Clomipramine: veterinary dose and monograph

At a glance

Drug class

Veterinary drug

Also known as

Clomicalm, Anafranil, Clonil

Species with doses

Dogs, Cats and Birds

General dose range

1–3 mg/kg PO q12–24h — check the species tables for the indication

Routes

PO

Last reviewed

1 October 2026

Indications

• Canine separation anxiety (licensed) with behaviour modification
• Compulsive/stereotypic disorders (e.g. acral lick dermatitis, tail chasing)
• Generalised anxiety / noise phobias (adjunct)
• Feline anxiety, urine marking and compulsive behaviours

Clomipramine dose by species

Doses are per administration unless stated. mg/kg doses scale with body weight; per-animal, per-quarter and infusion-rate doses are shown as the reference writes them.

Dogs

• Separation anxiety / compulsive disorder: Papich 5e and Plumb’s p.297 (Clomicalm label): 2–4 mg/kg/day PO as one dose or divided twice daily, increasing about every 14 days. Plumb’s: 1 mg/kg q12h for 2 weeks, then 2 mg/kg q12h, then 3 mg/kg q12h (Overall; Reisner & Houpt). Allow 4–6 weeks; taper to stop.

Cats

• Urine marking / anxiety / compulsive: Plumb’s p.297: 0.5 mg/kg once daily (Overall 1997); 0.3–0.5 mg/kg q24h (2.5–5 mg per cat) for urine marking (Landsberg; Levine); 0.5–1 mg/kg once daily (Reisner & Houpt). Papich 5e: 1–5 mg per cat q12–24h (≈0.5 mg/kg/day), up to 5 mg per cat daily for spraying. Watch for urinary retention and sedation.

Birds

• Feather-damaging behaviour / anxiety / self-mutilation: Carpenter's 6th ed (Bird psychotropic table): start 1 mg/kg PO q12h, therapeutic range 1–5 mg/kg PO q12h. Wait ~2 weeks before adjusting. ⚠ Adverse reactions in psittacines (macaws/cockatoos/greys) include illness, extrapyramidal signs, increased anxiety, serotonin overload and death — combine with behaviour/environmental modification. Plumb’s p.297 (Siebert 2007): reported doses for feather picking range from 0.5 to 9 mg/kg PO q12–24h.

Contraindications

MAO inhibitors / selegiline (serotonin syndrome — washout). Cardiac arrhythmias/conduction disease (TCA cardiotoxicity). Glaucoma, urinary retention (anticholinergic). Seizure disorders. Hepatic impairment. Known hypersensitivity. Concurrent strongly serotonergic drugs.

Species-specific warnings

Cats: Use low feline doses; anticholinergic effects can cause urinary retention/constipation — monitor, especially in cats predisposed to lower-urinary-tract issues.

Adverse effects

• Sedation, anticholinergic effects (dry mouth, constipation, urinary retention)
• GI upset, reduced appetite
• Cardiac conduction effects / arrhythmia at high dose (TCA)
• Lowered seizure threshold

Drug interactions

• MAO inhibitors / selegiline: contraindicated — serotonin syndrome
• Other serotonergic drugs (SSRIs, tramadol, trazodone): additive serotonin-syndrome risk
• Anticholinergics: additive (urinary retention, ileus)
• Antiarrhythmics / QT-prolonging drugs: additive cardiac effects
• CYP interactions can alter levels

Pregnancy and lactation

Limited data; avoid in pregnancy unless clearly necessary.

Monitoring

• Behavioural response over several weeks
• Anticholinergic effects (urination, GI), sedation
• Cardiac status (consider ECG in older patients/high doses)
• Concurrent serotonergic drugs; taper to discontinue

Toxicity and overdose

TCA overdose is dangerous: anticholinergic signs (mydriasis, tachycardia, ileus, urinary retention), CNS signs (agitation then depression, seizures), and cardiotoxicity (wide-QRS arrhythmias, hypotension) — the cardiac effects are the main cause of death. A frequent scenario is a dog ingesting human TCA tablets.

Management: Decontaminate if recent (charcoal). For TCA cardiotoxicity: IV sodium bicarbonate (narrows QRS, treats arrhythmia/hypotension), IV fluids/vasopressors, control seizures with benzodiazepines, and ECG monitoring. Serotonin syndrome: cyproheptadine, cooling, supportive care. No single antidote — bicarbonate is the key cardiac intervention.

Clinical pearls

• A licensed TCA for canine separation anxiety — effective but with more anticholinergic/sedative effects than SSRIs
• Give it weeks to work and combine with a behaviour-modification plan
• Mind the cardiac and anticholinergic profile — caution in patients with heart disease, glaucoma or urinary issues
• In overdose, sodium bicarbonate is the cornerstone for TCA cardiotoxicity
• Avoid combining with selegiline/other serotonergic drugs (serotonin syndrome)

Mechanism of action

Inhibits presynaptic reuptake of serotonin (and, via its metabolite desmethylclomipramine, noradrenaline), increasing monoamine availability in the CNS; chronic dosing produces adaptive receptor changes that reduce anxiety and compulsive behaviour. It also blocks muscarinic, histaminic and alpha-adrenergic receptors (the source of its anticholinergic/sedative side effects) and, like all TCAs, affects cardiac sodium channels at toxic levels.

Formulations and products

• 5 / 20 / 80 mg tablet (Clomicalm, dogs)
• 10 / 25 / 50 mg tablet (human)
• Clomicalm (Elanco (Novartis)) — 5 / 20 / 80 mg tablet, Tablet
• Clonil — 10 / 25 / 50 mg tablet, Tablet (human-label)
• Anafranil — 10 / 25 mg tablet, Tablet (human-label)

Storage

Tablets: 15–30 °C, dry, protect from light.

Before you use this dose

Reference doses for veterinary professionals. Confirm the dose against the product label, the patient’s condition, current guidance and local regulations before use; the attending veterinarian remains responsible for every clinical decision.

Other hormones, emergency drugs, supplements and other drugs

• Cetirizine
• Chlorambucil
• Chlorpheniramine Maleate
• Clenbuterol
• Clopidogrel
• Cloprostenol
• Cyanocobalamin (Vitamin B12)
• Cyclophosphamide

Frequently asked questions