Long COVID Patterns in the RECOVER-Adult Study
November 21, 2025
Brand Name :
Anafranil
Synonyms :
clomipramine
Class :
Antidepressants, TCAs
Dosage Forms & Strengths Â
capsule Â
25mg Â
50mg Â
75mg Â
Obsessive-Compulsive DisorderÂ
25
mg
Orally 
every day
Over the course of two weeks, gradually raise the dosage to 100 mg/day (divided up with meals)
Up to 250 mg/day may be increased further
once tolerated, may provide as a single daily dose of qHS
Dosage Forms & Strengths Â
capsule Â
25mg Â
50mg Â
75mg Â
Obsessive-Compulsive DisorderÂ
25
mg
Orally 
every day
Over the course of two weeks, gradually raise the dosage to 100 mg/day
Up to 250 mg/day may be increased further
once tolerated, may provide as a single daily dose of qHS
Age: ≥10 years
25 mg PO orally every day; gradually raise the dosage to 3 mg/kg/day or 100 mg/day
Up to 200 mg/day may be increased further
once tolerated, may provide as a single daily dose of qHS
Refer to adult dosingÂ
may have an increased QTc-prolonging effect when combined with QT-prolonging agents
may have an increased QTc-prolonging effect when combined with QT-prolonging agents
may have an increased QTc-prolonging effect when combined with QT-prolonging agents
may have an increased QTc-prolonging effect when combined with QT-prolonging agents
may have an increased QTc-prolonging effect when combined with QT-prolonging agents
QTc-prolonging agents: they may increase the QTc-prolonging effect of clomipramine
QTc-prolonging agents: they may increase the QTc-prolonging effect of clomipramine
QTc-prolonging agents: they may increase the QTc-prolonging effect of clomipramine
QTc-prolonging agents: they may increase the QTc-prolonging effect of clomipramine
when both drugs are combined, there may be an increase in qtc interval  
may increase the QTc prolonging effect of QT-prolonging Class III Antiarrhythmics
It may enhance QTc interval when combined with pentamidine
It may enhance QTc interval when combined with perphenazine
may increase the QT-prolonging effect and enhance the risk of ventricular arrhythmias
It may reduce the effects when combined with pleurisy root by an unspecified interactions mechanism
clomipramine: they may enhance the serum concentration of CYP1A2 Inhibitors
clomipramine: they may enhance the serum concentration of CYP1A2 Inhibitors
clomipramine: they may enhance the serum concentration of CYP1A2 Inhibitors
clomipramine: they may enhance the serum concentration of CYP1A2 Inhibitors
clomipramine: they may enhance the serum concentration of CYP1A2 Inhibitors
When clomipramine is used together with bromisoval, the risk or seriousness of CNS depression is enhanced
When clomipramine is used together with medazepam, the risk or seriousness of CNS depression is enhanced
Combining tegafur with clomipramine can reduce tegafur’s metabolism
When clomipramine is used together with niaprazine, the risk or seriousness of CNS depression is enhanced
When dexrabeprazole and clomipramine is used together, this leads to reduction in the dexrabeprazole’s metabolism
tinidazole has the potential to reduce the rate of excretion of clomipramine, potentially leading to an elevation in level of serum
clomipramine: they may enhance the serum concentration of CYP2D6 Inhibitors
clomipramine: they may enhance the serum concentration of CYP2D6 Inhibitors
clomipramine: they may enhance the serum concentration of CYP2D6 Inhibitors
clomipramine: they may enhance the serum concentration of CYP2D6 Inhibitors
clomipramine: they may enhance the serum concentration of CYP2D6 Inhibitors
When clomipramine is used together with melitracen, this leads to enhanced risk or seriousness of CNS depression
When ponesimod is used together with clomipramine, this leads to enhanced risk or seriousness of bradycardia
When clomipramine is used together with adenosine, this leads to enhanced risk or seriousness of QTc prolongation
When clomipramine is used together with givinostat, this leads to enhanced risk or seriousness of Qtc prolongation
When emylcamate is used together with clomipramine, this leads to enhanced risk or seriousness of CNS depression
When bufexamac is used together with clomipramine, this leads to enhanced risk or seriousness of gastrointestinal bleeding
When clomipramine is used together with oleandomycin, this leads to enhanced concentration serum of clomipramine
When clomipramine is used together with patupilone, this leads to enhanced concentration serum of clomipramine
When clomipramine is used together with ridaforolimus, this leads to enhanced concentration serum of clomipramine
piperine, when combined with clomipramine, may result in an increased serum concentration of clomipramine
When clomipramine is used together with profenamine, this leads to enhanced risk or seriousness of adverse events
when both drugs are combined, there may be an increased risk or severity of QTC prolongation  
when used together, entrectinib and clomipramine both increase the QTc interval
CYP1A2 inhibitors increase the concentration of clomipramine in serum
it enhances by affecting the hepatic enzyme CYP2D6 metabolism
glycopyrrolate inhaled and formoterolÂ
may decrease the toxic effects of each other by sedation
may increase the risk or severity of hypertension when combined
an alteration in the therapeutic activity of either of the drugs may be seen
the serum levels of Clomipramine may be increased
it increases the toxicity of atropine through an unknown mechanism
relugolix/​estradiol/​norethindroneÂ
may increase the effect of each other by an unknown mechanism
Actions and Spectrum:Â
In works by increasing the levels of serotonin and norepinephrine in the brain and help to elevate mood by reducing the symptoms of anxiety and depression. Â
Frequency Defined Â
>10% Â
Headache (50-55%) Â
Xerostomia (84%) Â
Constipation (47%) Â
Fatigue (35-40%) Â
Ejaculation failure (42%) Â
Nausea (30-35%) Â
Weight gain (18%) Â
Impotence (20-25%) Â
1-10% Â
Hepatotoxicity (1-3%) Â
Weight loss (5%) Â
Frequency Not Defined Â
Blurred vision Â
Dyspepsia Â
Dizziness Â
Black Box WarningÂ
Suicidal ideationÂ
Contraindication/Caution:Â
It is contraindicated with known hypersensitivity, heart attack, heart block, liver disease, and suicidal ideation.Â
Pregnancy warnings:    Â
US FDA pregnancy category: CÂ
Lactation:  Â
Excreted into human milk is known Â
Pregnancy Categories:        Â
Pharmacology: Â
clomipramine is an tricyclic antidepressant which acts on serotonin and norepinephrine.Â
Pharmacodynamics: Â
It increases the levels serotonin in brain and acts as a reuptake inhibitor for serotonin and norepinephrine but to a lesser extent for dopamine which enhances the activity of these neurotransmitters in the brain. Pharmacokinetics:  Â
Absorption Â
absorbed wellÂ
Distribution Â
large volume of distribution.Â
Metabolism Â
Metabolized by cytochrome P450 (CYP2D6)Â
Elimination and Excretion Â
Half-life is 24 hours.Â
Administration: Â
It is taken orally and available in capsule formÂ
Patient information leafletÂ
Generic Name: clomipramineÂ
Why do we use clomipramine?Â
Clomipramine is a tricyclic antidepressant which is effective in treating obsessive-compulsive disorder, depression, panic disorder, chronic pain, and other anxiety disorders. Clomipramine used as an alternative for those who are not responded well to other antidepressants.Â