clomipramine hydrochloride
Consumer Medicine Information

NOTICE: This Consumer Medicine Information (CMI) is intended for persons living in Australia. This page contains answers to some common questions about Anafranil. It does not contain all the information that is known about Anafranil. It does not take the place of talking to your doctor or pharmacist. All medicines have risks and benefits. Your doctor has weighed the risk of you using this medicine against the benefits he/she expects it will have for you. If you have any concerns about using this medicine, ask your doctor or pharmacist. Bookmark or print this page, you may need to read it again.

What Anafranil is used for

Anafranil is used to treat:

1. depression that is longer lasting and/or more severe than the "low moods" that everyone has from time to time due to the stress of everyday life. Depression is thought to be caused by a chemical imbalance in parts of the brain. This imbalance affects your whole body and can cause emotional and physical symptoms such as feeling low in spirit, loss of interest in activities, being unable to enjoy life, poor appetite or overeating, disturbed sleep, loss of sex drive, lack of energy and feelings of guilt.

2. obsessive-compulsive disorders (OCD) and phobias in adults

3. muscle weakness in people with a sleep disorder called narcolepsy.

The symptoms of these disorders vary from person to person. Your doctor can provide you with more information.
Anafranil belongs to a group of medicines called tricyclic antidepressants.
Your doctor may have prescribed it for another purpose.
This medicine is only available with a doctor's prescription.

Before you take Anafranil

When you must not take it

Do not take Anafranil if you have an allergy to:
clomipramine (the active ingredient) or any of the other ingredients of Anafranil listed at the end of this leaflet
any other tricyclic antidepressant
Do not start taking Anafranil if you are already taking another medicine called a monoamine-oxidase inhibitor (MAOI) or you have been taking it within the past 2 weeks.
Taking Anafranil together with a MAOI may cause a serious reaction with a sudden increase in body temperature, extremely high blood pressure and seizures (fits). Your doctor will know when it is safe to start Anafranil after the MAOI has been stopped.
Do not take Anafranil if you are recovering from a recent heart attack.
It may make your condition worse.
In that case, return it to your pharmacist.

Before you start to take it

an irregular heart beat or other problems with your heart
an inherited heart problem called congenital long QT syndrome
increased pressure in the eye from any cause (e.g. glaucoma)
difficulty in passing urine (water), due to prostate trouble or any other cause
seizures (fits)
severe liver or kidney disease
a low level of potassium in your blood (called hypokalaemia)
a mental disorder other than the one being treated (e.g. schizophrenia, mania)
problems with blood pressure (either too high or too low)
a blood disorder
a thyroid problem
chronic constipation
Parkinson's disease
a tumour of the adrenal gland
This medicine may affect your baby if you take it while you are pregnant, especially during the last 7 weeks of pregnancy. Your baby may have some side effects from the medicine during the first month after birth.
Breast-feeding is not recommended while you are taking Anafranil. The active ingredient passes into the breast milk and could affect your baby.
Tell your doctor if you smoke.
Nicotine can affect the amount of Anafranil that is in your body. Sudden changes in your usual smoking habits can also change the effects of Anafranil.
Tell your doctor if you are lactose intolerant.
This medicine contains lactose.

Taking other medicines

Some medicines and Anafranil may interfere with each other. These include:
MAOI medicines. You must not take Anafranil together with a MAOI (see "When you must not take it")
medicines for high blood pressure or heart problems
medicines to help you sleep or calm you down
other medicines for depression called SSRIs or SNaRIs (e.g. fluoxetine, paroxetine, sertraline, fluvoxamine)
medicines for other mental disorders
medicines for seizures (fits)
medicines to prevent blood clots (e.g. warfarin)
diuretic medicines, also called fluid or water tablets
some medicines for colds or allergies, including antihistamines and some nose drops
anticholinergic medicines, which are used to relieve stomach cramps, spasms and travel sickness
medicines for thyroid problems
cimetidine, a medicine for stomach ulcers
medicines for Parkinson's disease
oestrogens (e.g. birth control pills, hormone replacement therapy)
nicotine in medicines used to help you quit smoking, such as nicotine patches or chewing gum
methylphenidate (Ritalin®)
disulfiram, a medicine for alcoholism
rifampicin, an antibiotic
terbinafine, a medicine used to treat skin, hair or nail infections due to fungus
medicines used to reduce fat in blood
grapefruit/grapefruit juice or cranberry juice.
You may need to take different amounts of your medicines or you may need to take different medicines. Your doctor and pharmacist have more information.

How to take Anafranil

They may differ from the information contained in this leaflet.

How much to take

For depression, obsessive-compulsive disorders and phobias, treatment is usually started with a low dose of 2 or 3 tablets (50 to 75 mg) each day. The dose can be raised slowly up to 4 to 6 tablets each day. Some people will need higher doses than others because each person's body chemistry is different. Once you are feeling better, your doctor may be able to slowly reduce the dose, usually down to 2 to 4 tablets each day.

When to take it

Take the tablets in 2 or 3 doses spread over the day unless your doctor advises you otherwise.
If you have narcolepsy and you have trouble sleeping at night, take the last dose before evening to avoid making your insomnia worse.

How to take it

Swallow the tablets with a full glass of water. If your stomach is upset after taking the tablets, take them with a meal or after a snack.

How long to take it

Take this medicine until your doctor tells you to stop treatment.
The length of treatment will depend on your condition and on how well the medicine works.
For depression, the length of treatment will depend on how quickly your symptoms improve. This type of medicine takes time to work, so don't be discouraged if you don't feel better right away. Some of your symptoms may improve in 1 or 2 weeks but it can take up to 4 to 6 weeks to feel any real improvement. Even when you feel well, you will usually have to take Anafranil for several months or even longer to make sure the benefits will last.
Do not stop taking Anafranil suddenly as you could suffer possible withdrawal symptoms.

If you forget to take it

If it is almost time for your next dose (e.g. within 2 or 3 hours), skip the dose you missed and take the next one when you are meant to.
Otherwise, take the dose as soon as you remember, and then go back to taking the tablets as you would normally.

If you take too much (overdose)

Immediately telephone your doctor or Poisons Information Centre (telephone 13 11 26) or go to Accident and Emergency at your nearest hospital, if you think that you or anyone else may have taken too much Anafranil. Do this even if there are no signs of discomfort or poisoning.
Keep the telephone numbers for these places handy.
Children are much more sensitive than adults to tricyclic antidepressants. An accidental overdose is especially dangerous.

While you are taking Anafranil

Things you must do

If you become pregnant while taking Anafranil, tell your doctor immediately.
Your doctor may want to take some blood tests and check your heart and blood pressure from time to time. This helps to prevent unwanted side effects.
Contact your doctor immediately if you or someone you know develop any of the following symptoms at any time during treatment with Anafranil:
thoughts about suicide or dying
attempts to commit suicide
new or worse depression
new or worse anxiety
feeling very agitated or restless
panic attacks
difficulty sleeping (insomnia)
new or worse irritability
acting aggressive, being angry, or violent
acting on dangerous impulses
an extreme increase in activity and talking
other unusual changes in behaviour or mood
Before having any surgery or emergency treatment, even a minor procedure, tell the doctor or dentist in charge that you are taking Anafranil or have been taking it within the last two weeks or so.
If possible, this medicine should be stopped before surgery to avoid unnecessary side effects.
If this medicine causes your mouth to feel dry and this problem doesn't go away, tell your doctor or dentist. Be sure to have regular dental checkups.
Continuing dryness of the mouth may increase the chance of gum disease or cavities. You can relieve dry mouth by frequent sips of water, sucking sugarless lollies or chewing sugarless gum.
If you wear contact lenses and find that your eyes are dry, sticky or irritated, tell your doctor.
These side effects could damage your eyes.
Tell any other doctor, dentist or pharmacist who treats you that you are taking Anafranil.

Things you must not do

Do not stop taking Anafranil or change the dose without first checking with your doctor. Do not let yourself run out of medicine over the weekend or on holidays.
If you stop taking this medicine suddenly, your condition may worsen or you may have unwanted side effects such as headache, nausea (feeling sick), vomiting, diarrhoea and nervousness. If possible, your doctor will gradually reduce the amount you take each day before stopping the medicine completely.

Things to be careful of

Be careful driving, operating machinery or doing jobs that require you to be alert while you are taking Anafranil until you know how it affects you.
This medicine may cause tiredness, dizziness, drowsiness or blurred vision in some people.
Be careful to stay out of direct sunlight as much as possible until you find out if your skin is more sensitive than usual. Wear protective clothing and use a sunscreen. Do not use a sunlamp.
This medicine makes some people more sensitive to sunlight.
After you have stopped taking Anafranil, you should still be careful for 1 or 2 weeks since some of the effects of the medicine will still be in your body.

Side effects

Tell your doctor or pharmacist as soon as possible if you do not feel well while you are taking Anafranil.
If you are over 65 years old, you should be especially careful while taking this medicine. Report any side effects promptly to your doctor.
Anafranil can cause confusion or disorientation, especially in older people or those with Parkinson's disease. Your family or carer should be aware of this. Special care may be needed.
Patients aged 50 years or older and taking a medicine of this group are more likely to experience bone fractures.
drowsiness, dizziness, blurred vision or difficulty focussing your eyes, especially when treatment is started or the dose is increased.
lightheadedness, especially when you get up too quickly from a sitting or lying position.
dry mouth
difficulty urinating (passing water)
dry or sticky eyes if you wear contact lenses
sweating or hot flushes
increased appetite and weight gain
decreased appetite
tired feeling and mental dullness
feeling of unrest or anxiety
a compelling need to be in constant motion
repetitive, involuntary, purposeless movements
disturbed sleep or nightmares
shakiness or trembling
nausea (feeling sick), vomiting, diarrhoea
poor appetite or weight loss
sores in the mouth or on the tongue
reduced sexual desire or difficulty in reaching orgasm
swelling of the breasts or discharge of milk
swelling of the testicles
increased sensitivity to the sun
ringing in the ears
hair loss
change in sense of taste
delayed or no ejaculation of semen if you are a male
constant "flu-like" symptoms (chills, fever, sore throat, aching joints, swollen glands, tiredness or lack of energy)
unusual bleeding or bruising
pain in the stomach or abdomen that is severe or doesn't go away
muscle numbness, tingling or spasms
weakness or loss of balance
severe dizziness or drowsiness
fainting spells or seizures (fits)
difficulty in speaking or slurred speech
unusually high energy, irritability or outbursts of anger
frequent passing of large amounts of urine
yellow colour to the skin or eyes
eye pain
symptoms like agitation, confusion, diarrhoea, high temperature, increased blood pressure, excessive sweating and rapid heartbeat (syndrome caused due to increase in naturally occurring messenger, serotonin)

After using Anafranil


Keep your medicine in the original container until it is time to take a dose.
Store it in a cool dry place at room temperature.
Do not store Anafranil or any other medicine in the bathroom or near a sink.
Do not leave it in the car or on windowsills.
Keep the tablets where children cannot reach them.



Product description

What it looks like

Anafranil 25 mg tablets are round, pale yellow, sugar-coated tablets; supplied in packs of 50 tablets.


Anafranil tablets contain 25 mg of clomipramine hydrochloride as the active ingredient. They also contain:
silica-colloidal anhydrous
magnesium stearate
stearic acid
PVP-VA copolymer
polyethylene glycol (macrogol)
titanium dioxide
iron oxide yellow CI 77492
This medicine does not contain gluten, tartrazine or any other azo dyes.


Anafranil is supplied in Australia by:
NOVARTIS Pharmaceuticals Australia Pty Limited
ABN 18 004 244 160
54 Waterloo Road
North Ryde NSW 2113
Telephone: 1 800 671 203
Web site:
®= Registered Trademark
This leaflet was prepared in
April 2015
Australian Registration Number.
Anafranil 25 mg AUST R 10987
Internal use: (anf010415c) based on PI (anf010415i)