
• glycopyrrolate
• grapefruit juice
• Guanfacine
• HIV protease inhibitors (e.g., atazanavir, indinavir, ritonavir, saquinavir)
• ipratropium
• levodopa
• Linezolid
• lithium
• macrolide antibiotics (e.g., clarithromycin, erythromycin)
• Methadone
• methoxsalen
• methylene blue
• Methylphenidate
• Metoclopramide
• Mexiletine
• mifepristone
• Mirabegron
• Mirtazapine
• monoamine oxidase inhibitors (M.O.S. e.g., moclobemide, Rasagiline, Selegiline, Tranylcypromine)
• muscle relaxants (e.g., Baclofen, Cyclobenzaprine, methocarbamol, orphenadrine)
• Nabilone
• narcotic pain relievers (e.g., Codeine, Fentanyl, Morphine, Oxycodone)
• nefazodone
• nonsteroidal anti-inflammatory drugs (NSAIDS; e.g., Ibuprofen, Naproxen)
• norepinephrine
• Oxybutynin
• phenylephrine
• potassium chloride
• Pramipexole
• pramlintide
• Primaquine
• procainamide
• quinidine
• quinine
• quinolone antibiotics (e.g., ciprofloxacin, Ofloxacin)
• rifabutin
• rifampin
• Rivastigmine
• Ropinirole
• Rotigotine
• scopolamine
• secretin
• seizure medications (e.g., Carbamazepine, Clobazam, Levetiracetam, phenobarbital, Phenytoin, primidone, Topiramate, Valproic acid, zonisamide)
• serotonin antagonists (e.g., Granisetron, Ondansetron)
• serotonin/norepinephrine reuptake inhibitors (SNRIs; e.g., Desvenlafaxine, Duloxetine, Venlafaxine)
• selective serotonin reuptake inhibitors (SSRIs; e.g., Citalopram, Fluoxetine, Paroxetine, Sertraline)
• St. John's wort
• sulfonylureas (e.g., Gliclazide, Glyburide, Tolbutamide)
• terbinafine
• thalidomide
• thiazide diuretics (water pills; e.g., Hydrochlorothiazide, Indapamide, Metolazone)
• thyroid replacements (e.g., desiccated thyroid, Levothyroxine)
• tiotropium
• Tolterodine
• Tramadol
• Trazodone
• other tricyclic antidepressants (e.g., Amitriptyline, Desipramine, Imipramine)
• "triptan" migraine medications (e.g., Eletriptan, Sumatriptan)
• Tryptophan
• tyrosine kinase inhibitors (e.g., Bortezomib, imatinib, Lapatinib, Pazopanib, Sunitinib)
• umeclidinium
• Warfarin
• Yohimbine
• Zolpidem
• Zopiclone

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than the ones listed above may interact with Anafranil (Clomipramine). Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications that you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Anafranil (Clomipramine).

Contact lens wearers: People who wear contact lenses should be cautious, as Anafranil (Clomipramine) may decrease tear production in the eye, thereby increasing the chance of eye damage for those wearing contact lenses.

Dental effects: Lengthy treatment with Anafranil (Clomipramine) may lead to more dental cavities as a result of Dry Mouth. You should have regular dental checkups and practice good dental hygiene while taking Anafranil (Clomipramine).

Drowsiness/reduced alertness: Since Anafranil (Clomipramine) may cause drowsiness, especially at the beginning of treatment, be careful when engaging in activities requiring mental alertness, judgment, and physical coordination such as driving or operating machinery.

Glaucoma: Anafranil (Clomipramine) may cause the symptoms of glaucoma (increased pressure in the eye) to become worse. If you have glaucoma, discuss with your doctor how Anafranil (Clomipramine) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Anafranil (Clomipramine), and whether any special monitoring is needed. Report any changes in vision to your doctor as soon as possible while you are taking Anafranil (Clomipramine).

Heart disease: People who are at risk of heart attack or Stroke may be more likely to experience heart problems when taking Anafranil (Clomipramine). If you have been told that you have an increased risk of heart attack or stroke, discuss with your doctor how Anafranil (Clomipramine) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Anafranil (Clomipramine), and whether any special monitoring is needed.

Heart rhythm: Anafranil (Clomipramine) can cause changes to the normal rhythm of the heart, including an irregular heartbeat called QT prolongation. QT prolongation can cause fainting, seizures, and sudden death. If you are at risk for heart rhythm problems (e.g., people with heart failure, Angina, low potassium or magnesium levels), discuss with your doctor how Anafranil (Clomipramine) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Anafranil (Clomipramine), and whether any special monitoring is needed.

Neuroleptic malignant syndrome (NMS): Anafranil (Clomipramine) may contribute to a potentially fatal syndrome known as neuroleptic malignant syndrome (NMS), when it is taken in combination with certain other medications. If you notice the symptoms of NMS such as high Fever, muscle stiffness, confusion or loss of consciousness, sweating, racing or irregular heartbeat, or fainting, get immediate medical attention.

Orthostatic hypotension (dizziness upon arising): Move slowly when rising from a sitting or lying down position, as Anafranil (Clomipramine) can cause sudden temporary Low Blood Pressure resulting in dizziness.

Seizures: There have been occasional reports of seizures occurring with Anafranil (Clomipramine). Seizures are more likely to occur when higher doses of Anafranil (Clomipramine) are taken. If you have a history of Epilepsy or medical conditions that increase the risk of seizures, discuss with your doctor how Anafranil (Clomipramine) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Anafranil (Clomipramine), and whether any special monitoring is needed.

Suicidal or agitated behaviour: People taking antidepressants such as Anafranil (Clomipramine) may feel agitated (restless, anxious, aggressive, emotional, trouble sleeping, and feeling not like themselves), or they may want to hurt themselves or others. If you notice any changes in mood, behaviours, thoughts, or feelings in yourself or someone who is taking Anafranil (Clomipramine), contact a doctor immediately. Your doctor will monitor you closely for behaviour changes, especially at start of treatment or when your dose is increased or decreased.

Thyroid disease: People who have an overactive thyroid gland are at an increased risk of developing an irregular heartbeat while taking Anafranil (Clomipramine). If you have been diagnosed as having an overactive thyroid, discuss with your doctor how Anafranil (Clomipramine) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Anafranil (Clomipramine), and whether any special monitoring is needed.

Urinary problems: Anafranil (Clomipramine) may cause urinary retention (difficulty urinating). If you have urinary tract problems, these symptoms may become worse. Discuss with your doctor how Anafranil (Clomipramine) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Anafranil (Clomipramine), and whether any special monitoring is needed.

Withdrawal: Withdrawal symptoms such as dizziness, nausea, headache, and sleep disturbance have occurred when Anafranil (Clomipramine) is stopped suddenly. This is not a sign of addiction. Do not suddenly stop taking Anafranil (Clomipramine). If you are supposed to stop taking Anafranil (Clomipramine), contact your doctor, who will advise you on how to gradually reduce the dose.

Pregnancy: The safety of Anafranil (Clomipramine) for use by pregnant women has not been established. It should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking Anafranil (Clomipramine), contact your doctor immediately.

Breast-feeding: Anafranil (Clomipramine) passes into breast milk. If you are a breast-feeding mother and are taking Anafranil (Clomipramine), it may affect your baby. Talk to your doctor about whether you should continue breast-feeding, or whether you should gradually withdraw the medication.

Children: Anafranil (Clomipramine) has not been studied for use by people under 10 years of age, and specific recommendations for its use by this age group cannot be provided. The long-term effects of Anafranil (Clomipramine) on childhood growth and development have not been determined.

Seniors: Seniors may be more at risk of side effects from Anafranil (Clomipramine) and may need to take lower doses.

This medication is typically used only once a day. However, your pharmacist may have suggested a different schedule that is more appropriate for you. Take it regularly and continuously to maintain its beneficial effects. It is not advisable to stop using this product suddenly, particularly if you have been on it for several weeks. If you are considering stopping the medication, talk to your pharmacist first. This medication may irritate the stomach, and should be taken with food. It is best to avoid coffee, spicy food or alcohol. Consuming alcohol may intensify the effect of this product. If you choose to drink alcohol, do so in moderation. Talk to your health care professional to find out exactly how much alcohol you can drink.