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 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: 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 approved; investigational; vet_approved
ATC Code N06AA04
DrugBank ID DB01242
KEGG ID D07727
MeSH ID D002997
PubChem ID 2801
TTD Drug ID D0ZS8P
NDC Product Code Not Available
UNII NUV44L116D
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
ADRs Induced by Drug
*The priority for ADR severity classification is based on FAERS assessment, followed by the most severe level in CTCAE rating. If neither is available, it will be displayed as 'Not available'.
**The 'Not Available' level is hidden by default and can be restored by clicking on the legend twice..
ADR Term ADReCS ID ADR Frequency (FAERS) ADR Severity Grade (FAERS) ADR Severity Grade (CTCAE)
Vestibular disorder17.02.02.008; 04.04.02.001--
Vision blurred17.17.01.010; 06.02.06.007--
Visual field defect17.17.01.001; 06.02.07.003--Not Available
Visual impairment06.02.10.013--Not Available
Vomiting07.01.07.0030.003864%
Vulval disorder21.08.01.007--Not Available
Waxy flexibility19.11.03.005--Not Available
Weight decreased13.15.01.005--
Weight increased13.15.01.006--
Withdrawal syndrome19.07.06.023; 08.06.02.0120.001932%Not Available
Yawning22.12.03.037--Not Available
Psychomotor skills impaired19.22.01.002; 17.02.10.0050.004830%Not Available
Contusion15.03.05.007; 24.07.06.001; 23.03.11.002; 12.01.06.001--
Acute coronary syndrome02.02.02.015; 24.04.04.011--Not Available
Lymphatic disorder01.09.01.003--Not Available
Musculoskeletal discomfort15.03.04.001--Not Available
Inappropriate antidiuretic hormone secretion14.05.07.001; 05.03.03.001--Not Available
Depressive symptom19.15.02.003--Not Available
Affect lability19.04.01.001--Not Available
Transaminases increased13.03.04.036--Not Available
Stomach dilation procedure25.02.03.001--Not Available
Angiopathy24.03.02.007--Not Available
Blood alkaline phosphatase increased13.04.02.004--
Urine output increased13.13.03.002--Not Available
Hot flush08.01.03.027; 24.03.01.005; 21.02.02.001--
Breast disorder21.05.04.004--Not Available
Cardiac disorder02.11.01.003--Not Available
Connective tissue disorder15.06.01.006; 10.04.04.026--Not Available
Libido disorder21.03.02.006; 19.08.03.004--Not Available
Malnutrition14.03.02.004--Not Available
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ADReCS-Target
Drug Name ADR Term Target
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