Vet Guide to Clomipramine (Clomicalm®) in 2025 🐾

Hi, I’m Dr Duncan Houston BVSc—founder of Ask A Vet. Clomipramine hydrochloride, sold as Clomicalm®, is a tricyclic antidepressant (TCA) that’s FDA-approved for treating separation anxiety in dogs. It also helps with noise phobia, compulsive behaviors in both dogs and cats, and urine spraying in cats—when paired with training techniques. 🐶🐱

📘 What Is Clomipramine?

Clomipramine increases **serotonin and norepinephrine** levels in the brain—helping pets feel calmer and less reactive :contentReference[oaicite:3]{index=3}. While it has antihistamine effects that add to its calming properties, it's not a sedative :contentReference[oaicite:4]{index=4}.

✅ Approved & Off‑Label Uses

• Separation anxiety in dogs: barking, destruction, house-soiling :contentReference[oaicite:5]{index=5}
• Noise phobias & compulsive disorders: tail-chasing, licking—approved extra-label in dogs :contentReference[oaicite:6]{index=6}
• Urine spraying in cats: reduces marking in ~75% of treated cases :contentReference[oaicite:7]{index=7}
• Must always be paired with behavior modification and environmental strategies :contentReference[oaicite:8]{index=8}

📐 Dosing Recommendations (2025)

🐶 Dogs (Clomicalm®):

• Recommendation: 2–4 mg/kg/day, either once daily or split BID with food :contentReference[oaicite:9]{index=9}
• Start at 1–2 mg/kg daily and adjust based on response and tolerance

🐱 Cats (off-label):

• Suggested: 0.25–1 mg/kg once daily, often ~5 mg per cat :contentReference[oaicite:10]{index=10}
• Dosing frequency may be extended based on tolerance and signs

⏱️ How It Works & Onset

The calming effect builds over **4–6 weeks**. It's crucial to keep giving it consistently and combine with training—this supports lasting behavioral improvements :contentReference[oaicite:11]{index=11}.

⚠️ Side Effects & Safety Considerations

Common (usually mild):

• Lethargy, dry mouth, constipation, urinary hesitation :contentReference[oaicite:12]{index=12}
• Appetite changes, vomiting, diarrhea, increased heart rate

Serious (rare):

• Cardiac arrhythmias—use caution with heart disease :contentReference[oaicite:13]{index=13}
• Glaucoma or urinary retention exacerbation :contentReference[oaicite:14]{index=14}
• Seizures—avoid use in epileptic pets unless monitored closely :contentReference[oaicite:15]{index=15}

🔗 Drug Interactions & Contraindications

• Can cause **serotonin syndrome** if combined with SSRIs, MAO inhibitors, or other serotonergic agents—strict washout required between meds :contentReference[oaicite:16]{index=16}
• Avoid in pets <6 months old or <1.25 kg—safety not established :contentReference[oaicite:17]{index=17}
• Use caution in any pet with epilepsy, heart disease, urinary retention, or glaucoma :contentReference[oaicite:18]{index=18}

🩺 Monitoring & Follow‑Up

• Track behavior, energy, appetite, urinary function weekly
• Adjust dosing based on behavioral progress and side effects
• For long-term use, periodic cardiac and blood pressure checks, especially in heart-screened pets

⏳ Missed Dose & Withdrawal

• If a dose is missed, give the next one on schedule—do not double up
• Wean gradually over ≥2 weeks to prevent rebound effects :contentReference[oaicite:19]{index=19}

🏡 Real‑World Scenarios

🐶 Separation Anxiety in Dogs

• Start at 2 mg/kg with food in the morning and pair with crate training, enrichment, pheromones
• Reassess after 2 weeks; if no change, increase to 3–4 mg/kg split BID

🐱 Urine Spraying in Cats

• Begin ~5 mg daily and use environmental management (extra litter boxes, pheromone diffusers)
• Evaluate after 4 weeks to adjust dose or continue treatment

❓ Frequently Asked Questions

Is it better than fluoxetine?

Both can be useful—clomipramine often works faster in compulsive behaviors; fluoxetine may have fewer sedative side effects :contentReference[oaicite:20]{index=20}.

When should improvements appear?

Early changes can be seen at 4 weeks; best effects typically at 6–8 weeks when training and medication work together.

Is it safe long-term?

Yes, with vet oversight. Include periodic behavior reassessment and health checkups.

Can I use human clomipramine?

Only under veterinary prescription—dosages and excipients often differ from Clomicalm®.

📌 Final Takeaways

• Clomipramine is a trusted TCA for separation anxiety (dogs), compulsive behaviors, and feline spraying.
• Dosing: dogs 2–4 mg/kg/day; cats 0.25–1 mg/kg/day. Always with food.
• Monitor for sedation, GI, urinary, or cardiac side effects; avoid abrupt discontinuation.
• Serotonin interactions are serious—keep washout periods when changing meds.
• Successful treatment = medication + behavioral training + environmental support.

Considering clomipramine to help your pet’s anxiety or behaviors? Download the Ask A Vet app for personalized dosing plans, behavior tracking tools, and 24/7 veterinary support to guide your pet toward calm—and happier days! 🐾❤️