Drug interactions
Aprepitant + Clozapine
Severity: Moderate
Aprepitant and Clozapine: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Aprepitant is a moderate CYP3A4 inhibitor and can raise clozapine exposure, since CYP3A4 contributes to its metabolism alongside CYP1A2. Higher clozapine levels may cause more sedation, hypotension, seizures or QT effects.
What this interaction means in plain words
Aprepitant and Clozapine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Aprepitant belongs to Gastrointestinal Tract; Clozapine belongs to Central Nervous System.
Why it happens
Aprepitant inhibits CYP3A4-mediated clozapine metabolism, which may increase plasma clozapine concentrations.
What to do
Monitor for sedation, orthostatic hypotension and other clozapine adverse effects during and shortly after the aprepitant course. Reduce the clozapine dose if toxicity appears.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Aprepitant
- Aprepitant + Lomitapide Contraindicated
- Aprepitant + Pimozide Contraindicated
- Aprepitant + Avapritinib Major
- Aprepitant + Bosutinib Major
- Aprepitant + Carbamazepine Major
- Aprepitant + Cobicistat Major
Other interactions of Clozapine
- Clozapine + Deferiprone Contraindicated
- Clozapine + Irinotecan Contraindicated
- Clozapine + Pimozide Contraindicated
- Clozapine + Thioridazine Contraindicated
- Acalabrutinib + Clozapine Major
- Adagrasib + Clozapine Major
Frequently asked questions
Can I take Aprepitant with Clozapine?
MediHelp rates the interaction as moderate. Aprepitant and Clozapine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Aprepitant is a moderate CYP3A4 inhibitor and can raise clozapine exposure, since CYP3A4 contributes to its metabolism alongside CYP1A2. Higher clozapine levels may cause more sedation, hypotension, seizures or QT effects.
How serious is the interaction between Aprepitant and Clozapine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for sedation, orthostatic hypotension and other clozapine adverse effects during and shortly after the aprepitant course. Reduce the clozapine dose if toxicity appears.
What other medicines interact with Aprepitant?
MediHelp also lists interactions of Aprepitant with, for example, Lomitapide, Pimozide, Avapritinib. The full list is on the Aprepitant page.
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