英文药名: Anafranil(Clomipramine Tablets)

中文药名: 氯米帕明片

生产厂家: Novartis Pharmaceuticals Corp.

药物名称

正式品名：盐酸氯米帕明片
商品名：安拿芬尼
英文名：Clomipramine Hydrochioride Tablets
性状: 本品为浅黄色圆形双凸面糖衣片，除去糖衣后，显白色。
药理作用

本品具有抗抑郁作用，且治疗范围广。它能改善抑郁综合征的各种表现，特别是缺乏动力，情绪低落，同时对持续存在的焦虑也有作用。通常在治疗第一周便产生疗效。根据动物实验，本品的主要作用可能是抑制神经元对释放于突触间隙的去甲肾上腺素（NA）和5-羟色胺（5-HT）的再摄取，其中又以抑制5-HT的重摄取为主。本品的另一特点是具有广谱的药理作用，包括α1抗肾上腺素、抗胆碱能、抗组胺和抗5-羟色胺能（5-HT-受体阻滞）等作用。
药代动力学

吸收：口服后活性物质吸收完全。
分布：以本品恒定的口服日剂量治疗期间，患者间的氯米帕明稳态血浆浓度变异性很大。
蛋白结合率：97.6% 在脑脊液中的浓度约相当于血浆浓度的2%。
代谢：活性代谢物去甲氯米帕明达到稳态敌国浆浓度的方式与氯米帕明类似，然而在每日使用75mg本品的情况下，平均来讲，去甲氯米帕明比氯米帕明高40-85%。
消除：β相血浆消除半衰期为21小时。
排泄：2/3以水溶性结合形式从尿中排出，约1/3从粪便排出。
适应症

各种病因和症状表现的抑郁状态：
内源性、反应性、神经症性、器质性、隐匿性及更年期性抑郁。
与精神分裂症和人格障碍伴随的抑郁。由于早老、衰老、慢性疼痛状态、慢性躯体疾病引起的抑郁综合征。
反应性、神经症性及精神病性的抑郁心境障碍，包括其相应的躯体表现，也见于儿童患者。
强迫综合症
其它适应症：恐怖症和惊恐发作，伴有发作性睡病的猝倒症，慢性疼痛状态。
夜间遗尿（5岁以上，且应首先排除可能的器质性病因）。
用法用量

抑郁症、强迫症和恐怖症：
治疗初期：每次一片，每日2-3次，以后的剂量视患者对药物的耐受性逐渐增加，如在治疗第一周每隔二、三天增加25毫克，直到每日4-6片。
在病情严重时，每日最大剂量可增加到250mg。一旦病情显著改善，则将剂量调整到维持量，即平均每日25mg片剂2-4片。
惊恐发作，广场恐怖：初期，每日服用10mg，可与某种苯二氮卓类药物合用，根据对药物的耐受程度来增加剂量以达理想疗效。同时逐渐撤用苯二氮卓类药物。每日所需量因病人而异，差距很大，从25mg至100mg不等，如病情需要，可增至150mg。一般认为，治疗应至少持续6个月，在此期间可逐渐减少维持量。
伴有发作性睡病的猝倒症：每日口服本品25-75mg。
慢性疼痛状态：剂量应个体化（每日10-150mg），因考虑患者可能合并用止痛药（或可能减少止痛药的用量）。
老年患者：开始采用每日10mg治疗，以后逐步增加剂量到每日30-50mg的合适剂量，通常约需10日左右，以后维持此量直到治疗结束。
小儿患者：开始用10mg每日治疗，在10日内，5-7岁的儿童用量增至每日20mg，8-14岁儿童增至每日20-50mg，14岁以上的儿童增至50mg或更多。
夜间遗尿（限于5岁以5岁以上儿童）：初期日剂量：5-8岁儿童-20-30mg，2-3片；9-12岁儿童-25mg片剂，1-2片；12岁以上儿童-25mg片剂，1-3片。在用药一周内无充分疗效时，应给以更高剂量，一般应在晚饭后一次性给药，但对入睡不久便遗尿的儿童要预先（下午4时）给予部分剂量。获得预期疗效后，应逐渐减少维持量，并继续治疗1-3月。尚无对5岁以下儿童的治疗经验。
任何疑问，请遵医嘱！
禁忌症

苯二氮卓类三环抗抑郁药过敏者禁用。
本品严禁与MAO（单胺氧化酶）抑制剂合用。
心肌梗塞急性发作期禁用。
不良反应

抗胆碱能作用：常见：口干、出汗、便秘、视力调节失调、视物模糊、排尿障碍
中枢神经系统：精神作用：常见：嗜睡、短时疲劳、不安感、食欲增加。
神经病学作用：常见：晕眩、震颤、头痛、肌阵挛。
心血管系统 偶见：体位性低血压，窦性心动过速。
胃肠道：常见：恶心。偶见：呕吐、腹部不适、腹泻、厌食、味觉反常。
内分泌系统及代谢功能：常见：体重增加、性欲和性功能失调等。

Anafranil (Clomipramine)
Class and Category of Drug
Before you buy Anafranil (Clomipramine) online, read common information about the medication.
Chemical class: Dibenzazepine derivative

Therapeutic class: Antiobsessional tricyclic antidepressant

Pregnancy category: C

Drug Indications and Dosages
Before purchase Anafranil (Clomipramine) online , you must read how it works.
To treat obsessive-compulsive disorder

Capsules,Tablets
Adults. Initial: 25 mg daily. Gradually increased to 100 mg daily in divided doses over 2 wk, then to maximum of 250 mg daily in divided doses over next few weeks.

At maximum dose, total daily amount may be given at bedtime.

Children age 10 and over. Initial: 25 mg daily. Gradually increased to the lesser of 3 mg/kg daily or 100 mg daily in divided doses over 2 wk, then to maximum of 3 mg/kg daily or 200 mg daily, whichever is less. At maximum dose, total daily amount may be given at bedtime.

Contraindications of Drug
Read contraindications if you want cheap Anafranil (Clomipramine) online.
Acute recovery period after MI, hypersensitivity to clomipramine or its components, use of an MAO inhibitor within 14 days

Generic Drug Interactions
Drugs
anticholinergics: Increased anticholinergic effects

barbiturates: Decreased level and effects of clomipramine; additive CNS depression

bupropion, cimetidine, haloperidol, H2-receptor antagonists, selective serotonin reuptake inhibitors, valproic acid: Increased blood level and therapeutic and adverse effects of clomipramine

carbamazepine: Decreased blood clomipramine level; increased carbamazepine level

clonidine: Severely increased blood pressure and risk of hypertensive crisis

CNS depressants: Increased CNS depression dicumarol: Increased anticoagulant effect

grepafloxacin, quinolones, sparfloxacin: Increased risk of life-threatening arrhythmias

guanethidine: Antagonized antihypertensive effect of guanethidine

levodopa: Delayed absorption and decreased bioavailability of levodopa

MAO inhibitors: Increased risk of seizures, coma, or death

rifamycins: Decreased clomipramine level sympathomimetics: Possibly potentiated cardiovascular effects

thyroid drugs: Increased effects of thyroid drugs and clomipramine

Activities
alcohol use: Increased CNS depression

Order pharmaceuticals online no prescription drugs for treatment disease

Drugs Adverse Reactions
Central Nervous System: Anxiety, confusion, depersonalization, depression, dizziness, drowsiness, emotional lability, fatigue, headache, insomnia, panic reaction, paresthesia, somnolence, suicidal ideation (children and teens), syncope, tremor, unusual dreams, yawning

Cardiovascular: Orthostatic hypotension, palpitations, tachycardia

Eyes, Ears, Nose, And Throat: Blurred vision, dry mouth, epistaxis, pharyngitis, rhinitis, sinusitis, unpleasant taste

Gastrointestinal: Abdominal pain, anorexia, constipation, diarrhea, flatulence, increased appetite, indigestion, nausea, vomiting

Genitourinary: Dysmenorrhea, ejaculation failure, impotence, urinary hesitancy, urine retention

Respiratory: Bronchospasm

Skin: Abnormal skin odor, acne, dermatitis, dry skin, photosensitivity, rash, urticaria

Other: Weight gain

Savings of up to 90% on common OTC drugs (tablets [tab, tabs], pills, capsules [cap, caps], softgels, solutions, ointments, creams, inhalers) and prescriptions drugs.

Nursing Considerations for Generic Drugs
• Be aware that stopping clomipramine abruptly may cause withdrawal symptoms and worsen disorder.

WARNING Don't give drug within 14 days of an MAO inhibitor to avoid possible seizures, coma, or death. WARNING Monitor children and teens closely for evidence of suicidal ideation; clomipramine increases the risk in these groups.

Remember it if you buying Anafranil (Clomipramine) online.
Clomipramine
Preparations
International Brand Drug Names
The information about drugs (tablets, pills, capsules, creams, solution, nasal spray, inhaler) around the world.

The United States Pharmacopeia 31, 2008: Clomipramine Hydrochloride Capsules.