Adverse Drug Reaction Classification System

Pharmaceutical Information
Drug Name Clomipramine
Drug ID BADD_D00499
Description Clomipramine, the 3-chloro analog of imipramine, is a dibenzazepine-derivative tricyclic antidepressant (TCA). TCAs are structurally similar to phenothiazines. They contain a tricyclic ring system with an alkyl amine substituent on the central ring. In non-depressed individuals, clomipramine does not affect mood or arousal, but may cause sedation. In depressed individuals, clomipramine exerts a positive effect on mood. TCAs are potent inhibitors of serotonin and norepinephrine reuptake. Tertiary amine TCAs, such as clomipramine, are more potent inhibitors of serotonin reuptake than secondary amine TCAs, such as nortriptyline and desipramine. TCAs also down-regulate cerebral cortical β-adrenergic receptors and sensitize post-synaptic serotonergic receptors with chronic use. The antidepressant effects of TCAs are thought to be due to an overall increase in serotonergic neurotransmission. TCAs also block histamine-H1 receptors, α1-adrenergic receptors and muscarinic receptors, which accounts for their sedative, hypotensive and anticholinergic effects (e.g. blurred vision, dry mouth, constipation, urinary retention), respectively. See toxicity section below for a complete listing of side effects. Clomipramine may be used to treat obsessive-compulsive disorder and disorders with an obsessive-compulsive component (e.g. depression, schizophrenia, Tourette’s disorder). Unlabeled indications include panic disorder, chronic pain (e.g. central pain, idiopathic pain disorder, tension headache, diabetic peripheral neuropathy, neuropathic pain), cataplexy and associated narcolepsy, autistic disorder, trichotillomania, onchophagia, stuttering, premature ejaculation, and premenstrual syndrome. Clomipramine is rapidly absorbed from the gastrointestinal tract and demethylated in the liver to its primary active metabolite, desmethylclomipramine.
Indications and Usage Unlabeled indications include: depression, panic disorder, chronic pain (e.g. central pain, idiopathic pain disorder, tension headache, diabetic peripheral neuropathy, neuropathic pain), cataplexy and associated narcolepsy (limited evidence), autistic disorder (limited evidence), trichotillomania (limited evidence), onchophagia (limited evidence), stuttering (limited evidence), premature ejaculation, and premenstrual syndrome.
Marketing Status Prescription; Discontinued
ATC Code N06AA04
DrugBank ID DB01242
KEGG ID D07727
MeSH ID D002997
PubChem ID 2801
TTD Drug ID D0ZS8P
NDC Product Code Not Available
Synonyms Clomipramine | Chlomipramine | Chlorimipramine | Hydiphen | Clomipramine Maleate (1:1) | Clomipramine Monohydrochloride | Monohydrochloride, Clomipramine | Anafranil | Clomipramine Hydrochloride | Hydrochloride, Clomipramine
Chemical Information
Molecular Formula C19H23ClN2
CAS Registry Number 303-49-1
SMILES CN(C)CCCN1C2=CC=CC=C2CCC3=C1C=C(C=C3)Cl
Chemical Structure
ADR Related Proteins Induced by Drug
ADR Term Protein Name UniProt AC TTD Target ID PMID
Poisoning and toxicityCytochrome P450 2D6P10635T57392Not Available
ADRs Induced by Drug
ADR Term ADReCS ID ADR Frequency (FAERS) ADR Severity Grade (FAERS) ADR Severity Grade (CTCAE)
Oxygen saturation decreased13.02.01.0040.008855%Not Available
Pain08.01.08.004--
Pallor24.03.04.001; 23.03.03.031; 08.01.03.032--Not Available
Palpitations02.01.02.003--
Pancytopenia01.03.03.0030.003465%Not Available
Panic reaction19.06.04.003--Not Available
Paraesthesia17.02.06.005--
Paranoia19.05.01.005--Not Available
Paresis17.01.04.008--Not Available
Parkinsonism17.01.05.003--Not Available
Parosmia22.04.03.007; 17.04.04.002--Not Available
Parotid gland enlargement07.06.03.001--Not Available
Peptic ulcer07.04.07.001--Not Available
Peripheral ischaemia24.04.03.002--
Pharyngeal oedema22.04.05.003; 10.01.05.016; 23.04.01.016--Not Available
Pharyngitis22.07.03.004; 11.01.13.003; 07.05.07.004--
Phobia19.06.03.002--Not Available
Photophobia17.17.02.006; 06.01.01.004--
Photosensitivity reaction23.03.09.003--
Piloerection23.02.06.005--Not Available
Pneumonia22.07.01.003; 11.01.09.003--Not Available
Pollakiuria20.02.02.007--
Polyarteritis nodosa24.05.02.011; 20.01.02.004; 15.06.01.003; 10.02.02.001--Not Available
Polyuria20.02.03.002--Not Available
Pre-eclampsia24.08.07.002; 20.01.08.002; 18.02.03.0020.013282%Not Available
Premature baby18.04.02.0010.017710%Not Available
Premature delivery18.07.01.0060.013282%
Premature ejaculation21.03.01.008; 19.08.01.002--Not Available
Prolonged labour18.07.01.0010.013282%Not Available
Prostatic disorder21.04.01.001--Not Available
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