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Each divitab (divisible tablet) contains 75 mg of clomipramine hydrochloride.
Excipients: Red iron oxide and titanium dioxide.
Treatment of depressive states with various etiology and symptoms, obsessive-compulsive
syndromes, phobias and panic attacks, cataplexy accompanying narcolepsy, chronic pain
cases, enuresis nocturnal (only in patients older than five years and an organic
not due to cause).
Hypersensitivity to clomipramine and any of the excipients in the preparation
or cross-sensitivity to tricyclic antidepressants of the dibenzazepine group
should not be used in people.
Anafranil in combination with a MAO inhibitor or with an MAO inhibitor
It should not be given within 14 days before or after treatment (See "Drug Interactions").
and Other Interactions "). Also selective, reversible MAO-A inhibitors such as moclobemide.
Concomitant use with it is contraindicated. Recently had a myocardial infarction
should not be given to people.
Warnings / Precautions:
Tricyclic antidepressants are known to lower the convulsion threshold and Anafranil
Therefore, in patients with epilepsy and eg; in brain damage with different etiology,
In combination with neuroleptics, alcohol or drugs with anticonvulsive properties
(eg benzodiazepines) in patients with predisposing factors such as
should be used with caution. The occurrence of seizures is dose dependent. Therefore, it is recommended
The total daily dose of Anafranil should not be exceeded.
Anafranil cardiovascular disorders, especially cardiovascular failure,
Conduction disturbances (e.g. atrioventricular block 1st to 3rd degree) or arrhythmias
should be given to patients with special care. In such patients and also in elderly patients
monitoring of heart function and ECG are required.
Due to its anticholinergic properties, Anafranil increased intraocular pressure, narrow angle
Use with caution in patients with glaucoma or urinary retention (e.g. prostate disease).
should be used.
Severe liver disease and tumors of the adrenal medulla (e.g. pheochromocytoma,
When tricyclic antidepressants are given to patients with neuroblastoma), care should be taken as they may provoke hypertensive crises.
more severe anxiety was observed (See "Usage and Dosage"). Anxious
this paradoxical increase is most common within the first few days of treatment and is usually 2
disappears within weeks.
Sometimes activation of psychosis in schizophrenic patients taking tricyclic antidepressants
has been observed.
With recurrent mental disorders treated with a tricyclic antidepressant
Hypomanic or manic seizures have also been reported in patients during the depressive phase. It
reduction of the dose of Anafranil or discontinuation of Anafranil in such cases and
An antipsychotic medication may need to be given. After these seizures are over, if necessary
With the low dose of Anafranil, treatment can be resumed.
Blood pressure in patients with postural hypotension or irregular blood circulation
Before starting treatment with Anafranil, the patient's blood pressure
It is recommended to check the pressure.
Cardiac toxicity in patients with hyperthyroidism or using thyroid preparations.
Care should be taken due to the possibility.
Periodic monitoring of liver enzyme levels in patients with liver disease
recommended to be followed.
Changes in white blood cell count have only been seen rarely with Anafranil.
periodic blood counts and symptoms such as fever and sore throat.
monitoring, especially during the first few months of treatment and during prolonged treatment.
As with similar tricyclic antidepressants, with electroconvulsive therapy
Anafranil should only be given under careful supervision.
In susceptible and elderly patients, tricyclic antidepressants should be pharmacogenic, especially at night.
(delirium) can cause psychosis. These are a few after cessation of treatment.
they disappear during the day.
The risk of suicide may be seen in severe depression and when a significant improvement is seen.
can continue until. At the beginning of treatment with benzodiazepines or neuroleptics
combined therapy may be effective (See "Warnings / Precautions" and "Drug Interactions and Other
Interactions "). Anafranil can be used in overdose from other tricyclic antidepressants.
lower rates of deaths have been reported.
It should be used with caution in patients with chronic constipation. Tricyclic antidepressants
They can cause paralytic ileus, especially in the elderly and bedridden patients.
Before general or local anesthesia, the anesthesiologist takes Anafranil
(See "Drug Interactions and Other Interactions").
An increase in tooth decay in long-term treatment with tricyclic antidepressants
It has been reported. For this reason, regular dental examinations during long-term treatment
It is recommended to have it done.
Tricyclic antidepressants decreased tear rate due to their anticholinergic properties.