The following provides information on contraindications to the use of clomipramine in general, pregnancy, breastfeeding and children. Please note that the contraindications may vary depending on the dosage form of a drug (eg tablet, syringe, ointment).
When should Clomipramine not be used?
The drug should not be used in case of hypersensitivity to clomipramine or other tri- and tetracyclic antidepressants, concurrent use of MAO inhibitors, poisoning from sleeping pills, painkillers, psychotropic drugs or alcohol as well as patients with a Deliriumn.
If you have problems with emptying the bladder (acute urinary retention) or enlarged prostate with urinary retention, untreated glaucoma (angle-closure glaucoma), disorders of the pylorus (pyloric stenosis) or bowel obstruction (paralytic ileus) may not be used clomipramine also.</p >
Only after careful medical benefit-risk assessment clomipramine may be prescribed if an enlarged prostate without urinary retention is present, the liver or kidney function are severely impaired or the patient is prone to convulsions.
For disorders of blood formation, adrenocortical tumors and pre-damaged heart, special medical precautions must be taken and regular medical checks must be carried out. This is especially true for older patients and patients with mental disorders, due to a brain organic cause (brain organic psychosyndrome). You should be carefully monitored by a doctor while you are taking Clomipramine.
During the healing phase after a heart attack and patients with existing stimulus conduction disorders to the heart muscle (AV block II. And III. Degree) or blockages in heart conduction system (diffuse supraventricular or ventricular conduction abnormalities) should not be taken clomipramine.
Patients with irritable conduction abnormalities to the heart muscle atrioventricular block first degree or other conduction disturbances, particularly in left bundle branch block, however, may be treated only with close medical ECG control with the drug.
If you experience clomipramine manic phases with extremely high mood and excessive drive, the drug must be discontinued immediately. This also applies if additional depressive symptoms occur during the treatment, especially in the course of schizophrenia (schizophrenia).
What should you watch out for during pregnancy and lactation?
There is insufficient experience in the use of clomipramine in pregnancy. Developmental disorders of the unborn child can not be safely ruled out. Therefore, the active substance should be used in pregnancy, especially in the first three months, only for compelling reasons and after careful medical benefit-risk assessment. If clomipramine is given during pregnancy, clomipramine should be discontinued or reduced in dose (if it is justifiable for the treatment) but at least seven weeks before the calculated date of birth. Otherwise, breathing problems or cramps may occur in the newborn.
Because clomipramine passes into breast milk, therefore, the active substance should not be used during breast-feeding. If necessary, it must be weaned before treatment with Clomipramine.
What should be considered in children?
In children under the age of five, the drug should not be used as there is insufficient experience for this patient group.
Warnings and Precautions
- Blood pressure should be monitored regularly for patients with high blood pressure and circulatory problems, as it may cause severe drops in blood pressure during treatment.
- Patients with cardiovascular disease should have their heart function monitored by the doctor (ECG control).
- In liver disease, liver function should be monitored regularly during treatment.
- Regular medical check-up of kidney function is recommended especially in elderly patients.
- Since the drug can lead to changes in the blood count, the doctor must regularly check the blood count.
- Medical checks, especially in cases of fever and influenza-like infections, are necessary throughout the treatment period.
- Since dental caries has been increasingly observed in long-term use, regular visits to the dentist are necessary.
- EEG checks by the doctor should be performed at regular intervals.
- Severe depressive patients and especially young adults under the age of 30 are at particular risk of suicide despite receiving therapy.
- High-dose therapy should not be stopped abruptly, otherwise unwanted reactions (agitation, anxiety, sweating, dizziness, vomiting, diarrhea, headache, sleep disturbances) can occur.
- If excessive (mania) or schizophrenic symptoms occur, discontinue use immediately.
- Patients with epilepsy or brain damage may experience increased seizures.
- In patients with hyperthyroidism or thyroid hormones, the drug may potentiate the cardiac-damaging effects.
- Prior to local or general anesthesia, the anesthetist must be informed of the treatment with the drug.
- Contact lens wearers may experience damage to the cornea due to decreased lacrimal gland activity.
- Intense UV radiation (sun, sunbed) should be avoided during treatment.
- The antidepressant effect of the drug is mitigated by nicotine.
- The medicine may increase the risk of bone fractures.
- Especially in the first few days of treatment, responsiveness is impaired to such an extent that driving a car and operating machinery are dangerous. This is especially true in conjunction with alcohol.
Sometimes medications release allergic reactions.
If you notice any signs of allergic reaction, tell your doctor or pharmacist immediately.