Drug interactions
Clozapine + Epcoritamab
Severity: Moderate
Clozapine and Epcoritamab: 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
Epcoritamab causes cytokine release that can temporarily suppress CYP450 enzymes. Because clozapine is cleared mainly by CYP1A2 and has a narrow therapeutic margin, its exposure may increase, leading to sedation, hypotension, seizures or myocarditis-like symptoms. The effect is most likely at the start of treatment and during cytokine release syndrome.
What this interaction means in plain words
Clozapine and Epcoritamab 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; Epcoritamab belongs to Oncology.
Why it happens
Cytokine-mediated downregulation of CYP1A2 activity decreases clozapine metabolism.
What to do
Monitor for signs of clozapine toxicity during the first weeks of epcoritamab and during any CRS episode, and consider a clozapine level. Reduce the clozapine dose if toxicity develops.
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 Epcoritamab
- Epcoritamab + Ergotamine Major
- Epcoritamab + Pimozide Major
- Bendamustine + Epcoritamab Moderate
- Carbamazepine + Epcoritamab Moderate
- Clomipramine + Epcoritamab Moderate
- Cyclosporin + Epcoritamab Moderate
Frequently asked questions
Can I take Clozapine with Epcoritamab?
MediHelp rates the interaction as moderate. Clozapine and Epcoritamab 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. Epcoritamab causes cytokine release that can temporarily suppress CYP450 enzymes. Because clozapine is cleared mainly by CYP1A2 and has a narrow therapeutic margin, its exposure may increase, leading to sedation, hypotension, seizures or myocarditis-like symptoms. The effect is most likely at the start of treatment and during cytokine release syndrome.
How serious is the interaction between Clozapine and Epcoritamab?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for signs of clozapine toxicity during the first weeks of epcoritamab and during any CRS episode, and consider a clozapine level. Reduce the clozapine dose if toxicity develops.
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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