Anafranil® clomipramine hydrochloride Consumer Medicine Information What is in this leaflet thought to be caused by a Some of the symptoms of an allergic chemical imbalance in parts of reaction may include shortness of This leaflet answers some common the brain. This imbalance affects breath, wheezing or difficulty questions about Anafranil. your whole body and can cause breathing; swelling of the face, lips, emotional and physical symptoms tongue or other parts of the body; It does not contain all the available such as feeling low in spirit, loss rash, itching or hives on the skin. information. It does not take the of interest in activities, being place of talking to your doctor or Do not start taking Anafranil if unable to enjoy life, poor appetite pharmacist. you are already taking another or overeating, disturbed sleep, medicine called a monoamine- The information in this leaflet was loss of sex drive, lack of energy oxidase inhibitor (MAOI) or you last updated on the date listed on the and feelings of guilt. have been taking it within the past final page. More recent information 2. obsessive-compulsive disorders 2 weeks. on the medicine may be available. (OCD) and phobias in adults Taking Anafranil together with a You should ensure that you speak 3. muscle weakness in people with a MAOI may cause a serious reaction to your pharmacist or doctor to sleep disorder called narcolepsy. with a sudden increase in body obtain the most up to date temperature, extremely high blood information on the medicine. You The symptoms of these disorders vary from person to person. Your pressure and seizures (fits). Your can also download the most up to doctor will know when it is safe to date leaflet from doctor can provide you with more information. start Anafranil after the MAOI has www.novartis.com.au. been stopped. Those updates may contain important Anafranil belongs to a group of Do not take Anafranil if you are information about the medicine and medicines called tricyclic recovering from a recent heart its use of which you should be aware. antidepressants. attack. All medicines have risks and Ask your doctor if you have any It may make your condition worse. benefits. Your doctor has weighed questions about why this medicine the risks of you taking this medicine has been prescribed for you. Do not take this medicine after the against the benefits it can provide. Your doctor may have prescribed it expiry date printed on the pack or if the packaging is torn or shows If you have any concerns about this for another purpose. signs of tampering. medicine, ask your doctor or This medicine is only available with pharmacist. a doctor's prescription. In that case, return it to your pharmacist. Keep this leaflet with the medicine. You may need to read it again. Before you start to take it Before you take Tell your doctor if you have any of Anafranil the following health problems/ medical conditions: What Anafranil is used for When you must not take it • an irregular heart beat or other problems with your heart Do not take Anafranil if you have Anafranil is used to treat: an allergy to: • an inherited heart problem called congenital long QT syndrome 1. depression that is longer lasting • clomipramine (the active and/or more severe than the "low ingredient) or any of the other • increased pressure in the eye from moods" that everyone has from ingredients of Anafranil listed at any cause (e.g. glaucoma) time to time due to the stress of the end of this leaflet everyday life. Depression is • any other tricyclic antidepressant ANAFRANIL® 1 • difficulty in passing urine (water), Your doctor will want to know if you • disulfiram, a medicine for due to prostate trouble or any are prone to allergies. alcoholism other cause • rifampicin, an antibiotic Taking other medicines • seizures (fits) • terbinafine, a medicine used to • severe liver or kidney disease Tell your doctor or pharmacist if treat skin, hair or nail infections you are taking any other • a low level of potassium in your due to fungus medicines, including any that you blood (called hypokalaemia) • medicines used to reduce fat in buy without a prescription from a blood • a mental disorder other than the pharmacy, supermarket or health one being treated (e.g. food shop. • grapefruit/grapefruit juice or schizophrenia, mania) cranberry juice. Some medicines and Anafranil may • problems with blood pressure interfere with each other. These You may need to take different (either too high or too low) include: amounts of your medicines or you may need to take different medicines. • a blood disorder • MAOI medicines. You must not Your doctor and pharmacist have • a thyroid problem take Anafranil together with a more information. • chronic constipation MAOI (see "When you must not take it") If you have not told your doctor • Parkinson's disease about any of these things, tell him/ • medicines for high blood pressure her before you start taking this • a tumour of the adrenal gland or heart problems medicine. Your doctor may not want you to • medicines to help you sleep or take this medicine or may want to calm you down take special precautions if you have any of the above conditions. • other medicines for depression called SSRIs or SNaRIs (e.g. How to take Anafranil Tell your doctor if you are fluoxetine, paroxetine, sertraline, pregnant or intend to become fluvoxamine) Follow all directions given to you pregnant. • medicines for other mental by your doctor and pharmacist This medicine may affect your baby disorders carefully. if you take it while you are pregnant, They may differ from the • medicines for seizures (fits) especially during the last 7 weeks of information contained in this leaflet. pregnancy. Your baby may have • medicines to prevent blood clots If you do not understand the some side effects from the medicine (e.g. warfarin) instructions on the label, ask your during the first month after birth. • diuretic medicines, also called doctor or pharmacist for help. Tell your doctor if you are breast- fluid or water tablets feeding or plan to breast-feed. • some medicines for colds or How much to take Breast-feeding is not recommended allergies, including antihistamines For depression, obsessive- while you are taking Anafranil. The and some nose drops compulsive disorders and phobias, active ingredient passes into the • anticholinergic medicines, which treatment is usually started with a breast milk and could affect your are used to relieve stomach low dose of 2 or 3 tablets (50 to 75 baby. cramps, spasms and travel mg) each day. The dose can be raised Tell your doctor if you smoke. sickness slowly up to 4 to 6 tablets each day. Nicotine can affect the amount of • medicines for thyroid problems Some people will need higher doses than others because each person's Anafranil that is in your body. • cimetidine, a medicine for body chemistry is different. Once Sudden changes in your usual stomach ulcers smoking habits can also change the you are feeling better, your doctor • medicines for Parkinson's disease effects of Anafranil. may be able to slowly reduce the • oestrogens (e.g. birth control dose, usually down to 2 to 4 tablets Tell your doctor if you are lactose pills, hormone replacement each day. intolerant. therapy) For muscle weakness accompanying This medicine contains lactose. • nicotine in medicines used to help narcolepsy, the dose is usually from Tell your doctor if you are allergic you quit smoking, such as 1 to 3 tablets (25 to 75 mg) each day. to any other medicines, foods, dyes nicotine patches or chewing gum If you are older than 65 years, your or preservatives. • methylphenidate (Ritalin®) doctor will probably start with a low dose (e.g. 1 tablet each day) to help ANAFRANIL® 2 avoid side effects. The dose is to taking the tablets as you would This helps to prevent unwanted side gradually increased over about ten normally. effects. days to 2 to 3 tablets each day and Do not take a double dose to make Contact your doctor immediately if kept at that dose for the rest of your up for the one that you missed. you or someone you know develop treatment. This may increase the chance of you any of the following symptoms at getting an unwanted side effect. any time during treatment with When to take it Anafranil: If you have trouble remembering Take the tablets in 2 or 3 doses when to take your medicine, ask • thoughts about suicide or dying spread over the day unless your your pharmacist for some hints. • attempts to commit suicide doctor advises you otherwise. • new or worse depression If you have narcolepsy and you If you take too much • new or worse anxiety have trouble sleeping at night, take (overdose) the last dose before evening to • feeling very agitated or restless Immediately telephone your doctor avoid making your insomnia • panic attacks worse. or Poisons Information Centre (telephone 13 11 26) or go to • difficulty sleeping (insomnia) How to take it Accident and Emergency at your • new or worse irritability nearest hospital, if you think that • acting aggressive, being angry, or Swallow the tablets with a full glass you or anyone else may have taken violent of water. If your stomach is upset too much Anafranil. Do this even if after taking the tablets, take them there are no signs of discomfort or • acting on dangerous impulses with a meal or after a snack. poisoning. • an extreme increase in activity Keep the telephone numbers for and talking How long to take it these places handy. • other unusual changes in Take this medicine until your If you take too much Anafranil, you behaviour or mood doctor tells you to stop treatment.