{{위키데이터 속성 추적}}
{{Drugbox
| Watchedfields = changed
| verifiedrevid = 459591021
| IUPAC_name = 3-(3-chloro-10,11-dihydro-5''H''-dibenzo[''b'',''f'']azepin-5-yl)-''N'',''N''-dimethylpropan-1-amine
| image = Clomipramine2DACS.svg
| alt = Skeletal formula of clomipramine
| width = 200px
| image2 = Clomipramine-3D-balls.png
| alt2 = Ball-and-stick model of the clomipramine molecule
| width2 = 200px
<!--Clinical data-->
| tradename = Anafranil, Clomicalm, others
| Drugs.com = {{drugs.com|monograph|clomipramine-hydrochloride}}
| licence_US = Clomipramine
| MedlinePlus = a697002
| pregnancy_AU = C
| pregnancy_US = C
| legal_AU = S4
| legal_CA = Rx-only
| legal_UK = POM
| legal_US = Rx-only
| routes_of_administration = [[:en:Oral administration|By mouth]], [[수액 (의학)|intravenous]]<ref name="Maudsley">{{서적 인용| isbn = 978-0-47-097948-8 | title = Maudsley Prescribing Guidelines in Psychiatry | edition = 11th |author1=Taylor, D |author2=Paton, C |author3=Shitij, K | date = 2012 | publisher = Wiley-Blackwell | location = West Sussex }}</ref>
<!--Pharmacokinetic data-->
| bioavailability = ~50%<ref name="LemkeWilliams2012">{{서적 인용|author1=Thomas L. Lemke|author2=David A. Williams|title=Foye's Principles of Medicinal Chemistry|url=https://books.google.com/books?id=Sd6ot9ul-bUC&pg=PA604|date=24 January 2012|publisher=Lippincott Williams & Wilkins|isbn=978-1-60913-345-0|pages=604–605|url-status=live|archiveurl=https://web.archive.org/web/20170908174253/https://books.google.com/books?id=Sd6ot9ul-bUC&pg=PA604|archivedate=8 September 2017|df=}}</ref>
| protein_bound = 96–98%<ref name="LemkeWilliams2012" />
| metabolism = [[간]] ([[:en:CYP2D6]])<ref name="LemkeWilliams2012" />
| metabolites = [[Desmethylclomipramine]]<ref name="LemkeWilliams2012" />
| elimination_half-life = {{abbr|CMI|Clomipramine}}: 19–37 hours<ref name="LemkeWilliams2012"/><br />{{abbr|DCMI|Desmethylclomipramine}}: 54–77 hours<ref name="LemkeWilliams2012" />
| excretion = [[콩팥]] (51–60%)<ref name="LemkeWilliams2012" /><br />[[똥]] (24–32%)<ref name="LemkeWilliams2012" />
<!--Identifiers-->
| CAS_number_Ref = {{cascite|correct|??}}
| CAS_number = 303-49-1
| ATC_prefix = N06
| ATC_suffix = AA04
| PubChem = 2801
| IUPHAR_ligand = 2398
| DrugBank_Ref = {{drugbankcite|correct|drugbank}}
| DrugBank = DB01242
| ChemSpiderID_Ref = {{chemspidercite|correct|chemspider}}
| ChemSpiderID = 2699
| UNII_Ref = {{fdacite|correct|FDA}}
| UNII = NUV44L116D
| KEGG_Ref = {{keggcite|correct|kegg}}
| KEGG = D07727
| ChEBI_Ref = {{ebicite|correct|EBI}}
| ChEBI = 47780
| ChEMBL_Ref = {{ebicite|correct|EBI}}
| ChEMBL = 415
| synonyms = Clomimipramine; 3-Chloroimipramine; G-34586<ref name="Elks2014">{{서적 인용|author=J. Elks|title=The Dictionary of Drugs: Chemical Data: Chemical Data, Structures and Bibliographies|url=https://books.google.com/books?id=0vXTBwAAQBAJ&pg=PA299|date=14 November 2014|publisher=Springer|isbn=978-1-4757-2085-3|pages=299–|url-status=live|archiveurl=https://web.archive.org/web/20170215024945/https://books.google.com/books?id=0vXTBwAAQBAJ|archivedate=15 February 2017|df=}}</ref>
<!--Chemical data-->
| C=19 | H=23 | Cl=1 | N=2
| molecular_weight = 314.857 g/mol
| SMILES = ClC1=CC(N(CCCN(C)C)C2=C(CC3)C=CC=C2)=C3C=C1
| StdInChI_Ref = {{stdinchicite|correct|chemspider}}
| StdInChI = 1S/C19H23ClN2/c1-21(2)12-5-13-22-18-7-4-3-6-15(18)8-9-16-10-11-17(20)14-19(16)22/h3-4,6-7,10-11,14H,5,8-9,12-13H2,1-2H3
| StdInChIKey_Ref = {{stdinchicite|correct|chemspider}}
| StdInChIKey = GDLIGKIOYRNHDA-UHFFFAOYSA-N
}}

'''클로미프라민'''({{lang|en|clomipramine}}, 상표명: '''Anafranil''' 등)은 [[삼환계 항우울제]](TCA)이다.<ref name=AHFS2015>{{웹 인용|title=Clomipramine Hydrochloride|url=https://www.drugs.com/monograph/clomipramine-hydrochloride.html|publisher=The American Society of Health-System Pharmacists|accessdate=Dec 2, 2015|url-status=live|archiveurl=https://web.archive.org/web/20151208153943/http://www.drugs.com/monograph/clomipramine-hydrochloride.html|archivedate=2015-12-08|df=}}</ref> [[강박장애]], [[공황장애]], [[주요 우울 장애]], [[만성 통증]] 치료에 사용된다.<ref name=AHFS2015/> 65세 초과자의 [[자살]] 위험을 줄일 수 있다.<ref name=AHFS2015/> 구강으로 투여한다.<ref name=AHFS2015/>

일반적인 부작용으로는 구강 건조, 변비, 식욕 부진, 졸림, 체중 증가, 성 기능 장애, 소변 문제가 포함된다.<ref name=AHFS2015/> 심각한 부작용으로는 25세 미만자의 [[자살]] 위험 증가, 그리고 [[뇌전증 발작]], [[조증]], 간 질환이 포함된다.<ref name=AHFS2015/> 약물을 갑작스럽게 중단할 경우 두통, 발한, [[어지럼증]]과 함께 금단 증후군이 발생할 수 있다.<ref name=AHFS2015/> 임신 중에 투여해도 안전한지에 대해서는 확실치 않다.<ref name=AHFS2015/> 동작 구조는 분명히 밝혀져 있지 않으나 [[세로토닌]]의 수치 증가가 수반되는 것으로 간주된다.<ref name=AHFS2015/>

클로미프라민은 1964년 스위스의 제약사 [[노바티스|시바-가이기]](Ciba-Geigy)에 의해 발견되었다.<ref name="Zohar2012">{{서적 인용|author=Joseph Zohar|title=Obsessive Compulsive Disorder: Current Science and Clinical Practice|url=https://books.google.com/books?id=8fWIRJ1vPq4C&pg=PT19|date=31 May 2012|publisher=John Wiley & Sons|isbn=978-1-118-30801-1|pages=19–30, 32, 50, 59}}</ref> [[의료제도]]에 필수적인 가장 효과적이고 안전한 의약품 목록인 [[WHO 필수 의약품 목록]]에 등재되어 있다.<ref name=WHO19th>{{웹 인용|title=WHO Model List of Essential Medicines (19th List)|url=http://www.who.int/medicines/publications/essentialmedicines/EML_2015_FINAL_amended_NOV2015.pdf?ua=1|work=World Health Organization|accessdate=8 December 2016|date=April 2015|url-status=live|archiveurl=https://web.archive.org/web/20161213052708/http://www.who.int/medicines/publications/essentialmedicines/EML_2015_FINAL_amended_NOV2015.pdf?ua=1|archivedate=13 December 2016|df=}}</ref> [[제네릭 의약품]]으로 구매가 가능하다.<ref name=AHFS2015/> [[개발도상국]]의 도매가는 2014년 기준으로 일일 0.11~0.21 사이이다.<ref>{{웹 인용|title=Clomipramine|url=http://mshpriceguide.org/en/single-drug-information/?DMFId=195&searchYear=2014|website=International Drug Price Indicator Guide|accessdate=3 December 2015|보존url=https://web.archive.org/web/20191103142423/http://mshpriceguide.org/en/single-drug-information/?DMFId=195&searchYear=2014|보존날짜=2019-11-03|url-status=dead}}</ref> 미국 내 도매가는 2018년 기준으로 일일 대략 US$9이다.<ref>{{웹 인용|title=NADAC as of 2018-02-07|url=https://data.medicaid.gov/Drug-Pricing-and-Payment/NADAC-as-of-2018-02-07/p5w9-7jxh|website=Centers for Medicare and Medicaid Services|accessdate=9 February 2018|language=en|보존url=https://web.archive.org/web/20180612140124/https://data.medicaid.gov/Drug-Pricing-and-Payment/NADAC-as-of-2018-02-07/p5w9-7jxh|보존날짜=2018-06-12|url-status=dead}}</ref> [[이미프라민]]으로 만든다.<ref name=Zohar2012/>

== 약리학 ==
=== 약력학 ===
==== 세로토닌성 활성 ====
{| class="wikitable"
|+ <br />임상 승인 복용량에 따른 SRI에 의한 {{abbr|SERT|세로토닌 운반체}} 점유율
|-
! 약물 !! 복용 범위<br />(mg/day)<ref name="KoocherNorcross2013">{{서적 인용|author1=Gerald P. Koocher|author2=John C. Norcross|author3=Beverly A. Greene Ph.D.|title=Psychologists' Desk Reference|url=https://books.google.com/books?id=Ox1wAgAAQBAJ&pg=PA442|date=4 September 2013|publisher=Oxford University Press|isbn=978-0-19-984550-7|pages=442–}}</ref> !! ~80% {{abbr|SERT|Serotonin transporter}}<br />점유<br />(mg/일)<ref name="pmid21959785">{{저널 인용| vauthors = Gründer G, Hiemke C, Paulzen M, Veselinovic T, Vernaleken I | title = Therapeutic plasma concentrations of antidepressants and antipsychotics: lessons from PET imaging | journal = Pharmacopsychiatry | volume = 44 | issue = 6 | pages = 236–48 | year = 2011 | pmid = 21959785 | doi = 10.1055/s-0031-1286282 | url = }}</ref><ref name="pmid19367152">{{저널 인용| vauthors = Kasper S, Sacher J, Klein N, Mossaheb N, Attarbaschi-Steiner T, Lanzenberger R, Spindelegger C, Asenbaum S, Holik A, Dudczak R | title = Differences in the dynamics of serotonin reuptake transporter occupancy may explain superior clinical efficacy of escitalopram versus citalopram | journal = Int Clin Psychopharmacol | volume = 24 | issue = 3 | pages = 119–25 | year = 2009 | pmid = 19367152 | doi = 10.1097/YIC.0b013e32832a8ec8 | url = }}</ref> !! 비율 (복용량 /<br />80% 점유)
|-
| [[시탈로프람]] || 20–40 || 40 || 0.5–1
|-
| [[에스시탈로프람]] || 10–20 || 10 || 1–2
|-
| [[플루옥세틴]] || 20–80 || 20 || 1–4
|-
| [[플루복사민]] || 50–300 || 70 || 0.71–5
|-
| [[파록세틴]] || 10–60 || 20 || 0.5–3
|-
| [[설트랄린]] || 25–200 || 50 || 0.5–4
|-
| [[둘록세틴]] || 20–60 || 30 || 0.67–2
|-
| [[벤라팍신]] || 75–375 || 75 || 1–5
|-
| 클로미프라민 || 50–250 || 10 || 5–25
|}
== 같이 보기 ==
* [[SSRI]]
== 각주 ==
{{각주}}

{{항우울제}}

[[분류:알파-1 차단제]]
[[분류:항히스타민제]]
[[분류:클로로아렌]]
[[분류:노바티스의 제품]]
[[분류:다이벤즈아제핀]]
[[분류:다이메틸아미노 화합물]]
[[분류:도파민 대항제]]
[[분류:무스카린 대항제]]
[[분류:강박 장애]]
[[분류:세로토닌 수용체 대항제]]
[[분류:세로토닌-노르에피네프린 재흡수 억제제]]
[[분류:삼환계 항우울제]]
[[분류:세계 보건 기구 필수 의약품]]