Drug Name
Anafranil (Clomipramine)

Drug Uses
Anafranil is used for treating obsessive-compulsive disorder (OCD). It may also be used for other conditions as determined by your doctor.

How to use
Use Anafranil as directed by your doctor. Check the label on the medicine for exact dosing instructions.
Anafranil comes with an extra patient information sheet called a Medication Guide. Read it carefully. Read it again each time you get Anafranil refilled.
Take Anafranil by mouth with food to decrease stomach upset.
It may take 2 to 3 weeks before you notice the effect of Anafranil. Continue to use Anafranil even if you feel well. Do not miss any doses.

Drug Class and Mechanism
Anafranil is a tricyclic antidepressant. It works by increasing the activity of certain chemicals in the brain, which helps to reduce obsessive-compulsive behaviors.

Missed Dose
If you miss a dose of Anafranil, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Storage
Store Anafranil at room temperature, between 68 and 77 degrees F (20 and 25 degrees C). Store away from heat, moisture, and light. Keep Anafranil out of the reach of children and away from pets.

Warnings/Precautions
Do not use Anafranil if:

• you are allergic to any ingredient in Anafranil;
• you have taken furazolidone or a monoamine oxidase inhibitor (MAOI) (e.g., phenelzine) within the last 14 days, or you are taking astemizole or terfenadine;
• you are recovering from a recent heart attack.

Contact your doctor or health care provider right away if any of these apply to you.

Some medical conditions may interact with Anafranil . Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• if you are pregnant, planning to become pregnant, or are breast-feeding
• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
• if you have allergies to medicines, foods, or other substances
• if you drink alcohol-containing beverages daily or have a history of alcohol abuse
• if you take thyroid medicine or have a history of an overactive thyroid
• if you have a history of adrenal gland problems, glaucoma, heart problems, kidney or liver problems, diabetes, seizures, trouble urinating, the blood disease porphyria, or other blood problems
• if you have a history of suicidal thoughts or behavior, bipolar disorder, or any other mental disorders
• if you are undergoing electroshock therapy or you are scheduled to have any surgery

Some MEDICINES MAY INTERACT with Anafranil . Tell your health care provider if you are taking any other medicines, especially any of the following:

• Azole antifungals (eg, fluconazole), cimetidine, duloxetine, haloperidol, methylphenidate, mibefradil, phenothiazines (eg, chlorpromazine), selective serotonin reuptake inhibitors (SSRIs) (eg, fluoxetine), terbinafine, or valproic acid because they may increase the risk of Anafranil 's side effects
• Astemizole, furazolidone, ketolide antibiotics (eg, telithromycin), macrolide antibiotics (eg, erythromycin), MAOIs (eg, phenelzine), pimozide, or terfenadine because the risk of high blood pressure, serious heart problems (eg, irregular heartbeat), or seizures may be increased
• Barbiturates (eg, phenobarbital) or phenytoin because they may decrease Anafranil 's effectiveness
• Anticoagulants (eg, warfarin), carbamazepine, or sympathomimetics (eg, phenylephrine) because the risk of their side effects may be increased by Anafranil
• Clonidine, guanethidine, or guanfacine because their effectiveness may be decreased by Anafranil

Possible Side Effects
Check with your doctor if any of these most common side effects persist or become bothersome:

• constipation; diarrhea; dizziness; drowsiness; dry mouth; headache; irritability; loss of appetite; nausea; nightmares; sweating; tiredness; upset stomach; vomiting; weakness; weight loss or gain.

Seek medical attention right away if any of these severe side effects occur:

• severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); blurred vision or other vision changes; changes in sex drive; chest pain; confusion; decreased sexual ability; fainting; fast, slow, or irregular heartbeat; fever; flushing; frequent or difficult urination; impulsive behavior or other unusual changes in behavior; mental or mood changes (eg, increased anxiety, mood swings, agitation, irritability, nervousness, restlessness); numbness or tingling of the skin; panic attacks; ringing in the ears; seizures; severe dizziness or drowsiness; sore throat; stomach pain; suicidal thinking or behavior; swelling of the testicles; tremor; trouble sleeping; trouble walking or keeping your balance; twitching of the face or tongue; uncontrolled movements or stiffness of arms and legs; unusual bleeding or bruising; worsening of depression; yellowing of the skin or eyes.

More Information
Anafranil is to be used only by the patient for whom it is prescribed. Do not share it with other people.
If your symptoms do not improve or if they become worse, check with your doctor.