CLOMIPRAMINE (CLOMIPRAMINE HYDROCHLORIDE)

PATIENT INFORMATION

CLOMIPRAMINE CAPSULES BP
Please read this leaflet carefully before you take these capsules. It briefly outlines the most important things you need to know. If you want to know more about this medicine, or you are not sure about anything, ask your doctor or your pharmacist.
The name of your medicine is Clomipramine.

WHAT IS CLOMIPRAMINE?
Clomipramine capsules contain either 10, 25 or 50 mg of Clomipramine Hydrochloride. They also contain lactose, maize starch, polyvidone, sodium starch glycollate, sodium lauryl sulphate and magnesium stearate. The capsule shell contains gelatin and the colours, titanium dioxide (E171), and red, yellow and black iron oxides (E172). The 25 mg capsules also contain the colours, erythrosine (E127) and indigo carmine (E132); and the 50 mg capsules also contain the colour, indigo carmine (E132).
The product is available in packs of 28 capsules.
See outer packaging or the pharmacy label for contents i.e. the number of capsules.
Clomipramine belongs to a group of drugs called tricyclic antidepressants.

WHAT IS CLOMIPRAMINE USED FOR?
Clomipramine capsules are used to treat depression, phobias and obsessive states. They are also used to treat cataplexy (collapse) associated with narcolepsy (a sleep disorder). Ask your doctor or pharmacist for additional information.

BEFORE YOU TAKE CLOMIPRAMINE
Are you sensitive to any of the ingredients in the medicine, listed above?
Have you ever had an allergic reaction whilst taking antidepressants?
Do you have serious liver problems?
Have you recently had a heart attack or do you suffer from any other heart problems? Do you have prostate trouble or problems passing urine?
Do you suffer from mania, a mood disorder characterised by high levels of excitement and activity?
Do you suffer from glaucoma or have problems with your thyroid?
Do you suffer from epileptic fits or are you taking the anticonvulsants, carbamazepine or phenytoin?
Do you have phaeochromocytoma or neuroblastoma?
Are you taking, or have you recently taken any other medicines to treat depression or other mental illness e.g alprazolam, fluoxetine, fluvoxamine, thioridazine or a monoamine oxidase inhibitor such as moclobemide?
Are you taking a medicine for high blood pressure or irregular heart beat?
Are you taking a sedative; a sympathomimetic drug such as adrenaline or ephedrine (including nasal drops which you can buy without a prescription); or an anticholinergic drug such as atropine or levodopa?
Are you taking disulfiram (used to treat alcoholism), cimetidine (to reduce acid indigestion), coumarin or warfarin (to treat blood clotting disorders), nicotine, or oestrogen (included in birth control pills and hormone replacement therapy (HRT)?
Are you having electroconvulsive therapy (ECT)?
Are you pregnant or breast-feeding?
If the answer to any of these questions is YES, do not take Clomipramine before consulting your doctor or pharmacist.
Clomipramine should not be used by children.
Tell your doctor if you are planning to have surgery (including dental procedures), as the dose of Clomipramine may need to be reduced or stopped before you have an anaesthetic.
These capsules may make you feel drowsy. Do not drive or operate machinery until you are used to the medication.
Alcohol should be avoided as it may affect you more than usual.

TAKING CLOMIPRAMINE
The capsules should be swallowed with a drink of water.
The usual dosage is as follows;

Depression, and cataplexy associated with narcolepsy;
Initially one 10 mg capsule per day. This dose is often then increased to 30-150 mg daily. with a maximum of 250 mg daily, if your doctor considers it necessary.
Phobias and obsessive states:
Initially one 25 mg capsule per day which may be gradually increased if necessary. Older people may require a lower starting dose.

Your doctor has decided the dose which is suited to you. Always follow your doctor’s instructions and those which are on the pharmacy label. If you do not understand these instructions, or you are in any doubt, ask your doctor or pharmacist.
Do not stop taking your capsules suddenly. You should continue to take these capsules for as long as your doctor tells you to. If you forget to take a capsule, take one as soon as you remember, unless it is nearly time to take the next one. Never take two doses together. Take the remaining doses at the correct time. If you see another doctor or go into hospital, let him or the staff know what medicines you are taking. If you (or someone else) swallows a lot of the capsules all together, or if you think a child has swallowed any of the capsules, contact your nearest hospital casualty department or your doctor immediately.

AFTER TAKING CLOMIPRAMINE
Clomipramine, like many other medicines may cause side effects in some people.
The following effects have been reported with this type of drug;
Dry mouth, eye problems including blurred vision, problems passing urine, sweating, sickness, constipation or diarrhoea, other abdominal disorders, an unpleasant taste, headache and allergic reactions which may lead to skin rash, sensitivity to light and itching.
Other side-effects reported are of the following types:
Mood changes - e.g. restlessness, drowsiness, transient fatigue, yawning, impaired memory and concentration, a sense of detachment, confusion with disorientation and hallucinations, delusions, aggressiveness, agitation, elevated mood and hyperactivity, excitement, anxiety, dream and sleep disturbances.
Heart and blood - e.g. high or low blood pressure, or changes in heart rhythm. There have been reports of blood disorders which may be characterised by abnormal bruising of the skin or possibly fever or sore throat.
Co-ordination - e.g. numbness, dizziness, uncontrolled shaking, muscle weakness or spasm, loss of coordination, fits, slurred speech, ringing in the ears.
Metabolism - e.g. hot flushes, high body temperature, loss of appetite or increased appetite and weight gain.
Hypersensitivity - a severe reaction shortly after taking Clomipramine including low blood pressure, a dry cough and breathing difficulties.

Sexual problems and occasionally breast enlargement and milk production in women, even if they are not breast-feeding can occur. Rarely hepatitis, including jaundice characterised by yellowing of the skin and whites of the eyes has been reported. Prolonged treatment can lead to an increase in tooth decay.

If you have these or any other effects, whilst taking Clomipramine tell your doctor immediately. Withdrawal symptoms which may occur if you stop taking the capsules suddenly. These include headache, feeling or being sick, diarrhoea, abdominal pain, nervousness, anxiety and insomnia.

STORING CLOMIPRAMINE
Do not use this medicine after the expiry date shown on the outside packaging.
These capsules should be stored in a dry place, at or below 25CC, in the package or container supplied. Do not transfer them to another container. Keep them in a secure place where children cannot get at them. This medicine is for you ONLY, do not give it to anyone else. Unless your doctor tells you to, do not keep these capsules for longer than you need. Return all unused medicines to your pharmacist for safe disposal.

FURTHER INFORMATION
This leaflet only gives a brief outline of some of the more important points about Clomipramine. If you want to know more about these capsules or their effects, please ask your doctor or pharmacist.

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