Drug & supplement interaction

Cranberry + Clomipramine

Clomipramine brand names: Anafranil, Anafranil SR.

Moderate Interaction
The bottom line Moderate

Clomipramine falls into 2 drug categories that Cranberry can interact with; the most serious is rated moderate. Theoretically, cranberry might increase the levels and adverse effects of CYP3A4 substrates.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions2
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Cranberry and Clomipramine

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

Cranberry interacts with whole categories of medication. Clomipramine falls into 2 of those categories, so it can interact with Cranberry in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

1 of 2

Why this applies to Clomipramine

Clomipramine falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES — the group Cranberry interacts with.

Theoretically, cranberry might increase the levels and adverse effects of CYP3A4 substrates.
A case of upper back pain, rhabdomyolysis, and abnormal liver function has been reported for a patient taking atorvastatin, a CYP3A4 substrate, in combination with cranberry juice 16 ounces daily for 2 weeks. Creatinine kinase and liver enzymes normalized within 2 weeks of stopping cranberry juice. Also, animal research suggests that cranberry juice, administered intraduodenally 30 minutes prior to nifedipine, a CYP3A4 substrate, inhibits nifedipine metabolism and increases the area under the concentration-time curve by 1.6-fold compared to control.
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the basic idea: your body uses an enzyme called CYP3A4 to help break down clomipramine. Cranberry may slow that enzyme down a little, so in theory more clomipramine could linger in your system. That could nudge up the usual side effects of this medication, things like dry mouth, constipation, drowsiness, dizziness when standing, or a faster heartbeat.

That said, I want to be honest about how shaky this evidence is. It's mostly theoretical, with one case report involving a statin and some animal data, not real studies with clomipramine. An occasional glass of cranberry juice or holiday sauce is very unlikely to be a problem. If you're taking concentrated cranberry supplements daily, just mention it to your pharmacist or doctor so they can keep an eye on things.

References
  1. Uesawa, Y. and Mohri, K. Effects of cranberry juice on nifedipine pharmacokinetics in rats. J Pharm Pharmacol 2006;58(8):1067-1072. PubMed
  2. Doad GJ, Kabange W. Cranberry juice, atorvastatin and back pain. J Med Assoc Ga 2014;103(1):14.
Minor

CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES

2 of 2

Clomipramine also falls under CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES.

Theoretically, cranberry might increase the levels and adverse effects of CYP2C9 substrates. However, research is conflicting.
There is contradictory evidence about the effect of cranberry on CYP2C9 enzymes. In vitro evidence suggests that flavonoids in cranberry inhibit CYP2C9 enzymes. However, clinical research shows that cranberry juice does not significantly affect the levels, metabolism, or elimination of the CYP2C9 substrates flurbiprofen or diclofenac. Also, in patients stabilized on warfarin, drinking cranberry juice 250 mL daily for 7 days does not significantly increase the anticoagulant activity of warfarin, a CYP2C9 substrate. Additional pharmacokinetic research shows that cranberry juice does not increase peak plasma concentrations or area under the concentration-time curve of warfarin.
Severity Minor Likelihood Unlikely Evidence B

Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the short version: this one is mostly theoretical, and I wouldn't lose sleep over it. The idea is that compounds in cranberry might slow down a liver enzyme (CYP2C9) that helps clear clomipramine. If that happened, your levels could nudge up a little, which in theory could mean more of the usual tricyclic side effects like dry mouth, constipation, drowsiness, dizziness, or a faster heartbeat.

But the real-world evidence doesn't back up much worry. Studies with cranberry and other CYP2C9 drugs (even blood thinners like warfarin) showed no meaningful change. Everyday cranberry juice or a UTI-prevention supplement is very unlikely to cause a problem. Clomipramine is not a prodrug, so nothing flips here. Still, if you're starting a concentrated cranberry product, just mention it to your pharmacist or doctor.

References
  1. Anon. Possible interaction between warfarin and cranberry juice. Current Problems in Pharmacovigilance 2003;29:8. PubMed
  2. Greenblatt DJ, von Moltke LL, Perloff ES, et al. Interaction of flurbiprofen with cranberry juice, grape juice, tea, and fluconazole: in vitro and clinical studies. Clin Pharmacol Ther 2006;79:125-33. PubMed
  3. Hodek P, Trefil P, Stiborova M. Flavonoids-potent and versatile biologically active compounds interacting with cytochromes P450. Chem Biol Interact 2002;139:1-21.. PubMed
  4. Li Z, Seeram NP, Carpenter CL, et al. Cranberry does not affect prothrombin time in male subjects on warfarin. J Am Diet Assoc 2006;106:2057-61. PubMed
  5. Lilja JJ, Backman JT, Neuvonen PJ. Effects of daily ingestion of cranberry juice on the pharmacokinetics of warfarin, tizanidine, and midazolam - probes of CYP2C9, CYP1A2 and CYP3A4. Clin Pharmacol The 2007:81:833-9. PubMed
  6. Ushijima K, Tsuruoka S, Tsuda H, Hasegawa G, Obi Y, Kaneda T, Takahashi M, Maekawa T, Sasaki T, Koshimizu TA, Fujimura A. Cranberry juice suppressed the diclofenac metabolism by human liver microsomes, but not in healthy human subjects. Br J Clin Pharmaco PubMed

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Cranberry Also Interacts With Other Medications

Cranberry has 642 moderate, 69 minor known drug interactions in our database — the Clomipramine one above is among them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Cranberry

Covers the 2,830 medications we’ve checked against Cranberry. Pick one to open its full report.

From our Q&A

Questions About Cranberry or Clomipramine

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Cranberry or Clomipramine, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Clomipramine

This page covers Cranberry only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Clomipramine page lists 236 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Grapefruit (major), Henbane (major), Scopolia (major) and St. John's Wort (major).

By severity: 5 major · 179 moderate · 52 minor.

From our pharmacist’s overview on the Clomipramine page

“A tricyclic antidepressant used mostly for OCD, clomipramine (Anafranil) is unforgiving of shifts in its blood level, which is why its 236 supplement interactions deserve genuine wariness. Most of the list involves metabolism: herbs that speed up or slow down the liver enzymes handling clomipramine can drag its level too low or push it…”

Reviewed by 2 · Jul 18, 2026

Open the Clomipramine interaction page

One more smart check

Taking Cranberry as Part of a Dietary Supplement Product? Check It for Interactions

We hold 5,249 real supplement products containing Cranberry, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Cranberry. Your product may carry other ingredients that interact with Clomipramine too, on top of Cranberry — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Cranberry and Clomipramine Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Cranberry
Top 5%

#53 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Clomipramine
Steady interest

#1,961 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Cranberry

What is Cranberry?

Cranberry
  • Urinary tract infection prevention
  • Bladder health
  • Antioxidant support
  • Source of vitamin C

Cranberry is best known for helping to prevent repeated urinary tract infections (UTIs) in some people, and the evidence here is moderate but mixed. It is not a reliable treatment for an active UTI, which usually needs antibiotics. For most people cranberry products are well tolerated, but check with a pharmacist before relying on them, especially if you have frequent infections.

Read the full Cranberry monograph & all interactions
Medication

About Clomipramine

What Is Clomipramine Used For?

Brand names: Anafranil, Anafranil SR

Clomipramine — sold as Anafranil and under the generic name Clomipramine Hydrochloride — is approved to treat obsessions and compulsions in people with Obsessive-Compulsive Disorder (OCD). This includes adults and children/adolescents ages 10 to 17.

To qualify for treatment, the obsessions or compulsions must cause significant distress, take up a lot of time, or noticeably interfere with work, school, or social life.

See full Clomipramine drug information
Keep checking

Other Drugs & Cranberry

Browse every other medication we’ve checked against Cranberry — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
642Moderate
69Minor
2,118No known interaction
Moderate

642 interactions

Showing 60 of 642 moderate interactions — see all 642 on the Cranberry page.

Minor

69 interactions

Showing 60 of 69 minor interactions — see all 69 on the Cranberry page.

No interaction 2,118 drugs checked — show the list
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

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Pharmacist Counseling Corner

Taking Cranberry and Clomipramine Together: Common Questions

Can you take Cranberry with Clomipramine?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
Why are there 2 interactions listed for Cranberry and Clomipramine?
Clomipramine belongs to more than one drug category, and Cranberry interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Cranberry and Clomipramine interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Clomipramine and Cranberry?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.