英文药名: Anafranil SR(Clomipramine SR Tablets)

中文药名: 氯米帕明缓释片

生产厂家: Novartis Pharmaceuticals Corp.

药品介绍

药物名称： 氯米帕明
药物别名： 氯丙米嗪，安拿芬尼，Chlorimipramine，ANAFRANIL，Hydiphen
英文名称： Clomipramine

功用作用：
本品为一安全可靠、起效迅速的抗抑郁药，通过抑制突触前膜对NA与5-HT的再摄取而产生抗抑郁作用，同时还有抗焦虑与镇静作用。口服吸收良好，1～2周可达稳态血浓度。经肝脏代谢，代谢产物去甲氯米帕明浓度比原药浓度高2倍。血浆蛋白结合率为97.6％，t1/2为21小时。约70％自尿排出，30％自粪便排出。 　　
本品适用于治疗内源性、反应性、神经性、隐匿性抑郁症以及各种抑郁状态；伴有抑郁症的精神分裂症；强迫症、恐怖症；多种疼痛等。

用法用量：
治疗抑郁症、强迫症：
①口服，开始一次25mg，1日3次（或服缓释片，75mg，每晚1次），1周内可渐增至最适宜的治疗量。1日最大剂量为250mg，小儿或青年患者日200mg。症状好转后，改为维持量，每日50～100mg（缓释片剂每日75mg）。
②肌注：开始25～50mg，以后增至每日100～150mg，症状好转后，改为口服维持量。
③静注：开始25～75mg，溶于250～500ml等渗盐水或5％葡萄糖注射液中，每日1次，在1.5～3小时内输完，最好每日早晨输。一般第1周见效，见效后再继续滴注3～5天，然后改为口服维持量。
④老年患者，开始每日10mg，逐渐增加至每日30～50mg（约10天），然后改维持量。
⑤小儿：口服：每日10mg，10天后，5～7岁儿童增至20mg，8～14岁增至20～25mg，14岁以上增到50mg或按需要量，分次服用。

治疗慢性病性疾病：每日约10～150mg，最好同时服用止痛剂。

注意事项： 　
（1）主要不良反应有口干、出汗、眩晕、震颤、视力模糊、排尿困难、体位性低血压。偶见皮肤过敏、粒细胞减少。大剂量时可产生焦虑、心律不齐、传导阻滞、失眠等。罕见肝损伤、发热、癫痫发作。
（2）严重心脏病、循环障碍、急性心梗、传导阻滞、低血压、青光眼、排尿困难、白细胞过低、对本品过敏者禁用。
（3）癫痫患者及孕妇慎用。
（4）服用本品期间，不宜饮酒或含酒精饮料。不得与单胺氧化酶抑制剂合用。

包装规格：
·75mg *100 片
·75mg *50 片

Anafranil SR Description
Clomipramine is used to treat obsessive compulsive disorder (OCD). It helps decrease persistent/unwanted thoughts (obsessions), and it helps reduce the urge to perform repeated tasks (compulsions such as hand-washing, counting, checking) that interfere with daily living.
This medication belongs to a class of medications called tricyclic antidepressants. It works by restoring the balance of certain natural substances (serotonin, among others) in the brain.
OTHER USES: This section contains uses of this drug that are not listed in the approved professional labeling for the drug but that may be prescribed by your health care professional. Use this drug for a condition that is listed in this section only if it has been so prescribed by your health care professional.
This medication has also been used to treat depression, panic attacks, and ongoing pain.

Anafranil SR Directions
Read the Medication Guide available from your pharmacist. Consult your doctor or pharmacist if you have any questions.
Take this medication by mouth with or without food as directed by your doctor. To lessen side effects such as stomach upset, clomipramine may be started at a low dose, given in several doses during the day with meals, and slowly increased as your body gets used to it. After you have reached the best dose for you, the total dose can be taken once daily, usually at bedtime to prevent daytime drowsiness or as directed by your doctor. Usually, the daily dose will not be more than 250 milligrams for adults and 200 milligrams for children and teenagers.
Follow your doctor's instructions carefully. Do not take more or less medication or take it more frequently than prescribed. Your condition will not improve any faster and your risk of side effects such as seizures may be increased. Dosage is based on your medical condition and response to therapy.
Avoid eating grapefruit or drinking grapefruit juice while being treated with this medication unless your doctor instructs you otherwise. Grapefruit can increase the amount of certain medications in your bloodstream. Consult your doctor or pharmacist for more details.
Use this medication regularly in order to get the most benefit from it. Continue to take it even if you feel well. To help you remember, use it at the same time(s) each day.
Do not suddenly stop taking this medication without consulting your doctor. Some conditions may become worse when the drug is abruptly stopped. You may experience sweating, dizziness, nausea, vomiting, headache, or irritability if you suddenly stop taking this drug. Your dose may need to be gradually decreased.
It may take 2 to 3 weeks or longer before the full effects of this medication are noticed. Inform your doctor if your condition persists or if it worsens.

Anafranil SR Cautions
Before taking clomipramine, tell your doctor or pharmacist if you are allergic to it; or to other tricyclic antidepressants (e.g., imipramine, nortriptyline); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.
This medication should not be used if you have a certain medical condition. Before using this medicine, consult your doctor or pharmacist if you have had: a recent heart attack.
Before using this medication, tell your doctor or pharmacist your medical history, especially of: blood problems (e.g., purpura, thrombocytopenia), breathing problems (e.g., asthma, chronic bronchitis), certain eye problems (e.g., glaucoma, increased intraocular pressure), eating disorders (e.g., bulimia), heart problems (e.g., arrhythmias, coronary artery disease), intestinal problems (e.g., chronic constipation, ileus), liver problems, kidney problems, personal or family history of other mental/mood conditions (e.g., bipolar disorder, schizophrenia), history of hospitalization for a very serious reaction to certain medications (neuroleptic malignant syndrome), heartburn/stomach acid in the esophagus (e.g., due to hiatal hernia), seizures, overactive thyroid (hyperthyroidism), trouble urinating (urinary retention, enlarged prostate), any condition that may increase your risk of seizures (e.g., alcohol/sedative dependency, use of electroconvulsive therapy, brain injury/disease), certain types of tumors (e.g., pheochromocytoma, neuroblastoma).
Clomipramine may cause a condition that affects the heart rhythm (QT prolongation). QT prolongation can infrequently result in serious (rarely fatal) fast/irregular heartbeat and other symptoms (such as severe dizziness, fainting) that require immediate medical attention. The risk of QT prolongation may be increased if you have certain medical conditions or are taking other drugs that may affect the heart rhythm (see also Drug Interactions section). Before using clomipramine, tell your doctor or pharmacist if you have any of the following conditions: certain heart problems (heart failure, slow heartbeat, QT prolongation in the EKG), family history of certain heart problems (QT prolongation in the EKG, sudden cardiac death).
Low levels of potassium or magnesium in the blood may also increase your risk of QT prolongation. This risk may increase if you use certain drugs (such as diuretics/"water pills") or if you have conditions such as severe sweating, diarrhea, or vomiting. Talk to your doctor about using clomipramine safely.
This drug may make you dizzy or drowsy or cause temporary blurred vision. Do not drive, use machinery, or do any activity that requires alertness or clear vision until you are sure you can perform such activities safely. Limit alcoholic beverages.
To decrease dizziness and lightheadedness, get up slowly when rising from a seated or lying position.
Before having surgery, tell your doctor or dentist that you are taking this medication.
Caution is advised when using this drug in children who participate in active sports because it may increase the risk of heart problems. (See also the Warning section.)
Caution is advised when using this drug in the elderly because they may be more sensitive to the effects of the drug (e.g., bleeding, confusion, dizziness).
This medication should be used only when clearly needed during pregnancy. Newborns exposed to clomipramine during pregnancy may experience withdrawal symptoms or side effects. Tell your doctor immediately if you notice jitteriness, shaking, feeding problems, fast breathing, or seizures in your newborn. Discuss the risks and benefits with your doctor.
This drug passes into breast milk and may have undesirable effects on a nursing infant. Consult your doctor before breast-feeding.

Anafranil SR Side Effects
Dizziness, drowsiness, dry mouth, constipation, stomach upset, nausea, vomiting, changes in appetite/weight, flushing, sweating, tiredness and blurred vision may occur. Anxiety symptoms may temporarily worsen when you first start taking clomipramine. If any of these effects persist or worsen, notify your doctor or pharmacist promptly.
To relieve dry mouth, suck on (sugarless) hard candy or ice chips, chew (sugarless) gum, drink water or use a saliva substitute.
To prevent constipation, maintain a diet adequate in fiber, drink plenty of water, and exercise. If you become constipated while using this drug, consult your pharmacist for help in selecting a laxative (e.g., stimulant-type with stool softener).
Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.
Tell your doctor immediately if any of these unlikely but serious side effects occur: mental/mood changes (e.g., confusion, depression, hallucinations, memory problems), enlarged/painful breasts, unwanted breast milk production, irregular/painful menstrual periods, muscle stiffness/twitching, feelings of restlessness, ringing in the ears, sexual problems (e.g., decreased sexual ability, changes in desire), shakiness (tremors), numbness/tingling of the hands/feet, trouble urinating, severe vomiting.
Tell your doctor immediately if any of these rare but very serious side effects occur: easy bruising/bleeding, signs of infection (e.g., fever, persistent sore throat), unusual/uncontrolled movements (especially of the tongue/face/lips), severe stomach/abdominal pain, dark urine, yellowing of eyes/skin.
Seek immediate medical attention if any of these rare but very serious side effects occur: black stools, chest pain, fainting, high fever, slow/fast/irregular heartbeat, seizures, vomit that looks like coffee grounds.
A very serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction include: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.
This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

Anafranil SR Active Ingredients
Clomipramine