Drug Interaction Report

Clomipramine and Mefloquine: Interaction Details

A pharmacist-reviewed analysis of the Clomipramine and Mefloquine interaction: the documented clinical effects, severity rating, onset, mechanism, and management considerations, with cited references throughout.

AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature

Clomipramine

Anafranil Calmera Caniquell Clomicalm
+

Mefloquine

Lariam®
Dr. Brian Staiger, PharmD, BCPS
Medically reviewed by
Dr. Brian Staiger, PharmD, BCPS
Updated Aug 8, 2026
Editorial policy · Data sources
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Interaction severity
Major
Potentially serious — often needs a change or close monitoring.
How we grade severity & evidence

Severity levels

  • Contraindicated: These should generally not be used together.
  • Major: Potentially serious — often needs a change or close monitoring.
  • Moderate: Can be significant — usually manageable with monitoring.
  • Minor: Usually limited clinical impact.

Evidence grades

  • Established: Well documented — supported by controlled studies or strong clinical data.
  • Probable: Good supporting evidence, though not definitively proven.
  • Suspected: Some evidence suggests this interaction, but it is not well established.
  • Possible: Limited or conflicting evidence; the interaction may occur.
  • Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.

Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.

Of 197 documented Clomipramine interactions, 185 are rated major — including this one.
Worried about symptoms right now? Contact your pharmacist or prescriber, or call Poison Control at 1-800-222-1222 (US). Call 911 for an emergency.
Onset
unspecified
Evidence
theoretical
Severity
Major

What happens

An increased risk of QT interval prolongation and an increased risk of seizures

Interaction Deep Dive

Use caution when using clomiPRAMINE and mefloquine concomitantly due to a potential for additive effects on the QT interval and increased risk of serious cardiovascular events1. Concomitant use of clomiPRAMINE with mefloquine (seizure threshold-lowering agent) may also increase the risk of seizure 2.

Why it happens (mechanism)

Additive QT interval prolongation; additive seizure lowering effects

Common questions

Can I take Clomipramine and Mefloquine together?

An increased risk of QT interval prolongation and an increased risk of seizures Always confirm with your pharmacist or prescriber before making any change.

How serious is the Clomipramine and Mefloquine interaction?

It is rated major. Potentially serious — often needs a change or close monitoring.

How quickly could this interaction happen?

The documented onset is "unspecified". The timing of this interaction is not well characterized.

How strong is the evidence for this interaction?

The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.

Questions for your pharmacist

  • Does my dose of Clomipramine or Mefloquine need adjusting while I take them together?
  • What symptoms should prompt me to call you or my prescriber right away?
  • Does the timing of my doses matter for this combination?
  • Is there a safer alternative to one of these medications for me?

References (2)

  1. Product Information: LARIAM(R) oral tablets, mefloquine hcl oral tablets. Roche Laboratories, Inc, Nutley, NJ, 2009.
  2. Product Information: ANAFRANIL(TM) oral capsules, clomipramine hydrochloride oral capsules. SpecGx LLC (per Dailymed), Webster Groves, MO, 2024. DailyMed
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Clomipramine

Keep reading about Clomipramine

All Clomipramine interactions (197)
Also serious with: Metoclopramide Injection Metoclopramide Nasal Spray Linezolid Injection Penicillin V Potassium
Mefloquine

Keep reading about Mefloquine

All Mefloquine interactions (256) Mefloquine drug information
Also serious with: Mesoridazine Levomethadyl Pimozide Levoketoconazole
Beyond drug–drug

These medications also interact with supplements

Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:

Clomipramine + Activated Charcoal Grapefruit Henbane Scopolia St. John's Wort 1,3-dmaa Acacia Rigidula Active Hexose Correlated Compound (ahcc) + 228 more
Mefloquine + Activated Charcoal Biofeedback Coffee Charcoal Dendrobium European Mandrake Ginkgo Glucomannan Guar Gum + 15 more

major · moderate · minor — check everything you take with our drug–supplement interaction checker.

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This information is for education, not a substitute for professional medical advice. Do not start, stop, or change any medication without talking to your pharmacist or prescriber.