Drug interactions
Clorazepate + Clozapine
Severity: Major
Clorazepate and Clozapine: major 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
Both drugs depress the central nervous system, so combined use can produce marked sedation, dizziness and impaired psychomotor function. Rarely, benzodiazepines given with clozapine have been associated with respiratory depression, hypotension and collapse, particularly during clozapine initiation or dose escalation.
What this interaction means in plain words
Clorazepate 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.
Clorazepate belongs to Central Nervous System; Clozapine belongs to Central Nervous System.
Why it happens
Additive CNS depression from GABA-A potentiation by clorazepate plus the multireceptor antagonism of clozapine, with additive orthostatic hypotension.
What to do
Avoid starting both drugs together and use the lowest effective benzodiazepine dose, with close monitoring of sedation, blood pressure and respiration especially during clozapine titration. Counsel patients about driving and operating machinery.
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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Other interactions of Clorazepate
- Calcium / magnesium / potassium / sodium oxybates + Clorazepate Contraindicated
- Clorazepate + Sodium oxybate Contraindicated
- Alfentanil + Clorazepate Major
- Alprazolam + Clorazepate Major
- Amobarbital + Clorazepate Major
- Belladonna and opium + Clorazepate 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 Clorazepate with Clozapine?
MediHelp rates the interaction as major. Clorazepate 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. Both drugs depress the central nervous system, so combined use can produce marked sedation, dizziness and impaired psychomotor function. Rarely, benzodiazepines given with clozapine have been associated with respiratory depression, hypotension and collapse, particularly during clozapine initiation or dose escalation.
How serious is the interaction between Clorazepate 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 both drugs together and use the lowest effective benzodiazepine dose, with close monitoring of sedation, blood pressure and respiration especially during clozapine titration. Counsel patients about driving and operating machinery.
What other medicines interact with Clorazepate?
MediHelp also lists interactions of Clorazepate with, for example, Calcium / magnesium / potassium / sodium oxybates, Sodium oxybate, Alfentanil. The full list is on the Clorazepate page.
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