Drug interactions
Clozapine + Donepezil
Severity: Moderate
Clozapine and Donepezil: moderate 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
Donepezil has been associated with QT prolongation and torsades de pointes, and clozapine can also affect cardiac conduction. Using them together may add to arrhythmia risk, and donepezil's cholinergic effects oppose clozapine's anticholinergic action.
What this interaction means in plain words
Clozapine and Donepezil can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Clozapine belongs to Central Nervous System; Donepezil belongs to Central Nervous System.
Why it happens
Additive QT prolongation; donepezil also adds bradycardic effects through cholinesterase inhibition.
What to do
Obtain a baseline ECG and monitor it in patients with other QT risk factors, and correct electrolyte disturbances. Avoid further QT-prolonging drugs.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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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 Donepezil
- Donepezil + Dronedarone Contraindicated
- Donepezil + Pimozide Contraindicated
- Donepezil + Thioridazine Contraindicated
- Donepezil + Vandetanib Contraindicated
- Amiodarone + Donepezil Major
- Amisulpride + Donepezil Major
Frequently asked questions
Can I take Clozapine with Donepezil?
MediHelp rates the interaction as moderate. Clozapine and Donepezil can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Donepezil has been associated with QT prolongation and torsades de pointes, and clozapine can also affect cardiac conduction. Using them together may add to arrhythmia risk, and donepezil's cholinergic effects oppose clozapine's anticholinergic action.
How serious is the interaction between Clozapine and Donepezil?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Obtain a baseline ECG and monitor it in patients with other QT risk factors, and correct electrolyte disturbances. Avoid further QT-prolonging drugs.
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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