Drug interactions
Brexanolone + Clozapine
Severity: Major
Brexanolone and Clozapine: major interaction.
Last updated Sources: UK SmPC
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
Both drugs depress the central nervous system, and brexanolone infusion itself causes excessive sedation and sudden loss of consciousness. Combined with clozapine, sedation, hypotension and respiratory depression may be more pronounced.
What this interaction means in plain words
Brexanolone 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 depression via GABA-A positive modulation (brexanolone) and antihistaminic/antiadrenergic sedation (clozapine).
What to do
Monitor continuously with pulse oximetry during the brexanolone infusion and interrupt or reduce the infusion if excessive sedation occurs. Review the clozapine dose before and during treatment.
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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References
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 Brexanolone with Clozapine?
MediHelp rates the interaction as major. Brexanolone 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. Both drugs depress the central nervous system, and brexanolone infusion itself causes excessive sedation and sudden loss of consciousness. Combined with clozapine, sedation, hypotension and respiratory depression may be more pronounced.
How serious is the interaction between Brexanolone 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: Monitor continuously with pulse oximetry during the brexanolone infusion and interrupt or reduce the infusion if excessive sedation occurs. Review the clozapine dose before and during treatment.
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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