Prescription medication · Tricyclic Antidepressant (TCA)
clomipramine
Also sold as Anafranil. Clomipramine treats obsessive-compulsive disorder (OCD).
Data updated 2026-05-15
- 4,403
- FDA reportsLightly reported
- 15
- InteractionsSeveral interactions
- $0.28
- Generic price (NADAC)
What the data shows
clomipramine (Anafranil) is a prescription Tricyclic Antidepressant (TCA), among the least-reported drugs the FDA tracks (4,403 FDA reports), with 15 documented drug interactions.
Reporting volume reflects how widely a drug is used and studied, not how dangerous it is, a FAERS report documents a temporal association, never proof of cause.
clomipramine (Anafranil) is a prescription Tricyclic Antidepressant (TCA). Clomipramine treats obsessive-compulsive disorder (OCD).
Clomipramine (Anafranil) is a medicine used to treat obsessive-compulsive disorder (OCD). It helps reduce unwanted thoughts and repetitive behaviors.
Verify with FDA → · CMS NADAC pricing →
Drug Pricing (NADAC)
Generic Price
$0.28/unit
Generic Available
Yes (10 manufacturers)
Pricing data from NADAC (CMS), effective December 18, 2024. Compare all drug costs →
What it does
Clomipramine treats obsessive-compulsive disorder (OCD).
Common side effects
Dry mouth, Constipation, Nausea
Key warnings
Antidepressants may increase the risk of suicidal thoughts or actions in children, teens, and young adults.
The sections below are summarized in plain English from clomipramine's FDA-approved prescribing information. They describe what the official label says, and are not personal medical advice.
How It Works
Clomipramine is a type of antidepressant. It works by increasing the amount of certain chemicals in the brain. These chemicals help regulate mood and reduce OCD symptoms.
How to Take It
Start with a low dose, usually 25 mg per day. Take it with food to avoid stomach upset. Your doctor may increase the dose slowly, up to 250 mg per day. You can take the full dose at bedtime after your dose is stable.
This is a plain-language summary of clomipramine's FDA labeling, not individualized dosing advice. Ask a pharmacist or prescriber before changing how you take this medication.
Pregnancy & Breastfeeding
Tell your doctor if you are pregnant or plan to become pregnant. Clomipramine may harm your unborn baby. It can also pass into breast milk, so talk to your doctor about breastfeeding.
This is a plain-language summary of clomipramine's FDA labeling, not individualized advice. Ask a pharmacist or prescriber about pregnancy or breastfeeding on this medication.
Missed Dose
If you miss a dose, take it as soon as you remember. If it is close to your next dose, skip the missed dose and continue with your regular schedule.
This is a plain-language summary of clomipramine's FDA labeling, not individualized advice. Ask a pharmacist or prescriber what to do about your specific missed dose.
Storage
Store at room temperature (68° to 77°F) in a closed container, away from light and moisture.
Side Effects (from patient reports)
Based on 4,403 FDA adverse event reports.
Most-reported reactions
Adverse reactions in FAERS for clomipramine, by number of reports
- Interaction with another medicine
Interaction with another medicine
226 reports
- Sleepiness
Sleepiness
203 reports
- Falling down
Falling down
202 reports
- Shaking
Shaking
185 reports
- Feeling sick to your stomach
Feeling sick to your stomach
173 reports
- Trying to kill yourself
Trying to kill yourself
170 reports
- Taking too much medicine on purpose
Taking too much medicine on purpose
168 reports
- Feeling confused
Feeling confused
161 reports
- Being unconscious
Being unconscious
160 reports
- Feeling worried or nervous
Feeling worried or nervous
157 reports
What this shows Bars show how often each reaction was reported, not how likely it is to happen, a report records a temporal association, never proof that the drug caused it.
Reports over time
Adverse-event reports filed for clomipramine each year to the FDA Adverse Event Reporting System (FAERS).
Year-to-year volume tracks usage, prescribing, and scrutiny, not a change in per-patient risk. Source: FDA FAERS.
Where clomipramine sits
clomipramine has more FDA adverse-event reports than 24% of the drugs FAERS tracks. A high position reflects how widely a drug is used and watched, not how dangerous it is.
Percentile across all drugs PlainMeds tracks by FAERS report volume. The dot is clomipramine; the line is the median (50th percentile).
FDA Adverse Event Report Analysis
Detailed analysis of 4,403 reports from the FDA Adverse Event Reporting System (FAERS). Reports span 1998–2025.
Total Reports
4,403
Reports Mentioning Death
393
8.9% of reports — not proof of cause
Hospitalization Reports
2,376
Top Indication
Product Used For Unknown Indication
Gender Distribution
Age Distribution
Most Reported Adverse Reactions (FAERS)
| # | Reaction | Reports |
|---|---|---|
| 1 | DRUG INTERACTION | 225 |
| 2 | SOMNOLENCE | 203 |
| 3 | FALL | 202 |
| 5 | TREMOR | 185 |
| 6 | NAUSEA | 173 |
| 7 | SUICIDE ATTEMPT | 169 |
| 8 | INTENTIONAL OVERDOSE | 168 |
| 10 | COMA | 160 |
| 11 | CONFUSIONAL STATE | 160 |
| 12 | ANXIETY | 157 |
| 13 | DEPRESSION | 144 |
| 14 | MALAISE | 143 |
| 15 | TACHYCARDIA | 141 |
| 16 | ASTHENIA | 140 |
| 17 | DIZZINESS | 136 |
Reactions in Death Reports
Reactions in Hospitalization Reports
Source: FDA FAERS (Adverse Event Reporting System) FDA FAERS (Adverse Event Reporting System) Reports are voluntary and do not establish causation
Serious Warnings
Antidepressants may increase the risk of suicidal thoughts or actions in children, teens, and young adults. Watch closely for worsening mood or unusual behavior. Clomipramine is only approved for OCD in children.
Known Drug Interactions
While all the selective serotonin reuptake inhibitors (SSRIs), e.g., fluoxetine, sertraline, paroxetine, and fluvoxamine, inhibit P450 2D6, they may vary in the extent of inhibition.
Mechanism: Sertraline blocks a specific liver protein that breaks down clomipramine. This can cause clomipramine to build up to higher levels in your blood.
What to do: Your doctor may need to lower your clomipramine dose or watch you closely for side effects.
The plasma concentration of CMI has been reported to be increased by the concomitant administration of haloperidol; plasma levels of several closely related tricyclic antidepressants have been reported to be increased by the concomitant administration of methylphenidate or hepatic enzyme inhibitors (e.g., cimetidine, fluoxetine) and decreased by the concomitant administration of hepatic enzyme inducers (e.g., barbiturates, phenytoin), and such an effect may be anticipated with CMI as well. While all the selective serotonin reuptake inhibitors (SSRIs), e.g., fluoxetine, sertraline,...
Mechanism: Fluoxetine slows down the liver's process for clearing clomipramine from your body. This can lead to higher and potentially unsafe levels of clomipramine.
What to do: Your doctor may need to adjust your medication levels and monitor you for increased side effects.
The plasma concentration of CMI has been reported to be increased by the concomitant administration of haloperidol; plasma levels of several closely related tricyclic antidepressants have been reported to be increased by the concomitant administration of methylphenidate or hepatic enzyme inhibitors (e.g., cimetidine, fluoxetine) and decreased by the concomitant administration of hepatic enzyme inducers (e.g., barbiturates, phenytoin), and such an effect may be anticipated with CMI as well.
Mechanism: Methylphenidate can interfere with how your body gets rid of clomipramine. This causes the amount of clomipramine in your system to increase.
What to do: Your doctor may need to change your clomipramine dose and check how you are feeling more often.
While all the selective serotonin reuptake inhibitors (SSRIs), e.g., fluoxetine, sertraline, paroxetine, and fluvoxamine, inhibit P450 2D6, they may vary in the extent of inhibition.
Mechanism: Paroxetine blocks the liver enzyme responsible for breaking down clomipramine. This makes clomipramine stay in your body longer and reach higher levels.
What to do: Your doctor should monitor your blood levels or adjust your dose to ensure the combination is safe.
Several tricyclic antidepressants have been reported to block the pharmacologic effects of guanethidine, clonidine, or similar agents, and such an effect may be anticipated with CMI because of its structural similarity to other tricyclic antidepressants.
Mechanism: Clomipramine can interfere with how clonidine works in your body. This prevents clonidine from effectively lowering your blood pressure.
What to do: Your doctor should check your blood pressure regularly to make sure your blood pressure medicine is still working.
This is a plain-language summary of interactions documented in FDA labeling, not individualized advice. Ask a pharmacist or prescriber before combining medications.
Common Questions
Can I stop taking clomipramine suddenly?
How long does it take for clomipramine to work?
Can I drink alcohol while taking clomipramine?
Will clomipramine cure my OCD?
Can clomipramine cause weight gain?
Is it safe to take clomipramine with other medications?
What should I do if I experience side effects?
Can clomipramine affect my sex drive?
Does clomipramine interact with any foods?
What if I think I've taken too much clomipramine?
What are the common side effects of clomipramine?
Does clomipramine interact with other medications?
What drug class is clomipramine?
Is clomipramine safe during pregnancy?
Related Medications in Tricyclic Antidepressant (TCA)
Other drugs grouped near clomipramine - same-class peers and common alternatives.
acamprosate
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alprazolam
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amitriptyline
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amphetamine/dextroamphetamine
Adderall, Adderall XR
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aripiprazole
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Medication Guides
Understanding Drug Interactions
How CYP450 enzymes, inhibitors, and inducers affect your medications
Generic vs Brand Name Drugs
FDA requirements, cost savings, and when the difference matters
Narrow Therapeutic Index Drugs
Why some drugs demand precise dosing and monitoring
Common Drug Interactions
Dangerous medication combinations and how to protect yourself
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What the FDA Data Shows for clomipramine
The FDA label for clomipramine (sold under brand names such as Anafranil) classifies it as a prescription-only medication in the Tricyclic Antidepressant (TCA) class. Clomipramine treats obsessive-compulsive disorder (OCD). Official labeling lists 17 commonly reported side effects, including Dry mouth, Constipation, Nausea.
Post-market surveillance from the FDA Adverse Event Reporting System (FAERS) captures real-world experience. For this drug, FAERS contains 4,403 voluntary reports. The database also lists 15 documented drug interactions derived from FDA labeling, with the top-flagged interaction rated minor severity. NADAC pricing from CMS shows a generic unit cost of $0.28.
Report counts do not establish causation, a FAERS entry documents a temporal association, not proof that the drug produced the outcome. Widely prescribed medications naturally accumulate more reports than niche therapies, so raw totals must be interpreted alongside total exposure. Shortage status, recall history, and patent information further shape supply and switching decisions. This page summarizes public FDA data for educational purposes only and is not a substitute for professional medical advice, always consult a licensed healthcare provider before starting, stopping, or changing any medication.
Data Sources
Drug labeling: FDA Drug Labels (SPL/DailyMed). Adverse events: FDA Adverse Event Reporting System (FAERS). Pricing: CMS National Average Drug Acquisition Cost (NADAC).
FAERS reports are voluntary and do not establish causation. Drug interactions are derived from FDA labeling and clinical references. Always consult a healthcare professional before making medication decisions.
Last updated: May 13, 2025
Read our methodology - how this data is sourced, computed, and verified.
Data currency: FDA FAERS adverse-event reports through 2025, CMS NADAC acquisition-cost pricing effective December 2024, compiled and last refreshed May 2026. See our methodology for per-source dates and refresh cadence. Spot a figure that looks wrong? Report a correction.
All federal data sources used on this page
- FDA Orange Book - approved drug products with therapeutic equivalence. accessdata.fda.gov/cder/ob
- FDA DailyMed - NIH-hosted drug labeling for FDA-approved meds. dailymed.nlm.nih.gov
- FDA Adverse Event Reporting System (FAERS) - post-marketing safety surveillance. fda.gov/drugs/faers
- NLM RxNorm - standardized clinical drug nomenclature. nlm.nih.gov/research/umls/rxnorm
- CMS Medicare Part B Drug Average Sales Price Files - federal drug pricing data. cms.gov/medicare/part-b-drugs/asp
- FDA Drug Shortages Database - current and resolved drug shortage tracking. accessdata.fda.gov/drugshortages