Drug interactions
Clonazepam + Fosphenytoin
Severity: Moderate
Clonazepam and Fosphenytoin: 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
Phenytoin, the active form of fosphenytoin, induces CYP3A4 and can lower clonazepam concentrations. Clonazepam may also alter phenytoin levels unpredictably, so seizure control and drug levels may shift.
What this interaction means in plain words
Clonazepam and Fosphenytoin 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.
Clonazepam belongs to Central Nervous System; Fosphenytoin belongs to Central Nervous System.
Why it happens
Phenytoin induces hepatic CYP3A4, increasing clonazepam clearance.
What to do
Monitor seizure control and phenytoin levels, and increase the clonazepam dose if needed.
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 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 Fosphenytoin
- Dronedarone + Fosphenytoin Contraindicated
- Fosphenytoin + Ledipasvir-sofosbuvir Contraindicated
- Fosphenytoin + Lorlatinib Contraindicated
- Fosphenytoin + Lurasidone Contraindicated
- Fosphenytoin + Ranolazine Contraindicated
- Fosphenytoin + Sofosbuvir-velpatasvir-voxilaprevir Contraindicated
Frequently asked questions
Can I take Clonazepam with Fosphenytoin?
MediHelp rates the interaction as moderate. Clonazepam and Fosphenytoin 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. Phenytoin, the active form of fosphenytoin, induces CYP3A4 and can lower clonazepam concentrations. Clonazepam may also alter phenytoin levels unpredictably, so seizure control and drug levels may shift.
How serious is the interaction between Clonazepam and Fosphenytoin?
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 seizure control and phenytoin levels, and increase the clonazepam dose if needed.
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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