When This Medicine Should Not Be Used:
This medicine is not right for everyone. Do not use it if you had an allergic reaction to clomipramine or similar medicines, or you had a recent heart attack.

How to Use This Medicine:
Capsule, Tablet

• Take your medicine as directed. Your dose may need to be changed several times to find what works best for you.
• Your doctor may tell you to take the medicine at bedtime to prevent drowsiness during the day.
• It is best to take this medicine with food or milk.
• This medicine should come with a Medication Guide. Ask your pharmacist for a copy if you do not have one.
• Missed dose: Take a dose as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose. Do not take extra medicine to make up for a missed dose.
• Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.

Drugs and Foods to Avoid:
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Do not use this medicine and an MAO inhibitor (MAOI), such as linezolid or methylene blue, within 14 days of each other.
• Some medicines can affect how clomipramine works. Tell your doctor if you are using any of the following:
  
  • Buspirone, cimetidine, clonidine, digoxin, fentanyl, guanethidine, haloperidol, lithium, methylphenidate, St John's wort, tramadol, tryptophan
  • A blood thinner (such as warfarin), depression medicine (such as fluoxetine, fluvoxamine, paroxetine, sertraline), heart rhythm medicine (such as flecainide, propafenone, quinidine), triptan medicine for migraine headaches, phenothiazine medicine (such as chlorpromazine, perphenazine, promethazine, prochlorperazine, thioridazine), seizure medicine (such as phenobarbital, phenytoin), thyroid medicine
• Alcohol, narcotic pain relievers, or sleeping pills may cause you to feel more lightheaded, dizzy, or faint when used with this medicine. Tell your doctor if you drink alcohol or use pain relievers or sleeping pills.

Warnings While Using This Medicine:

• Tell your doctor if you are pregnant or breastfeeding, or if you have kidney disease, liver disease, an adrenal gland tumor (such as neuroblastoma), glaucoma, heart disease, depression, mood or mental problems, an overactive thyroid, trouble urinating, or a history of seizures.
• This medicine may cause the following problems:
  
  • Serotonin syndrome (more likely when taken with certain other medicines)
  • Problems with sex (in males)
• For some children, teenagers, and young adults, this medicine may increase mental or emotional problems. This may lead to thoughts of suicide and violence. Talk with your doctor right away if you have any thoughts or behavior changes that concern you. Tell your doctor if you or anyone in your family has a history of bipolar disorder or suicide attempts.
• This medicine may make you dizzy or drowsy. Do not drive or do anything that could be dangerous until you know how this medicine affects you.
• Do not stop using this medicine suddenly. Your doctor will need to slowly decrease your dose before you stop it completely.
• Tell any doctor or dentist who treats you that you are using this medicine. You may need to stop using this medicine several days before you have surgery or medical tests.
• Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.
• Keep all medicine out of the reach of children. Never share your medicine with anyone.

Possible Side Effects While Using This Medicine:
Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Agitation, confusion, depression, irritability, memory problems
• Anxiety, restlessness, fever, sweating, muscle spasms, nausea, vomiting, diarrhea, seeing or hearing things that are not there
• Chest pain or a fast, pounding heartbeat
• Feeling more excited or energetic than usual, racing thoughts, trouble sleeping
• Lightheadedness, dizziness, or fainting
• Seizures or tremors
• Thoughts of hurting others or yourself, unusual behavior

If you notice these less serious side effects, talk with your doctor:

• Cough, sore throat, runny or stuffy nose
• Dry mouth, nausea, vomiting, diarrhea, constipation, loss of appetite, stomach pain or upset
• Eye pain, vision changes, seeing halos around lights
• Headache
• Increased sweating, warmth or redness in your face, neck, arms, or upper chest
• Problems with ejaculation or decreased sexual performance
• Weight gain or loss

If you notice other side effects that you think are caused by this medicine, tell your doctor.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088