Clomipramine Hcl
Brand names: Anafranil, Clomipramine Hcl
At a glance
- Medicare prescriptions, 2024
- 77,457
- Medicare drug cost
- $8.5M
- Average cost per prescription
- $110
- Clinicians who prescribed it
- 3,863
Where it is prescribed
List the prescribers in any state, county, city or ZIP code →
What it is used for
Anafranil ™ (clomipramine hydrochloride) Capsules USP is indicated for the treatment of obsessions and compulsions in patients with Obsessive-Compulsive Disorder (OCD). The obsessions or compulsions must cause marked distress, be time-consuming, or significantly interfere with social or occupational functioning, in order to meet the DSM-III-R (circa 1989) diagnosis of OCD. Obsessions are recurrent, persistent ideas, thoughts, images, or impulses that are ego-dystonic. Compulsions are repetitive, purposeful, and intentional behaviors performed in response to an obsession or in a stereotyped fashion, and are recognized by the person as excessive or unreasonable. The effectiveness of Anafranil for the treatment of OCD was demonstrated in multicenter, placebo-controlled, parallel-group studies, including two 10-week studies in adults and one 8-week study in children and adolescents 10 to 17 years of age. Patients in all studies had moderate-to-severe OCD (DSM-III), with mean baseline ratings on the Yale-Brown Obsessive Compulsive Scale (YBOCS) ranging from 26 to 28 and a mean baseline rating of 10 on the NIMH Clinical Global Obsessive Compulsive Scale (NIMH-OC). Patients taking CMI experienced a mean reduction of approximately 10 on the YBOCS, representing an average improvement on this scale of 35% to 42% among adults and 37% among children and adolescents.
From the FDA-approved prescribing information (label dated November 2024). Full labels on DailyMed (opens in a new tab)
Boxed warning
Suicidality and Antidepressant Drugs Antidepressants increased the risk compared to placebo of suicidal thinking and behavior (suicidality) in children, adolescents, and young adults in short-term studies of major depressive disorder (MDD) and other psychiatric disorders. Anyone considering the use of clomipramine hydrochloride or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. Short-term studies did not show an increase in the risk of suicidality with antidepressants compared to placebo in adults beyond age 24; there was a reduction in risk with antidepressants compared to placebo in adults aged 65 and older. Depression and certain other psychiatric disorders are themselves associated with increases in the risk of suicide. Patients of all ages who are started on antidepressant therapy should be monitored appropriately and…
The FDA’s strongest warning on a label. It doesn’t mean the drug is unsafe for most people; talk to your doctor or pharmacist before stopping or changing any medicine.
Who prescribes it
- Psychiatry 42.0%
- Psychiatric Nurse Practitioners 26.4%
- Nurse Practitioners 7.5%
- Family Medicine 7.1%
- Internal Medicine 5.4%
- Physician Assistants 4.6%
- Child & Adolescent Psychiatry 3.1%
- Geriatric Medicine 1.1%
- Neurology 0.9%
- Hospitalist 0.3%
- General Practice 0.2%
- Physical Medicine & Rehabilitation (PM&R) 0.2%
All prescribers, by place, name or specialty →
Share of Medicare prescriptions written by each specialty. Select one to list its prescribers.
Trend, 2019–2024
Medicare prescriptions fell 5% from 2019 to 2024.
Biggest change by state since 2019
- Illinois −1%
- Pennsylvania −2%
- New York −3%
- Ohio −6%
- Michigan −8%
- California (smallest change) −17%
- Massachusetts (smallest change) −14%
From CMS’s yearly state and national Part D summaries, which count every prescriber, including those CMS leaves out of its per-clinician data (fewer than 11 prescriptions). That is why these totals are higher than the count at the top of this page. Prescriptions include refills.
What it looks like
Pills from 2 makers on file. The same medicine can look different depending on who made it, so check the imprint (the letters and numbers on the pill) with your pharmacist if a refill looks different.
Ax Pharmaceutical Corp
| Strength | Looks like | Imprint |
|---|---|---|
| 1 g | white powder | |
Specgx LLC
| Strength | Looks like | Imprint |
|---|---|---|
| 25 mg | yellow capsule, 18 mm | M ANAFRANIL 25 MG |
| 50 mg | blue capsule, 20 mm | M ANAFRANIL 50 MG |
| 75 mg | yellow capsule, 20 mm | M ANAFRANIL 75 MG |
Source: DailyMed (U.S. National Library of Medicine), from each maker’s FDA drug listing. A few makers are shown, not every one. Never take a pill you can’t identify; ask a pharmacist.
Industry payments about this drug
No industry payments to clinicians named this drug in 2025.
Recalls and shortages
Not on the FDA drug shortage list.
4 recalls since 2020
- Oct 2025 · Zydus Pharmaceuticals (USA) Inc · Class II
cGMP deviations: an observed Out of Specification of Nitrosamine Drug Substance-Related Impurities (NDSRIs), N-Nitroso Desmethyl-Clomipramine, above the FDA acceptable intake limit. - Jun 2025 · Lupin Pharmaceuticals Inc. · Class II
Failed Impurities/Degradation Specifications: an out of specification result observed in degradation product test (any unspecified degradation product) during retention sample testing at expiry. - Apr 2025 · Lupin Pharmaceuticals Inc. · Class II
Failed Impurities/Degradation Specifications: an out of specification result observed in degradation product test (any unspecified degradation product) during 18-month long term stability study. - Aug 2022 · Leading Pharma, LLC · Class III
Superpotent Drug: Assay value found to be 110.6% in Chlomipramine Hydrocholoride capsules
Recalls usually affect specific lots from one maker, not every version of a drug. Class I is the most serious; most drug recalls are Class II. FDA recalls (opens in a new tab)
Sources: CMS Medicare Part D Prescribers by Provider and Drug (2024; prescriptions include refills, and CMS hides counts under 11 per prescriber); U.S. Food and Drug Administration, openFDA (drug labels, NDC directory, enforcement reports, drug shortages); CMS Open Payments 2025; ClinicalTrials.gov. General information only, not medical advice; not yet reviewed by our medical reviewer.