Drug interactions
Benzhydrocodone / acetaminophen + Clozapine
Severity: Major
Benzhydrocodone / acetaminophen and Clozapine: major 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
Clozapine and the opioid benzhydrocodone both depress the central nervous system. Together they can cause profound sedation, respiratory depression, coma and death. Clozapine can also cause respiratory and circulatory collapse, which adds to the danger.
What this interaction means in plain words
Benzhydrocodone / acetaminophen and Clozapine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Why it happens
Additive CNS and respiratory depression from opioid receptor agonism combined with the sedative effects of clozapine.
What to do
Reserve the combination for patients with no adequate alternative, and use the lowest effective opioid dose for the shortest duration. Monitor closely for sedation, hypotension and respiratory depression, especially at initiation and after dose increases.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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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 Benzhydrocodone / acetaminophen with Clozapine?
MediHelp rates the interaction as major. Benzhydrocodone / acetaminophen and Clozapine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Clozapine and the opioid benzhydrocodone both depress the central nervous system. Together they can cause profound sedation, respiratory depression, coma and death. Clozapine can also cause respiratory and circulatory collapse, which adds to the danger.
How serious is the interaction between Benzhydrocodone / acetaminophen and Clozapine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Reserve the combination for patients with no adequate alternative, and use the lowest effective opioid dose for the shortest duration. Monitor closely for sedation, hypotension and respiratory depression, especially at initiation and after dose increases.
What other medicines interact with Clozapine?
MediHelp also lists interactions of Clozapine with, for example, Deferiprone, Irinotecan, Pimozide. The full list is on the Clozapine page.
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