Drug interactions
Clozapine + Dextromethorphan
Severity: Minor
Clozapine and Dextromethorphan: minor 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
Dextromethorphan has serotonergic activity, and combining it with an antipsychotic could theoretically contribute to serotonin toxicity or neuroleptic malignant syndrome. Clozapine also has sedative and autonomic effects that could make early toxicity harder to recognize.
What this interaction means in plain words
Clozapine and Dextromethorphan have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised.
Clozapine belongs to Central Nervous System; Dextromethorphan belongs to Respiratory.
Why it happens
Theoretical additive serotonergic and dopaminergic effects; the mechanism is not firmly established.
What to do
No routine dose change is needed; counsel the patient and caregivers to report fever, rigidity, tremor or confusion promptly.
What to ask your pharmacist
- Is there anything I should notice while taking both?
- Do I need to tell my doctor at the next visit?
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Other interactions of Dextromethorphan
- Dextromethorphan + Isocarboxazid Contraindicated
- Dextromethorphan + Linezolid Contraindicated
- Dextromethorphan + Phenelzine Contraindicated
- Dextromethorphan + Rasagiline Contraindicated
- Dextromethorphan + Safinamide Contraindicated
- Dextromethorphan + Selegiline Contraindicated
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 Clozapine with Dextromethorphan?
MediHelp rates the interaction as minor. Clozapine and Dextromethorphan have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised. Dextromethorphan has serotonergic activity, and combining it with an antipsychotic could theoretically contribute to serotonin toxicity or neuroleptic malignant syndrome. Clozapine also has sedative and autonomic effects that could make early toxicity harder to recognize.
How serious is the interaction between Clozapine and Dextromethorphan?
MediHelp rates it minor, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: No routine dose change is needed; counsel the patient and caregivers to report fever, rigidity, tremor or confusion promptly.
What other medicines interact with Dextromethorphan?
MediHelp also lists interactions of Dextromethorphan with, for example, Isocarboxazid, Linezolid, Phenelzine. The full list is on the Dextromethorphan page.
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