Comparative Pharmacology
Head-to-head clinical analysis: ANAFRANIL versus AVENTYL.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ANAFRANIL versus AVENTYL.
ANAFRANIL vs AVENTYL
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Clomipramine is a tricyclic antidepressant (TCA) that inhibits the reuptake of serotonin and norepinephrine, with a higher potency for serotonin reuptake inhibition. It also has anticholinergic, antihistaminergic, and alpha-adrenergic blocking properties.
Nortriptyline, the active ingredient, inhibits the reuptake of norepinephrine and serotonin in the central nervous system, potentiating their effects. It also has anticholinergic and antihistaminergic properties.
Initial: 25 mg PO tid; increase gradually to 100-150 mg/day. Maximum: 250 mg/day. Maintenance: lowest effective dose.
Adults: 25 mg orally 3 to 4 times daily, maximum 150 mg/day.
None Documented
None Documented
Terminal elimination half-life of clomipramine is approximately 21-26 hours; its active metabolite, desmethylclomipramine, has a half-life of approximately 36-42 hours. Steady-state is achieved within 7-14 days.
Terminal elimination half-life: 19-24 hours; requires 4-6 days to reach steady state.
Renal (primarily as conjugated metabolites, ~60-70% over 72 hours); fecal (biliary excretion of ~10-20%); <2% excreted unchanged in urine.
Renal (30% as unchanged drug and metabolites); biliary/fecal (70% as metabolites)
Category C
Category C
Tricyclic Antidepressant
Tricyclic Antidepressant