Anafranil SR (Clomipramine)

Do’s

• Take Anafranil exactly as prescribed by your healthcare provider, with or without food.
• To reduce side effects like stomach upset, your healthcare provider might start you on a low dose, taken several times daily with meals. The dose can gradually increase as your body adjusts.
• Use Anafranil regularly, even if you feel well. Aim to take it at the same time(s) each day for optimal benefit.
• Talk to the healthcare provider about grapefruit. Avoid grapefruit or grapefruit juice while taking Anafranil unless your healthcare provider advises it's safe. Grapefruit can interact with the medication.

Don'ts

• Don't take more or less medication than prescribed, or take it more often. This won't improve your condition faster and may increase side effects like seizures.
• Don't abruptly stop taking Anafranil without consulting your healthcare provider. Stopping suddenly can worsen your condition and cause withdrawal symptoms like sweating, dizziness, nausea, vomiting, headache, or irritability. Your healthcare provider may need to gradually decrease your dose.
• Don't expect immediate effects. It may take 2 to 3 weeks or longer to feel the full effects of Anafranil.

Common side effects:

• Feeling dizzy, drowsy, tired, or nervous
• Tremors or jerking muscle movements
• Sweating
• Changes in appetite or weight
• Urination problems
• Vision changes
• Decreased sex drive, impotence, or difficulty having an orgasm

Serious side effects (rare, but may require medical attention):

• Bladder pain
• Bloody or cloudy urine
• Blurred vision
• Body aches or pain
• Burning, crawling, itching, numbness, prickling, "pins and needles," or tingling feelings
• Confusion
• Difficult, burning, or painful urination
• Dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
• Excessive muscle tone
• Fear or nervousness
• Feeling sad or empty
• Fever
• Hearing changes
• Hives or welts, skin rash
• Irritability
• Lower back or side pain
• Muscle stiffness, tension, or tightness
• Poor concentration
• Rhythmic movement of muscles
• Sneezing
• Tightness of the chest

This is not an exhaustive list, and other side effects may occur. If you experience any unusual or severe side effects while taking Anafranil sr, contact your healthcare provider for medical advice.

Inform your healthcare provider if you are allergic to clomipramine, other tricyclic antidepressants, or any ingredients in Anafranil SR.

Disclose any pre-existing medical conditions to your healthcare provider before using Anafranil SR, especially:

• Bleeding problems
• Blood disorders (purpura, thrombocytopenia)
• Breathing problems (asthma, chronic bronchitis)
• Glaucoma (angle-closure type) or family history
• Eating disorders (bulimia)
• Heart problems (arrhythmias, coronary artery disease, recent heart attack)
• Intestinal problems (chronic constipation, ileus)
• Liver problems
• Kidney problems
• Mental/mood conditions (bipolar disorder, schizophrenia) or family history
• History of neuroleptic malignant syndrome
• Heartburn/stomach acid reflux
• Seizures
• Overactive thyroid (hyperthyroidism)
• Trouble urinating (urinary retention, enlarged prostate)
• Conditions that increase seizure risk (alcohol/sedative dependence, electroconvulsive therapy, brain injury/disease)
• Certain tumors (pheochromocytoma, neuroblastoma)

Anafranil SR may cause irregular heartbeat (QT prolongation). This can be serious and requires immediate medical attention. Your risk may be higher if you have certain medical conditions or take other medications that affect heart rhythm. Inform your healthcare provider about all medications you use and if you have any of the following:

• Certain heart problems (heart failure, slow heartbeat, QT prolongation)
• Family history of heart problems (QT prolongation, sudden cardiac death)
• Electrolyte imbalances (low potassium or magnesium)

Anafranil SR may cause dizziness, drowsiness, or blurred vision. Avoid driving, operating machinery, or activities requiring alertness or clear vision until effects subside. Limit alcohol and marijuana use while taking this medication.

Inform your healthcare provider about all medications you take, including Anafranil SR, before having surgery.

Older adults may be more sensitive to side effects like bleeding, confusion, dizziness, and QT prolongation. This can increase the risk of falling. They may also be more likely to develop low sodium in the blood.

Anafranil SR should only be used during pregnancy when clearly necessary. Newborns exposed to clomipramine during pregnancy may experience withdrawal symptoms. Discuss the risks and benefits with your healthcare provider.

Clomipramine passes into breast milk. Consult your healthcare provider before breastfeeding.