Placil (Clomipramine Hydrochloride)
Complete patient guide for uses, dosage, side effects, and safety information
Prescription RequiredQuick Facts
What Is Placil Used For?
Placil contains clomipramine hydrochloride and belongs to a group of medicines called tricyclic antidepressants. These medicines work by affecting brain chemicals called amines.
Primary Uses
Placil is used to treat: 1) Depression that is longer-lasting and/or more severe than typical ‘low moods’ from everyday stress, 2) Obsessive-compulsive disorders (OCD) and phobias in adults, and 3) Muscle weakness in people with narcolepsy (a sleep disorder).
How It Works
Depression is thought to be caused by a chemical imbalance in parts of the brain. This imbalance affects your whole body and can cause emotional and physical symptoms such as feeling low in spirit, loss of interest in activities, being unable to enjoy life, poor appetite or overeating, disturbed sleep, loss of sex drive, lack of energy and feelings of guilt.
How to Take Placil
Follow all directions given by your doctor and pharmacist carefully. The dose varies from person to person and your doctor will determine the right amount for you.
Dosage Instructions
For depression, OCD and phobias: Usually started with 2-3 tablets (50-75 mg) daily, can be increased to 4-6 tablets (100-150 mg) daily. Maintenance dose is typically 2-4 tablets (50-100 mg) daily. For narcolepsy muscle weakness: Usually 1-3 tablets (25-75 mg) daily. For patients over 65: Start with 1 tablet (25 mg) daily, gradually increased to 2-3 tablets (50-75 mg) daily. Take tablets 2-3 times throughout the day with a full glass of water. Can be taken with or without food.
What If You Miss a Dose?
If it’s almost time for your next dose (within 2-3 hours), skip the missed dose and take your next dose as scheduled. Otherwise, take the missed dose as soon as you remember, then return to your normal schedule. Never take a double dose to make up for a missed dose.
Important: Do not stop taking Placil suddenly or lower the dose without checking with your doctor. Most medicines of this type take time to work – it can take up to 4-6 weeks to feel the full benefit.
Side Effects
Like all medications, this medicine can cause side effects. Most are mild and temporary, but some require medical attention.
Common Side Effects
These side effects occur relatively frequently and usually don’t require emergency care:
- Tiredness, dizziness, drowsiness
- Blurred vision
- Dry mouth
- Dry, sticky or irritated eyes
- Lightheadedness when standing up
Seek immediate medical attention if you experience:
- Thoughts of suicide or self-harm
- New or worsening depression or anxiety
- Panic attacks
- Difficulty sleeping
- Acting aggressively, angry or violent
- Acting on dangerous impulses
- Extreme increase in activity and talking
- Unusual changes in behavior or mood
- Allergic reactions (rash, swelling, difficulty breathing)
- Heart rhythm problems
- Seizures
Important Warnings
There are important safety considerations before taking Placil. Some people should not take this medication, and others need special monitoring.
Who Should Not Take Placil
Do not take Placil if you: are allergic to clomipramine or other tricyclic antidepressants; are under 18 years old (not approved for children/adolescents); are taking or have taken MAOIs within the past 2 weeks; are recovering from a recent heart attack; have congenital long QT syndrome; or if the medication is expired or packaging is damaged.
Medical Conditions to Discuss
Tell your doctor if you have: heart or blood vessel problems, irregular heartbeat, coronary heart disease, angina; congenital long QT syndrome; increased eye pressure (glaucoma); difficulty urinating due to prostate problems; epilepsy or seizures; liver or kidney problems; low potassium levels; other mental disorders; blood pressure problems; blood disorders; overactive thyroid; chronic constipation; Parkinson’s disease; adrenal gland tumor; or lactose/galactose intolerance.
Pregnancy and Breastfeeding
Placil should not be taken during pregnancy unless your doctor specifically tells you to do so. It may affect your baby, especially during the last 7 weeks of pregnancy. Newborns may show withdrawal symptoms. Your doctor may recommend gradually stopping Placil 7 weeks before delivery. Breastfeeding is not recommended while taking Placil as the medication passes into breast milk.
Suicide Risk: Call your doctor immediately if you or someone you know has thoughts about suicide, develops new or worse depression/anxiety, panic attacks, difficulty sleeping, or unusual changes in behavior like being angry, violent, or acting on dangerous impulses.
Drug Interactions
Many medications can interfere with Placil and affect how it works. Always tell your doctor about all medicines you’re taking.
Grapefruit interaction: Avoid grapefruit, grapefruit juice, and cranberry juice while taking Placil as they can affect how the medication works.
- MAOIs (phenelzine, tranylcypromine, moclobemide) – must not be taken together
- Other antidepressants (SSRIs, SNRIs like fluoxetine, paroxetine, sertraline)
- Blood pressure and heart medications
- Sleep aids and anxiety medications
- Seizure medications (carbamazepine, phenytoin)
- Blood thinners (warfarin)
- Diuretics (water tablets)
- Cold and allergy medicines including antihistamines
- Stomach medications (cimetidine)
- Parkinson’s disease medications
- Birth control pills and hormone replacement therapy
- Nicotine replacement products
- ADHD medications (methylphenidate)
- Antibiotics (rifampicin)
- Antifungal medications (terbinafine)
Alcohol & Driving
Placil can affect your ability to drive safely and can increase the effects of alcohol. Take precautions to stay safe.
Alcohol
Tell your doctor if you drink alcohol. Placil can increase the drowsiness caused by alcohol, making you more drowsy, dizzy or lightheaded. Your doctor may suggest avoiding alcohol while taking Placil. Even after stopping Placil, be careful for 1-2 weeks as some effects may still be in your body.
Driving and Operating Machinery
Be careful before driving or using machines until you know how Placil affects you. The medication may cause tiredness, dizziness, drowsiness, lightheadedness or blurred vision. If any of these occur, do not drive, operate machinery or do anything that could be dangerous.
Sun Sensitivity
Placil makes some people more sensitive to sunlight. Stay out of direct sunlight as much as possible until you know if your skin is more sensitive than usual. Wear protective clothing and use SPF 30+ sunscreen. Do not use sunlamps.
Storage
Keep Placil in its original container until it’s time to take a dose. Store below 25°C in a cool, dry place away from moisture, heat and sunlight. Do not store in the bathroom, near a sink, in the car, or on window sills. Keep out of reach of children – a locked cupboard at least 1.5 meters above ground is recommended.
Overdose Information
If you think you or anyone else has taken too much Placil, seek urgent medical attention immediately. Call the Poisons Information Centre (Australia 13 11 26), contact your doctor, or go to the nearest hospital emergency department, even if there are no symptoms. Overdose symptoms may include sleepiness, restlessness, agitation, muscle stiffness, unusual movements, fever, sweating, vomiting, breathing difficulties, blood pressure drop, fast or irregular heartbeat, seizures, or loss of consciousness. Children are much more sensitive to overdose than adults.
Frequently Asked Questions
Some symptoms may improve in 1-2 weeks, but it can take up to 4-6 weeks to feel the full benefit of Placil. Don’t be discouraged if you don’t feel better right away – most medicines of this type take time to work.
Yes, Placil can be taken with or without food. If your stomach is upset after taking the tablets, take them with a meal or after a snack.
Do not stop taking Placil suddenly as you could suffer withdrawal symptoms such as headache, nausea, vomiting, diarrhea and nervousness. Your doctor will gradually reduce the amount you take each day before stopping the medicine completely.
Tell your doctor if you drink alcohol. Placil can increase the drowsiness caused by alcohol, making you more drowsy, dizzy or lightheaded. Your doctor may suggest avoiding alcohol while taking Placil.
Yes, but special care is needed. Elderly patients may become confused and are more likely to experience side effects. Doctors usually start with a low dose (25 mg daily) and gradually increase it over about ten days to avoid side effects.
If it’s almost time for your next dose (within 2-3 hours), skip the missed dose. Otherwise, take it as soon as you remember, then return to your normal schedule. Never take a double dose to make up for a missed dose.
Even when you feel well, you will usually need to take Placil for several months or longer to make sure the benefits last. The length of treatment depends on your condition and how you respond to the medication. Your doctor will determine the right duration for you.
Important Disclaimer
This information is intended for general educational purposes only and should not be considered medical advice. Always consult your healthcare provider or pharmacist before starting, stopping, or changing any medication.
If you think you may have a medical emergency, call your doctor or emergency services immediately.