Brand name:
Clopress (Anafranil, Clomipramine)
Pronounced: an-AF-ran-il
Generic name: Clomipramine hydrochloride
Why is Clopress (Anafranil, Clomipramine) prescribed?
Clopress (Anafranil, Clomipramine), a chemical cousin of tricyclic antidepressant medications
such as Tofranil and Elavil, is used to treat people who suffer from
obsessions and compulsions.
An obsession is a persistent, disturbing idea, image, or urge that
keeps coming to mind despite the person's efforts to ignore or forget
it--for example, a preoccupation with avoiding contamination.
A compulsion is an irrational action that the person knows is senseless
but feels driven to repeat again and again--for example, hand-washing
perhaps dozens or even scores of times throughout the day.
Most important fact about Clopress (Anafranil, Clomipramine)
Serious, even fatal, reactions have been known to occur when drugs
such as Clopress (Anafranil, Clomipramine) are taken along with drugs known as MAO inhibitors.
Drugs in this category include the antidepressants Nardil and Parnate.
Never take Clopress (Anafranil, Clomipramine) with one of these drugs.
How should you take Clopress (Anafranil, Clomipramine)?
Take Clopress (Anafranil, Clomipramine) with meals, at first, to avoid stomach upset. After
your regular dosage has been established, you can take 1 dose at bedtime
to avoid sleepiness during the day. Always take it exactly as prescribed.
This medicine may cause dry mouth. Hard candy, chewing gum, or bits
of ice may relieve this problem.
If you miss a dose...
If you take 1 dose at bedtime, consult your doctor. Do not take the
missed dose in the morning. If you take 2 or more doses a day, take
the missed dose as soon as you remember. If it is almost time for your
next dose, skip the one you missed and go back to your regular schedule.
Do not take 2 doses at the same time.
Storage instructions Clopress (Anafranil, Clomipramine)
Store at room temperature in a tightly closed container, away from
moisture.
Clopress (Anafranil, Clomipramine) side effects
Side effects cannot be anticipated. If any develop or change in intensity,
inform your doctor as soon as possible. Only your doctor can determine
if it is safe for you to continue taking Clopress (Anafranil, Clomipramine).
The most significant risk is that of seizures (convulsions). Headache,
fatigue, and nausea can be a problem. Men are likely to experience
problems with sexual function. Unwanted weight gain is a potential
problem for many people who take Clopress (Anafranil, Clomipramine), although a small number
actually lose weight.
* Side effects may include:
Constipation, dizziness, dry mouth, impotence, increased appetite, increased
sweating, indigestion, libido changes, nausea, nervousness, sleepiness, tremor,
twitching, visual changes, weight gain, weight loss
Why should Clopress (Anafranil, Clomipramine) not be prescribed?
Do not take Clopress (Anafranil, Clomipramine) if you are sensitive to or have ever had an
allergic reaction to a tricyclic antidepressant such as Tofranil, Elavil,
or Tegretol.
Be sure to avoid Clopress (Anafranil, Clomipramine) if you are taking, or have taken within
the past 14 days, an MAO inhibitor such as the antidepressants Parnate
or Nardil. Combining Clopress (Anafranil, Clomipramine) with one of these medications could
lead to fever, seizures, coma, and even death.
Do not take Clopress (Anafranil, Clomipramine) if you have recently had a heart attack.
Special warnings about Clopress (Anafranil, Clomipramine)
This drug should be used with caution in children with depression.
In clinical studies, antidepressants increased the risk of suicidal
thinking and behavior in children and adolescents with depression and
other psychiatric disorders. Anyone considering the use of Clopress (Anafranil, Clomipramine)
or any other antidepressant in a child or adolescent must balance this
risk with the clinical need. In children, Clopress (Anafranil, Clomipramine) is only approved
to treat obsessive-compulsive disorder.
Additionally, the progression of major depression is associated with
a worsening of symptoms and/or the emergence of suicidal thinking or
behavior in both adults and children, whether or not they are taking
antidepressants. Individuals being treated with Clopress (Anafranil, Clomipramine) and their
caregivers should watch for any change in symptoms or any new symptoms
that appear suddenly--especially agitation, anxiety, hostility, panic,
restlessness, extreme hyperactivity, and suicidal thinking or behavior--and
report them to the doctor immediately. Be especially observant at the
beginning of treatment or whenever there is a change in dose.
If you have narrow-angle glaucoma (increased pressure in the eye)
or are having difficulty urinating, Clopress (Anafranil, Clomipramine) could make these conditions
worse. Use Clopress (Anafranil, Clomipramine) with caution if your kidney function is not normal.
If you have a tumor of the adrenal gland, Clopress (Anafranil, Clomipramine) could cause your
blood pressure to rise suddenly and dangerously.
Because Clopress (Anafranil, Clomipramine) poses a possible risk of seizures, and because it
may impair mental or physical ability to perform complicated tasks,
your doctor will probably warn you to take special precautions if you
need to drive a car, operate complicated machinery, or take part in
activities such as swimming or climbing, in which suddenly losing consciousness
could be dangerous. Note that your risk of seizures is increased:
* If you have ever had a seizure
* If you have a history of brain damage or alcoholism
* If you are taking another medication that might predispose you to seizures
As with Tofranil, Elavil, and other tricyclic antidepressants, an
overdose of Clopress (Anafranil, Clomipramine) can be fatal. Do not be surprised if your doctor
prescribes only a small quantity of Clopress (Anafranil, Clomipramine) at a time. This is standard
procedure to minimize the risk of overdose.
Clopress (Anafranil, Clomipramine) may cause your skin to become more sensitive to sunlight.
Avoid prolonged exposure to sunlight.
Before having any kind of surgery involving the use of general anesthesia,
tell your doctor or dentist that you are taking Clopress (Anafranil, Clomipramine). You may
be advised to discontinue the drug temporarily.
When it is time to stop taking Clopress (Anafranil, Clomipramine), do not stop abruptly. Your
doctor will have you taper off gradually to avoid withdrawal symptoms
such as dizziness, fever, general feeling of illness, headache, high
fever, irritability or worsening emotional or mental problems, nausea,
sleep problems, vomiting.
Possible food and drug interactions when taking Clopress (Anafranil, Clomipramine)
Avoid alcoholic beverages while taking Clopress (Anafranil, Clomipramine).
If Clopress (Anafranil, Clomipramine) is taken with certain other drugs, the effects of either
could be increased, decreased, or altered. It is especially important
to check with your doctor before combining Clopress (Anafranil, Clomipramine) with the following:
Antipsychotic drugs such as Haldol and chlorpromazine
Barbiturates such as phenobarbital
Certain blood pressure drugs such as Ismelin and Catapres-TTS
Cimetidine (Tagamet)
Digoxin (Lanoxin)
Drugs that ease spasms, such as Donnatal, Cogentin, and Bentyl
Flecainide (Tambocor)
Methylphenidate (Ritalin)
MAO inhibitors such as Nardil and Parnate
Phenytoin (Dilantin)
Propafenone (Rythmol)
Quinidine (Quinidex)
Serotonin-boosting drugs such as the antidepressants Luvox, Paxil,
Prozac and Zoloft
Thyroid medications such as Synthroid
Tranquilizers such as Xanax and Valium
Warfarin (Coumadin)
Special information if you are pregnant or breastfeeding
If you are pregnant or plan to become pregnant, inform your doctor
immediately. Clopress (Anafranil, Clomipramine) should not be used during pregnancy unless absolutely
necessary; some babies born to women who took Clopress (Anafranil, Clomipramine) have had withdrawal
symptoms such as jitteriness, tremors, and seizures. Clopress (Anafranil, Clomipramine) appears
in breast milk. Your doctor may advise you to stop breastfeeding while
you are taking Clopress (Anafranil, Clomipramine).
Recommended dosage for Clopress (Anafranil, Clomipramine)
ADULTS
Overdosage
An overdose of Clopress (Anafranil, Clomipramine) can be fatal. If you suspect an overdose,
seek medical attention immediately.
* Critical signs and symptoms of Clopress (Anafranil, Clomipramine) overdose may include:
Impaired brain activity (including coma), irregular heartbeat, seizures, severely
low blood pressure
* Other signs and symptoms of overdosage may include:
Agitation, bluish skin color, breathing difficulty, delirium, dilated pupils,
drowsiness, high fever, incoordination, little or no urine output, muscle
rigidity, overactive reflexes, rapid heartbeat, restlessness, severe perspiration,
shock stupor, twitching or twisting movements, vomiting
