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INTRODUCTION
CLOFRANIL 25MG TABLET contains Clomipramine which belongs to the group of medicines called Antidepressants. It is used to depression, obsessive compulsive disorder (OCD), phobias (fear) and collapse (cataplexy) associated with narcolepsy (a sleep disorder).
Before taking CLOFRANIL 25MG TABLET inform your doctor if you have any liver, kidney or heart problems. You must also inform your doctor if you have low blood pressure, problems in adrenal gland or thyroid gland, brain injury, history of fits, or any other mental illnesses apart from depression and OCD (such as mania, schizophrenia, anxiety etc).
CLOFRANIL 25MG TABLET is not recommended for use in pregnant or breastfeeding women unless considered necessary by the physician. Avoid drinking grapefruit juice or cranberry juice while taking CLOFRANIL 25MG TABLET as it may increase the risk of side effects.
The most common side effects of taking CLOFRANIL 25MG TABLET are headache, dizziness, tiredness, nausea, vomiting, stomach upset, dry mouth, constipation, diarrhea, increased sweating, low sex drive, inability to maintain an erection, muscle twitching and problems in sleeping. Consult your doctor if any of these side effect worsens.
You must also inform your doctor if you experience any unusual behaviours (such as anxiety, panic attacks, difficulty in sleeping, irritability, restlessness) or worsening of depression, suicidal thoughts or behaviour after taking CLOFRANIL 25MG TABLET.
USES OF CLOFRANIL 25MG TABLET
It is used to treat:
- Depression
- Obsessive Compulsive Disorder (OCD)
- Fear (phobias)
- Cataplexy (collapse associated with narcolepsy)
HOW CLOFRANIL 25MG TABLET WORKS
CLOFRANIL 25MG TABLET is a tricyclic antidepressant. It works by increasing the levels of certain chemicals within the brain (such as serotonin and norepinephrine) that controls mood and mental health. As a result, it elevates mood and makes you feel active and energetic. It also reduces unwanted obsessive thoughts or fears and stops the attacks of cataplexy and sleep paralysis.
DIRECTIONS FOR USE
Take CLOFRANIL 25MG TABLET as advised by your physician. Swallow the medicine with a glass of water. Do not cursh or chew the medicine.
Your doctor will decide the correct dose and duration of therapy for you depending upon your age, body weight and disease condition.
Do not stop taking CLOFRANIL 25MG TABLET without consulting your doctor as it may lead to withdrawal symptoms such as nausea, vomiting, stomach pain, diarrhoea, lack of sleep, headache, nervousness and/or anxiety.
SIDE EFFECTS OF CLOFRANIL 25MG TABLET
COMMON
- headache, dizziness, tiredness, sleepiness
- nausea, vomiting, stomach upset
- increased hunger, weight gain
- dry mouth, constipation, diarrhea
- increased sweating, fast heart rate
- feeling lightheaded while standing up
- feeling shaky, restless or anxious
- low sex drive, inability to maintain an erection
- muscle twitching
- increase in blood sugar levels
- changes in the amount of urine produced
- speech problems
- problems in sleeping, nightmares
- feeling sad or depressed, memory problems
- breast enlargement and milk flow
- numbness or tingling in the arms and legs
- ringing in the ears (tinnitus)
UNCOMMON
- clumsiness and lack of coordination
RARE
- vaginal bleeding
Stop taking CLOFRANIL 25MG TABLET and contact your doctor immediately if you experience any of the following side effects:
- signs of serotonin syndrome (feeling agitated, hallucinations, confusion, loss of consciousness, fast heartbeat, feeling dizzy, increased sweating, flushing, tremors, stiff muscles, or muscle twitching, loss of coordination, nausea, vomiting, diarrhea or seizures)
- worsening of depression, suicidal thoughts or behavior
- behavioural changes (such as feeling excited anxiety, panic attacks, difficulty in sleeping, irritability, hallucinations, restlessness)
- difficulty in passing urine
- signs of allergic reactions (such as skin rash, swelling of the hands, face, tongue, neck or throat, increased fluid in tissues, fast heart rate, difficulty in breathing)
- signs of Neuroleptic malignant syndrome (such as high fever, rigid muscles, mood swings, fast or irregular heartbeat, changes in blood pressure, increased sweating)
- increased infections, fever, chills, sore throat, mouth ulcers
- signs of liver problems (such as nausea, vomiting, generally feel unwell, loss of appetite, fever, yellowing of the skin or whites of the eyes, light coloured stools and dark-coloured urine)
- signs of low blood potassium levels (such as shortness of breath, irregular heartbeat and fainting)
- low blood sodium levels (causing headache, nausea, difficulty in concentration, memory impairment, confusion, feeling weak or unsteady, hallucinations, fainting or seizures)
- sever muscle pain and damage
HOW TO MANAGE SIDE EFFECTS
Nausea or vomiting:
Take this medicine with, or just after meals. Stick to simple meals. Avoid eating rich or spicy food. Contact your doctor if nausea worsens.
Constipation:
Eat plenty of fibre rich foods such as fresh fruits, vegetables, and cereals and drink plenty of water. Exercise regularly. Contact your doctor if constipation persists.
Diarrhoea:
Drink fluids, such as water or fruit juice in enough quantity to keep yourself hydrated. Don’t take any medicine on your own for treating diarrhoea without talking to your doctor. Contact your doctor if diarrhoea worsen.
Loss of appetite:
Eat when you are hungry. Have smaller meals more often than usual. Snack only when you're hungry. Eat a nutritious snack which is rich in calories and protein, such as dry fruit and nuts. Contact your doctor if your appetite did not improve.
Headache:
Rest and relax. Drink plenty of water and electrolytes. Apply a pain-relieving balm on the head if needed. Do not consume alcohol. Contact your doctor if your headache did not improve.
Dizziness:
Try to rest and relax. Get enough sleep. Avoid driving or operate machinery if you feel dizzy. Avoid alcohol consumption as it aggravates dizziness. Contact your doctor if dizziness worsens.
WARNING & PRECAUTIONS
PREGNANCY
CLOFRANIL 25MG TABLET is not recommended for use in pregnant women, unless considered necessary by the physician. Therefore, inform your doctor before taking CLOFRANIL 25MG TABLET if you are pregnant or planning to become pregnant.
BREASTFEEDING
CLOFRANIL 25MG TABLET is not recommended for use in breast feeding women as it may pass through the breast milk. Therefore, consult your doctor before taking it.
DRIVING AND USING MACHINES
CLOFRANIL 25MG TABLET may impair your ability to drive or handle heavy tools. Therefore, avoid driving or handling any heavy tools or machines as a precaution.
ALCOHOL
Avoid consumption of alcohol while taking CLOFRANIL 25MG TABLET as it may increase the risk of side effects.
KIDNEY
CLOFRANIL 25MG TABLET should be used with caution in patients with kidney diseases. Therefore, consult your doctor before taking it.
LIVER
CLOFRANIL 25MG TABLET is not recommended for use in patients with severe liver diseases. It should be used with caution in patients with other liver problems. Therefore, consult your doctor before taking it.
ALLERGY
Do not take CLOFRANIL 25MG TABLET if you are allergic to Clomipramine or to any other tricyclic antidepressants (such as imipramine, amitriptyline).
HEART DISEASE
CLOFRANIL 25MG TABLET is not recommended for use in patients with heart problems (including a recent heart attack). It should be used with caution in patients with irregular heartbeat. Therefore, consult your doctor before taking it.
OTHERS
CLOFRANIL 25MG TABLET is not recommended for use if you:
- suffer from mania (mood disorder that causes high levels of excitement)
- have narrow-angle glaucoma (increased eye pressure)
- have difficulty in passing urine
Before taking CLOFRANIL 25MG TABLET inform your doctor if you:
- suffer from epilepsy (fits)
- have brain injury or any damage in the brain
- have hypokalaemia (low potassium levels in the blood)
- have any blood disorders
- have low blood pressure
- want to undergo electric shock therapy (ECT)
- suffer from schizophrenia or other mental illnesses (such as anxiety)
- have an overactive thyroid gland
- have severe constipation for a long time
- have phaeochromocytoma or neuroblastoma (tumour of the adrenal gland)
- wear contact lenses
- previously had suicidal thoughts
- are going to have any surgery (including dental procedures)
Use in Paediatrics:
CLOFRANIL 25MG TABLET is not recommended for use in children and adolescents (aged below 18 years). Therefore, consult your doctor for advice before taking it.
Use in Geriatrics:
CLOFRANIL 25MG TABLET should be used with caution in elderly patients. Therefore, consult your doctor before taking it. Proper dose adjustments and careful monitoring are required in such patients.
INTERACTIONS
A. Drug-Drug Interactions:
Before taking CLOFRANIL 25MG TABLET inform your doctor if you are taking any of the following medicines such as:
- other medicines used to treat depression such as MAOIs (Ex. tranylcypromine, phenelzine, moclobemide), SSRIs (Ex. fluoxetine, fluvoxamine, paroxetine, sertraline), SNRIs (Ex. venlafaxine), tricyclic and tetracyclic antidepressants (Ex. amitriptyline, dothiepin, maprotiline), St. John’s Wort
- diuretics (medicines used to increase urine output) such as furosemide
- anaesthetics (medicines used for the temporary loss of bodily sensation) Ex. lidocaine, sevoflurane
- antihistamines (used to treat allergies) Ex. cetirizine and terfenadine
- medicines used to treat anxiety and other psychiatric disorders (Ex. thioridazine, lithium, clozapine, pimozide, haloperidol, buspirone, diazepam and alprazolam)
- medicines used to treat high blood pressure and other heart problems (such as guanethidine, betanidine, reserpine, clonidine, alpha methyldopa, norepinephrine noradrenaline, disopyramide, flecainide, procainamide, epinephrine, isoprenaline, digoxin, amiodarone, quinidine, diltiazem, verapamil, atenolol, sotalol)
- anticoagulants (medicines used to treat blood clots) such as warfarin
- medicines used to treat Parkinson's disease (Ex. levodopa, biperiden, entacapone or selegiline)
- nicotine (a medicine used to quit smoking)
- medicines used to prevent seizures or fits (Ex. phenytoin, carbamazepine)
- medicines used to treat colds and flu (such as ephedrine, phenylephrine or phenylpropanolamine)
- methylphenidate (a medicine used to treat ADHD)
- rifampicin (a medicine used to treat tuberculosis)
- quinine (a medicine used to treat malaria)
- medicines used to treat pain (such as tramadol, fentanyl, nefopam, morphine or morphine related substances like codeine, dihydrocodeine, buprenorphine)
- contraceptive pills (Ex. levonorgestrel, ethinylestradiol)
- colestipol, cholestyramine (medicines used to treat high cholesterol levels)
- medicines used to treat viral infections (Ex. ritonavir, indinavir)
- terbinafine (used to treat fungal infections)
- disulfiram (a medicine helps to quit alcohol consumption)
- altretamine (a medicine used to treat cancer)
- baclofen (a medicine used to treat muscle spasms)
- levacetylmethadol (used to treat addiction to opioid drugs such as heroin)
- linezolid (used to treat bacterial infections)
- intravenous methylene blue (a medicine used to treat methemoglobinemia)
- triptans Ex. sumatriptan (medicine used for migraine)
- tryptophan (an amino acid that can induce sleep)
B. Drug-Food Interactions:
Avoid eating grapefruit or drinking grapefruit juice or cranberry juice while taking CLOFRANIL 25MG TABLET as it may increase the risk of side effects.
Overdosage:
If you or anyone else accidentally took more CLOFRANIL 25MG TABLET, consult your doctor immediately or visit the nearby hospital. Symptoms of overdose might include drowsiness, stupor (unable to move but still conscious), uncoordinated muscle movement, restlessness, enhanced reflexes, muscle stiffness, irregular muscle contractions, writhing movements of the hands and feet, fits, high or low blood pressure, high fever, rapid or irregular heartbeat, sudden chest pain (angina), abnormally dilated pupil, shortness of breath, blue skin and a decrease or absence of urine production.
SYNOPSIS
| Drug | : | Clomipramine |
| Pharmacological Category | : | Tricyclic antidepressants |
| Therapeutic Indication | : | Depression, obsessive compulsive disorder, phobias, Cataplexy |
| Dosage Forms | : | Tablet, Capsule |
MORE INFORMATION
- Keep CLOFRANIL 25MG TABLET out of sight and reach of children
- Store CLOFRANIL 25MG TABLET below 25°C
FAQs ABOUT CLOFRANIL 25MG TABLET
What is the use of CLOFRANIL 25MG TABLET?
CLOFRANIL 25MG TABLET is used to depression, obsessive compulsive disorder (OCD), phobias (fear) and collapse (cataplexy) associated with narcolepsy (a sleep disorder).
How long does it take for CLOFRANIL 25MG TABLET to work?
It may take several weeks for CLOFRANIL 25MG TABLET to heal your condition. Therefore, continue to take CLOFRANIL 25MG TABLET for the stipulated duration recommended by your doctor without any interruption.
Is CLOFRANIL 25MG TABLET a strong antidepressant?
Yes. CLOFRANIL 25MG TABLET is a strong antidepressant that effectively controls signs of depression. It works by increasing the levels of certain chemicals (serotonin and noreipherine) within the brain that stabilizes mental health.
What is the best time to take CLOFRANIL 25MG TABLET?
Take CLOFRANIL 25MG TABLET approximately at the same time each day. You can take CLOFRANIL 25MG TABLET either in the morning or in the evening as per doctor’s instructions. Taking it at the same time each day will have the best effect and it would also help you remember your daily dose.
Can CLOFRANIL 25MG TABLET be used to reduce anxiety?
CLOFRANIL 25MG TABLET is a prescription medicine used to treat depression. It has been shown to reduce anxiety. However, there are no proper evidence to prove that. If you wish to control anxiety using CLOFRANIL 25MG TABLET, speak with your doctor for advice.
How does CLOFRANIL 25MG TABLET works?
CLOFRANIL 25MG TABLET works by increasing the levels of certain chemicals within the brain (such as serotonin and norepinephrine) that controls mood and mental health. As a result, it elevates mood and makes you feel active and energetic. It also reduces unwanted obsessive thoughts or fears and stops the attacks of cataplexy and sleep paralysis.
Can CLOFRANIL 25MG TABLET cause weight gain?
Yes. Weight gain is one of the common side effects of taking CLOFRANIL 25MG TABLET. If this side effect bothers you, contact your doctor.
Will CLOFRANIL 25MG TABLET reduce my sex drive?
Yes. CLOFRANIL 25MG TABLET may affect your sexual life. It may decrease sex drive or cause problems in orgasm, ejaculation or erection. Therefore, consult your doctor if you experience any such symptoms.
Will the use of CLOFRANIL 25MG TABLET make you feel sleepy or tired?
Yes, CLOFRANIL 25MG TABLET can make your feel sleepy, drowsy, or tired. Do not drive or handle heavy machines or tool if you feel drowsy or sleepy. Avoid consumption of alcohol as it can aggravate your drowsiness.
Can CLOFRANIL 25MG TABLET be used in children?
CLOFRANIL 25MG TABLET is generally not recommended for use in children and adolescents (aged below 18 years). Therefore, consult your doctor before administration.
What to do if I forget to take a dose of CLOFRANIL 25MG TABLET?
If you forget to take a dose of CLOFRANIL 25MG TABLET, take it as soon as you remember. However, if it is time to take the next dose, skip the missed dose and take the next one at regular times. Do not take a double dose of CLOFRANIL 25MG TABLET to compensate a missed dose, as it could lead to toxicity.
Will taking a higher dose of CLOFRANIL 25MG TABLET than the prescribed one be beneficial?
No, taking a higher dose of CLOFRANIL 25MG TABLET will not be effective rather it can lead to toxicity. Always take the dose prescribed by your doctor. If the prescribed dose is not effective for you, consult your doctor for advice. Your doctor might increase the dose or suggest an alternative therapy.
Can I stop taking CLOFRANIL 25MG TABLET once my symptoms subside?
No. Do not stop taking CLOFRANIL 25MG TABLET without consulting your doctor even if you feel better during the mid-way of the therapy. You may feel better after 2 weeks of therapy with CLOFRANIL 25MG TABLET, but it might take several weeks for you to experience complete benefits. Also, sudden discontinuation of therapy may cause withdrawal symptoms such as nausea, vomiting, stomach pain, diarrhoea, lack of sleep, headache, nervousness and/or anxiety.
Can CLOFRANIL 25MG TABLET be taken daily?
Yes. CLOFRANIL 25MG TABLET can be taken daily as per your doctor’s instruction. However, if you are doubtful, consult your doctor.
Can CLOFRANIL 25MG TABLET be used in pregnant women?
CLOFRANIL 25MG TABLET is not recommended for use in pregnant women as it may harm the growing fetus. Therefore, consult your doctor before receiving it.
REFERENCES
1. KD. Tripathi. Antidepressant and Antianxiety Drugs. Essentials of Medical Pharmacology. 7th Edition. 2013. Page 455, 458.
2. Marcia Wilson, Jayson Tripp. Clomipramine. Stat pearls. NIH. National Library of Medicine. National Center for Biotechnology Information. May 2022. [Accessed on 18th November 2022] https://www.ncbi.nlm.nih.gov/books/NBK541006/
3. Clomipramine in the treatment of patients with obsessive-compulsive disorder. The Clomipramine Collaborative Study Group. NIH. National Library of Medicine. National Center for Biotechnology Information. Pubmed.gov. August 1991. [Accessed on 18th November 2022] https://pubmed.ncbi.nlm.nih.gov/1883256/
4. Generics UK. Limited. Electronic Medicines Compendium. [Revised in November 2020] [Accessed on 18th November 2022] https://www.medicines.org.uk/emc/files/pil.2550.pdf
5. Teva Pharmaceuticals. Hungary. Clomipramine. [Revised in October 2021] [Accessed on 18th November 2022] https://products.tevauk.com/mediafile/id/51807.pdf
AUTHOR DETAILS
Written By Srilekha. R, B.Pharm
Last updated on 19 Nov 2022 | 03:09 PM(IST)
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