It is very important to take Anafranil exactly as prescribed by your doctor. The usual start dose is 25 mg twice or thrice daily. The medication should be given in divided doses with meals to reduce the gastrointestinal side effects. Do not change the dose or stop the medication without consulting your doctor. Do not use the medication if you are allergic to clomipramine or any other ingredients in Anafranil or other tricyclic antidepressants, have been taking monoamine oxidase inhibitors such as moclobemide (used for the treatment of depression) from the past 2 weeks, are taking an antibiotic called linezolid, have a history of heart attack or stroke or suffer from heart disease known as congestive heart failure, have liver or kidney problems, an imbalance of body components and cells, suffer from glaucoma (increased eye pressure), hereditary prolonged QT interval (a heart rhythm disorder). Anafranil may interact with medications such as CNS depressants like barbiturates (phenobarbital) benzodiazepines (alprazolam) or general anesthetics, monoamine oxidase inhibitors such as moclobemide, anticholinergic drugs like biperiden, levodopa, atropine, antiarrhythmic drugs such as quinidine, antipsychotic drugs used to treat schizophrenia, antihypertensive medications such as clonidine, alpha-methyldopa, reserpine, diuretics used to treat hypertension, selective serotonin reuptake inhibitors such as fluoxetine, cimetidine (an antacid), methylphenidate (a CNS stimulant), antiepileptic medications like phenytoin, carbamazepine, anticoagulants like heparin, warfarin, steroid hormones like estrogens, colestipol and cholestyramine (used to lower cholesterol levels), terbinafine (an antifungal medication), St. John’s wort (a herbal supplement used to treat depression). Before taking Anafranil, inform your doctor if you have any medical conditions including epilepsy or a history of seizures, history of arrhythmias, history of heart attack, low blood pressure, have low potassium levels in the body, have thyroid disorders, have glaucoma, suffer from urinary retention, take any medicines that increase your chances of having a seizure such as antidepressants and antibiotics, are taking selective serotonin reuptake inhibitors or diuretics, suffer from pheochromocytoma, neuroblastoma (tumors of the adrenal gland), are pregnant, planning a pregnancy or are breastfeeding.
Anafranil can lead to blurred vision, drowsiness, disturbance in attention and confusion. Do not engage in activities that need quick reactions such as driving or operating heavy machinery, while taking Anafranil. Do not drink alcohol while taking Anafranil, as it can exaggerate the response to alcohol and other CNS depressants if they are taken along with this medication.