Drug interactions
Clorazepate + Indinavir
Severity: Major
Clorazepate and Indinavir: 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
Indinavir is a strong CYP3A4 inhibitor and can raise concentrations of nordiazepam, the active metabolite of clorazepate. This may lead to excessive sedation, confusion and respiratory depression, especially in older or frail patients.
What this interaction means in plain words
Clorazepate and Indinavir 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.
Why it happens
Inhibition of CYP3A4-mediated metabolism of the benzodiazepine by indinavir reduces its clearance.
What to do
Avoid the combination where possible or use a lower clorazepate dose with close monitoring for oversedation and respiratory depression. Consider a benzodiazepine not dependent on oxidative metabolism, such as lorazepam.
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
Frequently asked questions
Can I take Clorazepate with Indinavir?
MediHelp rates the interaction as major. Clorazepate and Indinavir 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. Indinavir is a strong CYP3A4 inhibitor and can raise concentrations of nordiazepam, the active metabolite of clorazepate. This may lead to excessive sedation, confusion and respiratory depression, especially in older or frail patients.
How serious is the interaction between Clorazepate and Indinavir?
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 or use a lower clorazepate dose with close monitoring for oversedation and respiratory depression. Consider a benzodiazepine not dependent on oxidative metabolism, such as lorazepam.
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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