Anafranil

Anafranil Drug Information

• Anafranil Overview

  Clomipramine is used to treat obsessive compulsive disorder (OCD). It helps decrease persistent/unwanted thoughts (obsessions), and it helps reduce the urge to perform repeated tasks (compulsions such as hand-washing, counting, checking) that interfere with daily living. Anafranil belongs to a class of medications called tricyclic antidepressants. It works by restoring the balance of certain natural substances (serotonin, among others) in the brain.

• Anafranil Warnings

  Antidepressant medications are used to treat a variety of conditions, including depression and other mental/mood disorders. These medications can help prevent suicidal thoughts/attempts and provide other important benefits. However, studies have shown that a small number of people (especially people younger than 25) who take antidepressants for any condition may experience worsening depression, other mental/mood symptoms, or suicidal thoughts/attempts. Therefore, it is very important to talk with the doctor about the risks and benefits of antidepressant medication (especially for people younger than 25), even if treatment is not for a mental/mood condition. Tell the doctor right away if you notice worsening depression/other psychiatric conditions, unusual behavior changes (including possible suicidal thoughts/attempts), or other mental/mood changes (including new/worsening anxiety, panic attacks, trouble sleeping, irritability, hostile/angry feelings, impulsive actions, severe restlessness, very rapid speech). Be especially watchful for these symptoms when a new antidepressant is started or when the dose is changed.

• How to Use Anafranil

  Read the Medication Guide provided by your pharmacist before you start taking clomipramine and each time you get a refill. If you have any questions, ask your doctor or pharmacist. Take Anafranil by mouth with or without food as directed by your doctor. To lessen side effects such as stomach upset, clomipramine may be started at a low dose, given in several doses during the day with meals, and slowly increased as your body gets used to it. After you have reached the best dose for you, the total dose can be taken once daily, usually at bedtime to prevent daytime drowsiness or as directed by your doctor. Follow your doctor's instructions carefully. Do not take more or less medication or take it more frequently than prescribed. Your condition will not improve any faster and your risk of side effects such as seizures may be increased. Dosage of Anafranil is based on your medical condition and response to therapy. Avoid eating grapefruit or drinking grapefruit juice while being treated with Anafranil unless your doctor instructs you otherwise. Grapefruit can increase the amount of certain medications in your bloodstream. Consult your doctor or pharmacist for more details. Use Anafranil regularly in order to get the most benefit from it. Continue to take it even if you feel well. To help you remember, use it at the same time(s) each day. Do not suddenly stop taking Anafranil without consulting your doctor. Some conditions may become worse when the drug is abruptly stopped. You may experience sweating, dizziness, nausea, vomiting, headache, or irritability if you suddenly stop taking Anafranil. Your dose may need to be gradually decreased. It may take 2 to 3 weeks or longer before the full effects of Anafranil are noticed. Inform your doctor if your condition persists or if it worsens.

• Anafranil Precautions

  Before taking clomipramine, tell your doctor or pharmacist if you are allergic to it; or to other tricyclic antidepressants (e.g., imipramine, nortriptyline); or if you have any other allergies. Anafranil may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details. Before using Anafranil, tell your doctor or pharmacist your medical history,blood problems (e.g., purpura, thrombocytopenia), breathing problems (e.g., asthma, chronic bronchitis), personal or family history of glaucoma (angle-closure type), eating disorders (e.g., bulimia), heart problems (e.g., arrhythmias, coronary artery disease, recent heart attack), intestinal problems (e.g., chronic constipation, ileus), liver problems, kidney problems, personal or family history of other mental/mood conditions (e.g., bipolar disorder, schizophrenia), history of hospitalization for a very serious reaction to certain medications (neuroleptic malignant syndrome), heartburn/stomach acid in the esophagus (e.g., due to hiatal hernia), seizures, overactive thyroid (hyperthyroidism), trouble urinating (urinary retention, enlarged prostate), any condition that may increase your risk of seizures (e.g., alcohol/sedative dependency, use of electroconvulsive therapy, brain injury/disease), certain types of tumors (e.g., pheochromocytoma, neuroblastoma). Clomipramine may cause a condition that affects the heart rhythm (QT prolongation). QT prolongation can rarely cause serious (rarely fatal) fast/irregular heartbeat and other symptoms (such as severe dizziness, fainting) that need medical attention right away. The risk of QT prolongation may be increased if you have certain medical conditions or are taking other drugs that may cause QT prolongation. Before using clomipramine,certain heart problems (heart failure, slow heartbeat, QT prolongation in the EKG), family history of certain heart problems (QT prolongation in the EKG, sudden cardiac death). Low levels of potassium or magnesium in the blood may also increase your risk of QT prolongation. This risk may increase if you use certain drugs (such as diuretics/"water pills") or if you have conditions such as severe sweating, diarrhea, or vomiting. Talk to your doctor about using clomipramine safely. Anafranil may make you dizzy or drowsy or temporarily blur your vision. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness or clear vision until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis). To decrease dizziness and lightheadedness, get up slowly when rising from a seated or lying position. Before having surgery, tell your doctor or dentist that you are taking Anafranil. Caution is advised when using Anafranil in children who participate in active sports because it may increase the risk of heart problems. (See also the Warning section.) Older adults may be more sensitive to the side effects of Anafranil, especially bleeding, confusion, dizziness, and QT prolongation (see above). Dizziness and confusion can increase the risk of falling. Older adults may also be more likely to develop low sodium in the blood, especially if they are taking water pills (diuretics). Anafranil should be used only when clearly needed during pregnancy. Newborns exposed to clomipramine during pregnancy may experience withdrawal symptoms or side effects. Tell your doctor right away if you notice jitteriness, shaking, feeding problems, fast breathing, or seizures in your newborn. Since untreated mental/mood problems (such as obsessive compulsive disorder, depression, panic attack) can be a serious condition, do not stop taking Anafranil unless directed by your doctor. If you are planning pregnancy, become pregnant, or think you may be pregnant, immediately discuss with your doctor the benefits and risks of using Anafranil during pregnancy. Anafranil passes into breast milk and may have undesirable effects on a nursing infant. Consult your doctor before breast-feeding.

• Anafranil Misdose

  If you miss a dose of Anafranil, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

• Anafranil Interactions

  See also the How to Use section. Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.anticholinergics (e.g., atropine, belladonna alkaloids, scopolamine), certain drugs for high blood pressure (e.g., clonidine, guanethidine), cisapride, digoxin, thyroid supplements, valproic acid, drugs that can cause bleeding/bruising (for example, "blood thinners" such as warfarin/heparin, anti-platelet drugs including aspirin or NSAIDs such as ibuprofen). Taking MAO inhibitors with Anafranil may cause a serious (possibly fatal) drug interaction. Avoid taking MAO inhibitors (isocarboxazid, linezolid, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, safinamide, selegiline, tranylcypromine) during treatment with Anafranil. Most MAO inhibitors should also not be taken for two weeks before and after treatment with Anafranil. Ask your doctor when to start or stop taking Anafranil. The risk of serotonin syndrome/toxicity increases if you are also taking other drugs that increase serotonin. Examples include street drugs such as MDMA/"ecstasy," St. John's wort, certain antidepressants (including SSRIs such as fluoxetine/paroxetine, SNRIs such as duloxetine/venlafaxine), among others. The risk of serotonin syndrome/toxicity may be more likely when you start or increase the dose of these drugs. Many drugs besides clomipramine may affect the heart rhythm (QT prolongation), including amiodarone, dofetilide, quinidine, sotalol, pimozide, procainamide, macrolide antibiotics (such as erythromycin), among others. Therefore, before using clomipramine, report all medications you are currently using to your doctor or pharmacist. Other medications can affect the removal of clomipramine from your body, which may affect how clomipramine works. Examples include artemether/lumefantrine, barbiturates (such as phenobarbital), cimetidine, haloperidol, certain drugs for heart rhythm (such as flecainide/propafenone), certain HIV protease inhibitors (such as fosamprenavir), phenothiazines (such as thioridazine), certain anti-seizure drugs (such as phenytoin), terbinafine. Tell your doctor or pharmacist if you are taking other products that cause drowsiness including alcohol, marijuana (cannabis), antihistamines (such as cetirizine, diphenhydramine), drugs for sleep or anxiety (such as alprazolam, diazepam, zolpidem), muscle relaxants (such as carisoprodol, cyclobenzaprine), and narcotic pain relievers (such as codeine, hydrocodone). Check all prescription and nonprescription medicine labels carefully since many medications contain pain relievers/fever reducers (NSAIDs such as aspirin, ibuprofen, naproxen) that, if taken together with Anafranil, may increase your risk for bleeding. Low-dose aspirin, as prescribed by your doctor for specific medical reasons such as heart attack or stroke prevention (usually at dosages of 81-325 milligrams per day), should be continued. Consult your doctor or pharmacist for more details. Check the labels on all your medicines (e.g., cough-and-cold products) because they may contain drowsiness-containing ingredients or decongestants that could increase your heart rate or blood pressure. Ask your pharmacist about the safe use of those products. Cigarette smoking decreases blood levels of Anafranil. Tell your doctor if you smoke or if you have recently stopped smoking.

• Anafranil Side Effects

  What are Anafranil side effects?

  Side effects are physical, mental or emotional symptoms which occur in addition to or outside of the desired effect of a therapeutic treatment such as an over-the-counter or prescribed drug or medication. Side effects from Anafranil may occur at the beginning or at the end of treatment and may also depend on the length of time an individual remains on the treatment. Side effects, also known as adverse effects, are generally more likely to occur when starting treatment. Individuals may also experience side effects from Anafranil as a result of an interaction with other medications.

  Side Effects of Anafranil

  The side effects of Anafranil may vary in number and intensity for many different reasons. Factors such as age, weight, gender and ethnicity may influence the side effects of Anafranil. Also, an individual’s state of general physical health and seriousness of the disease or illness as well as an increase or decrease in dosage may lead to side effects. Further, side effects from Anafranil may also occur as a result of an interaction with certain herbal supplements, foods or drinks.

  Prescription drug side effects can be serious and may cause patients to stop the treatment. However, when side effects from the use of a prescription drug, such as Anafranil, do occur a patient should consult their physician. A physician may prescribe an additional treatment in order to control the symptoms or an adjustment in the dosage may be made. In addition, changes to diet, exercise or other lifestyle activities may help to lessen the side effects of Anafranil.

  By understanding side effects and the factors which may influence the occurrence of side effects patients are empowered to take an active role in their care. Patients who have specific questions about the side effects of Anafranil, or any other medication, should contact their physician. General information about Anafranil and the side effects associated with Anafranil are described in the following:

  Common Anafranil Side Effects

  Severe

  • myoclonus

  Less Severe

  • visual changes
  • xerostomia
  • dyspepsia
  • constipation
  • erectile dysfunction
  • drowsy
  • dizziness
  • insomnia
  • fatigue
  • dysgeusia
  • anorexia
  • weight gain
  • increased appetite
  • headache disorder
  • nausea

  Less Frequent Anafranil Side Effects

  Severe

  • acute confusion
  • abnormal sexual function
  • bradycardia
  • cardiac arrhythmia
  • hypotension
  • hallucinations
  • tremor
  • dysuria
  • nervousness
  • abnormal hepatic function tests

  Less Severe

  • symptoms of anxiety
  • orthostatic hypotension
  • pharyngitis
  • rhinitis
  • irregular menstrual periods
  • myalgias
  • memory impairment
  • hyperhidrosis
  • paresthesia
  • flushing
  • vomiting
  • heartburn
  • flatulence
  • diarrhea
  • acute abdominal pain
  • tachycardia
  • disturbance in thinking
  • vertigo

  Rare or Very Rare Anafranil Side Effects

  Severe

  • paralytic ileus
  • purpura
  • agranulocytosis
  • suicidal ideation
  • tinnitus
  • epididymitis
  • gynecomastia
  • galactorrhea not associated with childbirth
  • skin photosensitivity
  • allergic dermatitis
  • pruritus of skin
  • alopecia
  • seizure disorder
  • skin rash
  • kidney stone
  • secondary angle-closure glaucoma
  • serotonin syndrome
  • abnormal ECG
  • delusional disorder
  • drug-induced psychosis
  • paranoid disorder
  • hypomania
  • manic disorder
  • leukopenia
  • anemia
  • thrombocytopenic disorder
  • pancytopenia
  • pharyngeal edema
  • DRESS syndrome
  • prolonged QT interval
  • hypokalemia
  • hypothyroidism
  • ovarian cyst
  • hyponatremia

  Less Severe

  • increased urinary frequency
  • dysmenorrhea
  • dry eye
  • sinusitis
  • fever
  • mydriasis
  • polyuria
  • disorder of prostate
  • urinary incontinence
  • menorrhagia

• Anafranil Storage

  Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets. Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard Anafranil when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.