Digoxin and Clomipramine: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Clomipramine
Digoxin
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.
What happens
Increased clomiPRAMINE exposure, an increased risk of clomiPRAMINE-related adverse effects, an increased digoxin exposure and an increased risk of digoxin-related adverse effects
Interaction Deep Dive
Coadministration of clomiPRAMINE with digoxin may cause an increased exposure of these drugs, potentially resulting in adverse effects, because clomiPRAMINE is highly bound to serum protein. Conversely, adverse effects may result from displacement of protein-bound of clomiPRAMINE by other drugs that are highly bound to protein, such as digoxin1.
Why it happens (mechanism)
Displacement of protein-bound
Common questions
Can I take Digoxin and Clomipramine together?
Increased clomiPRAMINE exposure, an increased risk of clomiPRAMINE-related adverse effects, an increased digoxin exposure and an increased risk of digoxin-related adverse effects Always confirm with your pharmacist or prescriber before making any change.
How serious is the Digoxin and Clomipramine 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 Digoxin or Clomipramine 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 (1)
- Product Information: ANAFRANIL(TM) oral capsules, clomipramine hydrochloride oral capsules. SpecGx LLC (per Dailymed), Webster Groves, MO, 2024. DailyMed
Keep reading about Clomipramine
Keep reading about Digoxin
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:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
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