Drug interactions
Chlordiazepoxide + Clozapine
Severity: Major
Chlordiazepoxide 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
Benzodiazepines combined with clozapine can cause marked sedation, hypotension and, rarely, respiratory depression or collapse, particularly during clozapine initiation or dose increases. Sialorrhea and aspiration risk may also be worsened by sedation.
What this interaction means in plain words
Chlordiazepoxide 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.
Chlordiazepoxide belongs to Central Nervous System; Clozapine belongs to Central Nervous System.
Why it happens
Additive CNS and respiratory depression, with clozapine's alpha-1 and H1 antagonism adding hypotension and sedation.
What to do
Avoid starting or rapidly increasing both drugs together, and monitor blood pressure, sedation and respiration closely. Use the lowest effective benzodiazepine dose and titrate clozapine slowly.
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 Chlordiazepoxide
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 Chlordiazepoxide with Clozapine?
MediHelp rates the interaction as major. Chlordiazepoxide 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. Benzodiazepines combined with clozapine can cause marked sedation, hypotension and, rarely, respiratory depression or collapse, particularly during clozapine initiation or dose increases. Sialorrhea and aspiration risk may also be worsened by sedation.
How serious is the interaction between Chlordiazepoxide 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: Avoid starting or rapidly increasing both drugs together, and monitor blood pressure, sedation and respiration closely. Use the lowest effective benzodiazepine dose and titrate clozapine slowly.
What other medicines interact with Chlordiazepoxide?
MediHelp also lists interactions of Chlordiazepoxide with, for example, Alfentanil, Alprazolam, Amobarbital. The full list is on the Chlordiazepoxide page.
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