Drug interactions
Clonazepam + Clozapine
Severity: Major
Clonazepam and Clozapine: major interaction.
Last updated Sources: US FDA label
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, particularly during initiation or at higher doses, have been associated with marked sedation, hypotension, respiratory depression and collapse. Even at stable doses, additive sedation and orthostasis are common.
What this interaction means in plain words
Clonazepam 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.
Clonazepam belongs to Central Nervous System; Clozapine belongs to Central Nervous System.
Why it happens
Additive CNS and respiratory depression, with clozapine's alpha-adrenergic blockade and sedative activity compounding benzodiazepine effects.
What to do
Introduce either drug gradually and monitor blood pressure, heart rate, respiratory status and sedation, especially during clozapine titration. Use the lowest effective clonazepam dose.
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 Clonazepam
- Calcium / magnesium / potassium / sodium oxybates + Clonazepam Contraindicated
- Clonazepam + Sodium oxybate Contraindicated
- Alfentanil + Clonazepam Major
- Alprazolam + Clonazepam Major
- Amobarbital + Clonazepam Major
- Belladonna and opium + Clonazepam Major
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 Clonazepam with Clozapine?
MediHelp rates the interaction as major. Clonazepam 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, particularly during initiation or at higher doses, have been associated with marked sedation, hypotension, respiratory depression and collapse. Even at stable doses, additive sedation and orthostasis are common.
How serious is the interaction between Clonazepam 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: Introduce either drug gradually and monitor blood pressure, heart rate, respiratory status and sedation, especially during clozapine titration. Use the lowest effective clonazepam dose.
What other medicines interact with Clonazepam?
MediHelp also lists interactions of Clonazepam with, for example, Calcium / magnesium / potassium / sodium oxybates, Sodium oxybate, Alfentanil. The full list is on the Clonazepam page.
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