Drug interactions
Brexpiprazole + Chlorpromazine
Severity: Moderate
Brexpiprazole and Chlorpromazine: 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
Chlorpromazine inhibits CYP2D6, one of the main enzymes that clears brexpiprazole, so brexpiprazole exposure may rise. Higher levels can increase sedation, orthostatic hypotension, akathisia and other dose-related adverse effects. Both drugs are also antipsychotics, so additive dopamine-blocking effects are expected.
What this interaction means in plain words
Brexpiprazole and Chlorpromazine 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.
Brexpiprazole belongs to Central Nervous System; Chlorpromazine belongs to Central Nervous System.
Why it happens
Chlorpromazine inhibits CYP2D6-mediated metabolism of brexpiprazole, with additive pharmacodynamic antipsychotic effects.
What to do
Avoid routine combination of two antipsychotics where possible; if used, consider reducing the brexpiprazole dose per labeling for CYP2D6 inhibitors. Monitor for sedation, hypotension and extrapyramidal symptoms.
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 Chlorpromazine
- Chlorpromazine + Dofetilide Contraindicated
- Chlorpromazine + Dronedarone Contraindicated
- Chlorpromazine + Droperidol Contraindicated
- Chlorpromazine + Ibutilide Contraindicated
- Chlorpromazine + Metrizamide Contraindicated
- Chlorpromazine + Panobinostat Contraindicated
Other interactions of Brexpiprazole
Frequently asked questions
Can I take Brexpiprazole with Chlorpromazine?
MediHelp rates the interaction as moderate. Brexpiprazole and Chlorpromazine 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. Chlorpromazine inhibits CYP2D6, one of the main enzymes that clears brexpiprazole, so brexpiprazole exposure may rise. Higher levels can increase sedation, orthostatic hypotension, akathisia and other dose-related adverse effects. Both drugs are also antipsychotics, so additive dopamine-blocking effects are expected.
How serious is the interaction between Brexpiprazole and Chlorpromazine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid routine combination of two antipsychotics where possible; if used, consider reducing the brexpiprazole dose per labeling for CYP2D6 inhibitors. Monitor for sedation, hypotension and extrapyramidal symptoms.
What other medicines interact with Chlorpromazine?
MediHelp also lists interactions of Chlorpromazine with, for example, Dofetilide, Dronedarone, Droperidol. The full list is on the Chlorpromazine page.
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