Drug interactions
Cisapride + Clozapine
Severity: Major
Cisapride 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
Clozapine can prolong the QT interval and has been linked to arrhythmias and myocarditis. With cisapride the risk of serious ventricular arrhythmia is increased.
What this interaction means in plain words
Cisapride 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.
Cisapride belongs to Gastrointestinal Tract; Clozapine belongs to Central Nervous System.
Why it happens
Additive QT prolongation via cardiac potassium channel blockade.
What to do
Avoid the combination where possible and use a different prokinetic. If both are needed, check a baseline ECG and electrolytes and monitor the QTc.
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
- Clozapine Viatris 100 mg Orodispersible Tablets - SmPC sections 4.3/4.5 (class statement: medicines known to increase QTc interval; "caution should be exercised when clozapine is prescribed with medicines known to increase QTc interval, or causing electrolyte imbalance.") — electronic medicines compendium (UK SmPC)
Other interactions of Cisapride
- Apomorphine + Cisapride Contraindicated
- Artemether + Cisapride Contraindicated
- Azithromycin + Cisapride Contraindicated
- Ceritinib + Cisapride Contraindicated
- Chloroquine + Cisapride Contraindicated
- Cisapride + Citalopram Contraindicated
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 Cisapride with Clozapine?
MediHelp rates the interaction as major. Cisapride 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. Clozapine can prolong the QT interval and has been linked to arrhythmias and myocarditis. With cisapride the risk of serious ventricular arrhythmia is increased.
How serious is the interaction between Cisapride 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 the combination where possible and use a different prokinetic. If both are needed, check a baseline ECG and electrolytes and monitor the QTc.
What other medicines interact with Cisapride?
MediHelp also lists interactions of Cisapride with, for example, Apomorphine, Artemether, Azithromycin. The full list is on the Cisapride page.
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