Drug interactions
Brexpiprazole + Clozapine
Severity: Moderate
Brexpiprazole 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
Both agents are antipsychotics that cause sedation, orthostatic hypotension and metabolic effects. Clozapine is a weak CYP2D6 inhibitor and brexpiprazole is a CYP2D6 and CYP3A4 substrate, so brexpiprazole exposure may rise modestly, although the main concern is additive adverse effects.
What this interaction means in plain words
Brexpiprazole 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.
Brexpiprazole belongs to Central Nervous System; Clozapine belongs to Central Nervous System.
Why it happens
Additive CNS depression and hypotension, with possible weak CYP2D6 inhibition by clozapine.
What to do
Monitor for sedation, orthostatic hypotension and akathisia, and titrate slowly. Avoid antipsychotic polypharmacy unless clearly indicated.
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 Brexpiprazole
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 Brexpiprazole with Clozapine?
MediHelp rates the interaction as moderate. Brexpiprazole 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. Both agents are antipsychotics that cause sedation, orthostatic hypotension and metabolic effects. Clozapine is a weak CYP2D6 inhibitor and brexpiprazole is a CYP2D6 and CYP3A4 substrate, so brexpiprazole exposure may rise modestly, although the main concern is additive adverse effects.
How serious is the interaction between Brexpiprazole 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 akathisia, and titrate slowly. Avoid antipsychotic polypharmacy unless clearly indicated.
What other medicines interact with Brexpiprazole?
MediHelp also lists interactions of Brexpiprazole with, for example, Alfentanil, Amisulpride, Apalutamide. The full list is on the Brexpiprazole page.
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