Drug interactions
Buprenorphine transdermal + Clozapine
Severity: Major
Buprenorphine transdermal 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 have the potential to prolong the QT interval, and the transdermal buprenorphine label warns about QT effects at higher doses. Combining them may raise arrhythmia risk and increase sedation and respiratory depression.
What this interaction means in plain words
Buprenorphine transdermal 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 effects on cardiac repolarisation, plus additive CNS depression.
What to do
Use the lowest effective buprenorphine dose and obtain a baseline ECG. Correct electrolyte abnormalities and monitor for QT prolongation and excessive sedation.
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 Buprenorphine transdermal with Clozapine?
MediHelp rates the interaction as major. Buprenorphine transdermal 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 have the potential to prolong the QT interval, and the transdermal buprenorphine label warns about QT effects at higher doses. Combining them may raise arrhythmia risk and increase sedation and respiratory depression.
How serious is the interaction between Buprenorphine transdermal 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: Use the lowest effective buprenorphine dose and obtain a baseline ECG. Correct electrolyte abnormalities and monitor for QT prolongation and excessive sedation.
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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