Drug interactions
Clozapine + Disopyramide
Severity: Major
Clozapine and Disopyramide: 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
Disopyramide is a class Ia antiarrhythmic with a known risk of QT prolongation and torsades de pointes. Adding clozapine, which can also prolong the QT interval, increases that risk. Both drugs also have anticholinergic effects that add together.
What this interaction means in plain words
Clozapine and Disopyramide 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.
Clozapine belongs to Central Nervous System; Disopyramide belongs to Cardiovascular.
Why it happens
Additive prolongation of cardiac repolarisation, plus additive anticholinergic effects.
What to do
Avoid the combination if possible and choose a different antiarrhythmic. If it must be used, monitor the ECG and electrolytes closely and watch for anticholinergic effects such as constipation or urinary retention.
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 Clozapine
- Clozapine + Deferiprone Contraindicated
- Clozapine + Irinotecan Contraindicated
- Clozapine + Pimozide Contraindicated
- Clozapine + Thioridazine Contraindicated
- Acalabrutinib + Clozapine Major
- Adagrasib + Clozapine Major
Other interactions of Disopyramide
- Amisulpride + Disopyramide Contraindicated
- Desipramine + Disopyramide Contraindicated
- Disopyramide + Dronedarone Contraindicated
- Disopyramide + Itraconazole Contraindicated
- Disopyramide + Ketoconazole Contraindicated
- Disopyramide + Maprotiline Contraindicated
Frequently asked questions
Can I take Clozapine with Disopyramide?
MediHelp rates the interaction as major. Clozapine and Disopyramide 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. Disopyramide is a class Ia antiarrhythmic with a known risk of QT prolongation and torsades de pointes. Adding clozapine, which can also prolong the QT interval, increases that risk. Both drugs also have anticholinergic effects that add together.
How serious is the interaction between Clozapine and Disopyramide?
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 if possible and choose a different antiarrhythmic. If it must be used, monitor the ECG and electrolytes closely and watch for anticholinergic effects such as constipation or urinary retention.
What other medicines interact with Clozapine?
MediHelp also lists interactions of Clozapine with, for example, Deferiprone, Irinotecan, Pimozide. The full list is on the Clozapine page.
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