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 disorder04.04.02.001; 17.02.02.008--
Vision blurred06.02.06.007; 17.17.01.010--
Visual field defect06.02.07.003; 17.17.01.001---
Visual impairment06.02.10.013---
Vomiting07.01.07.0030.003864%
Vulval disorder21.08.01.007---
Waxy flexibility19.11.03.005---
Weight decreased13.15.01.005--
Weight increased13.15.01.006--
Withdrawal syndrome08.06.02.012; 19.07.06.0230.001932%-
Yawning22.12.03.037---
Psychomotor skills impaired17.02.10.005; 19.22.01.0020.004830%-
Contusion12.01.06.001; 15.03.05.007; 23.03.11.002; 24.07.06.001--
Acute coronary syndrome02.02.02.015; 24.04.04.011---
Lymphatic disorder01.09.01.003---
Musculoskeletal discomfort15.03.04.001---
Inappropriate antidiuretic hormone secretion05.03.03.001; 14.05.07.001---
Depressive symptom19.15.02.003---
Affect lability19.04.01.001---
Transaminases increased13.03.04.036---
Stomach dilation procedure25.02.03.001---
Angiopathy24.03.02.007---
Blood alkaline phosphatase increased13.04.02.004--
Urine output increased13.13.03.002---
Hot flush08.01.03.027; 21.02.02.001; 24.03.01.005--
Breast disorder21.05.04.004---
Cardiac disorder02.11.01.003---
Connective tissue disorder10.04.04.026; 15.06.01.006---
Libido disorder19.08.03.004; 21.03.02.006---
Malnutrition14.03.02.004---
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ADReCS-Target
Drug Name ADR Term Target
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