Comprehensive medication guide to Clomipramine including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Estimated Insurance Pricing
With insurance, most patients pay a generic-tier copay of roughly $5 to $25 for a 30-day supply, though brand Anafranil may require prior authorization.
Estimated Cash Pricing
Without insurance or discount coupons, clomipramine typically costs between $30 and $150 for a 30-day supply, though generic versions with a coupon can bring the price down to $15–$60.
Medfinder Findability Score
55/100
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Clomipramine (brand name Anafranil) is a tricyclic antidepressant (TCA) that is FDA-approved for treating obsessive-compulsive disorder (OCD) in patients aged 10 and older. It is widely regarded as one of the most effective medications for OCD and is often tried when first-line SSRIs have not provided adequate relief. Off-label, clomipramine is also used for depression, anxiety disorders, panic disorder, neuropathic pain, cataplexy associated with narcolepsy, and several other conditions.
Clomipramine is the most potent serotonin reuptake inhibitor among all tricyclic antidepressants. It works primarily by blocking the serotonin transporter (SERT), which increases serotonin levels in the brain—this is the mechanism believed to drive its strong anti-OCD effect. Its active metabolite, desmethylclomipramine, adds norepinephrine reuptake inhibition, giving the drug a dual-action profile. Treatment typically begins at 25 mg per day and is gradually increased to a target range of 100–250 mg per day.
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25 mg oral capsule — capsule
50 mg oral capsule — capsule
75 mg oral capsule — capsule
Clomipramine receives a findability score of 55 out of 100. While it is a well-established generic medication, intermittent supply disruptions have made certain strengths harder to locate since 2020. Manufacturing delays and a limited number of generic producers mean you may need to call several pharmacies or use Medfinder to check real-time stock. Availability varies by region and dose strength, so planning refills a week or two ahead is a smart move.
Clomipramine is most commonly prescribed by psychiatrists, particularly those specializing in OCD and anxiety disorders. Neurologists may prescribe it for conditions like cataplexy or neuropathic pain, and pain medicine specialists sometimes use it for chronic pain management. Primary care and family medicine physicians can also prescribe clomipramine, and it is available through many telehealth platforms. Pediatricians may prescribe it for OCD in children aged 10 and older.
No, clomipramine is not a controlled substance. It is a prescription-only (Rx) medication but does not fall under any DEA schedule. This means it can generally be prescribed with standard refills and does not carry the same regulatory restrictions as controlled medications. However, it should still only be taken under medical supervision due to its side effect profile and the need for gradual dose titration and tapering.
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Fluvoxamine (Luvox)
An SSRI that is FDA-approved for OCD with fewer side effects than clomipramine, though it may be less effective for some patients.
Fluoxetine (Prozac)
A well-studied SSRI that is FDA-approved for OCD, widely available, and generally well-tolerated.
Sertraline (Zoloft)
A commonly used first-line SSRI for OCD with broad availability.
Paroxetine (Paxil)
An SSRI approved for OCD that is effective but may cause more discontinuation symptoms than other SSRIs.
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MAO inhibitors
moderateMust not be used within 14 days of each other due to risk of serotonin syndrome and hypertensive crisis.
Other serotonergic drugs (SSRIs, SNRIs, triptans, tramadol)
moderateIncreased risk of serotonin syndrome when combined.
CYP2D6 inhibitors (fluoxetine, paroxetine, quinidine)
moderateCan significantly increase clomipramine blood levels.
CYP1A2 inhibitors (fluvoxamine, ciprofloxacin)
moderateCan increase clomipramine levels.
Anticholinergic drugs
moderateAdditive side effects such as dry mouth, constipation, and urinary retention.
CNS depressants and alcohol
moderateIncreased sedation and impairment.
QT-prolonging drugs
moderateIncreased risk of dangerous heart rhythm changes.
Clomipramine remains one of the gold-standard treatments for OCD and can be a valuable option when SSRIs fall short. While it is available as an affordable generic, intermittent shortages mean finding it in stock can sometimes take extra effort. If you are having trouble locating clomipramine at your usual pharmacy, Medfinder can help you search real-time inventory at pharmacies near you. Talk to your doctor about whether clomipramine is the right fit for your treatment plan, and always plan refills ahead of time to avoid gaps in therapy.
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