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Anafranil Generic Name & Formulations
Legal Class
Rx
General Description
Clomipramine HCl 25mg, 50mg, 75mg; caps.
Pharmacological Class
Tricyclic.
How Supplied
Caps—30
Manufacturer
Generic Availability
YES
Anafranil Indications
Indications
Obsessive-compulsive disorder.
Anafranil Dosage and Administration
Adult
Take with food. Initially 25mg/day; titrate to 100mg/day in divided doses in first 2 weeks. Adjust as needed; max 250mg/day. After titration, total daily dose may be given at bedtime.
Children
<10yrs: not recommended. Take with food. ≥10yrs: initially 25mg/day. Increase gradually over first 2 wks to 3mg/kg per day or 100mg/day (in divided doses) whichever is smaller. Further increases as needed to max 3mg/kg per day or 200mg/day whichever is smaller. After titration, total daily dose may be given at bedtime.
Anafranil Contraindications
Contraindications
During or within 14 days of MAOIs. Concomitant linezolid or IV methylene blue. Acute post-MI.
Anafranil Boxed Warnings
Boxed Warning
Suicidality and antidepressant drugs.
Anafranil Warnings/Precautions
Warnings/Precautions
Increased risk of suicidal thinking and behavior in children, adolescents, and young adults; monitor for clinical worsening and unusual changes. Monitor for emergence of serotonin syndrome; discontinue if occurs. Angle-closure glaucoma. History of seizures or other predisposing factors (eg, brain damage, alcoholism). Hyponatremia (esp. in elderly or volume-depleted). Cardiovascular disease. Psychosis. Mania/hypomania. Bipolar disorder. ECT. Surgery. Hepatic or renal dysfunction; monitor. Hyperthyroidism. Increased intraocular pressure. Urinary retention. Adrenal tumors. Avoid abrupt cessation. Reevaluate periodically. Write ℞ for smallest practical amount. Elderly. Pregnancy (Cat.C). Nursing mothers: not recommended.
Anafranil Pharmacokinetics
See Literature
Anafranil Interactions
Interactions
See Contraindications. Seizures, coma and death with MAOIs. Risk of serotonin syndrome with concomitant serotonergic drugs (eg, triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, tryptophan, buspirone, St. John's Wort) and with drugs that impair serotonin metabolism (eg, MAOIs, linezolid, IV methylene blue). Concomitant diuretics; risk of hyponatremia. Potentiates alcohol, phenobarbital, other CNS depressants, anticholinergics, sympathomimetics, other protein-bound drugs (eg, warfarin, digoxin). Potentiated by CYP2D6 and/or CYP1A2 inhibitors; monitor plasma levels with cimetidine, SSRIs, phenothiazines, type 1C antiarrhythmics (eg, quinidine). Potentiated by haloperidol. Antagonized by barbiturates, phenytoin, other CYP450 inducers. Caution with drugs that lower seizure threshold. Blocks guanethidine, clonidine.
Anafranil Adverse Reactions
Adverse Reactions
Seizures, tremors, male sexual dysfunction, hyperthermia, dry mouth, constipation, anticholinergic effects, nausea, dyspepsia, anorexia, somnolence, dizziness, nervousness, myoclonus, changed libido, impotence, weight gain, visual changes; rare: DRESS (discontinue immediately if occurs).
Anafranil Clinical Trials
See Literature
Anafranil Note
Not Applicable
Anafranil Patient Counseling
See Literature
