Drug interactions
Clonazepam + Secobarbital
Severity: Major
Clonazepam and Secobarbital: 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
Barbiturates and benzodiazepines produce additive CNS and respiratory depression, with a risk of profound sedation, coma and death. Secobarbital also induces CYP3A4 and can lower clonazepam concentrations, making the net effect unpredictable.
What this interaction means in plain words
Clonazepam and Secobarbital 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; Secobarbital belongs to Central Nervous System.
Why it happens
Additive GABA-A mediated CNS depression, plus barbiturate induction of CYP3A4 that increases clonazepam clearance.
What to do
Avoid the combination where possible; if used, give the lowest doses and monitor respiratory status and sedation closely. Reassess clonazepam dosing when secobarbital is started or stopped.
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 Secobarbital
- Calcium / magnesium / potassium / sodium oxybates + Secobarbital Contraindicated
- Doravirine + Secobarbital Contraindicated
- Elbasvir / grazoprevir + Secobarbital Contraindicated
- Elvitegravir / cobicistat / emtricitabine / tenofovir df + Secobarbital Contraindicated
- Isavuconazonium + Secobarbital Contraindicated
- Lonafarnib + Secobarbital Contraindicated
Frequently asked questions
Can I take Clonazepam with Secobarbital?
MediHelp rates the interaction as major. Clonazepam and Secobarbital 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. Barbiturates and benzodiazepines produce additive CNS and respiratory depression, with a risk of profound sedation, coma and death. Secobarbital also induces CYP3A4 and can lower clonazepam concentrations, making the net effect unpredictable.
How serious is the interaction between Clonazepam and Secobarbital?
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; if used, give the lowest doses and monitor respiratory status and sedation closely. Reassess clonazepam dosing when secobarbital is started or stopped.
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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