Drug interactions
Clozapine + Fexinidazole
Severity: Major
Clozapine and Fexinidazole: major interaction.
Last updated Sources: UK SmPC
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
Fexinidazole can prolong the QT interval, and its label advises avoiding other QT-prolonging drugs. Clozapine also has QT liability, so the combination raises the risk of ventricular arrhythmia. Clozapine also carries a risk of myelosuppression, which complicates a patient already on a treatment course with fexinidazole.
What this interaction means in plain words
Clozapine and Fexinidazole 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
Additive prolongation of cardiac repolarisation.
What to do
Avoid the combination if possible, or defer clozapine changes during the fexinidazole course. If both are needed, monitor the ECG and electrolytes and correct hypokalaemia and hypomagnesaemia.
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
- Clozapine Viatris 100 mg Orodispersible Tablets - SmPC sections 4.3/4.5 (class statement: medicines known to increase QTc interval; "caution should be exercised when clozapine is prescribed with medicines known to increase QTc interval, or causing electrolyte imbalance.") — electronic medicines compendium (UK SmPC)
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 Fexinidazole?
MediHelp rates the interaction as major. Clozapine and Fexinidazole 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. Fexinidazole can prolong the QT interval, and its label advises avoiding other QT-prolonging drugs. Clozapine also has QT liability, so the combination raises the risk of ventricular arrhythmia. Clozapine also carries a risk of myelosuppression, which complicates a patient already on a treatment course with fexinidazole.
How serious is the interaction between Clozapine and Fexinidazole?
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, or defer clozapine changes during the fexinidazole course. If both are needed, monitor the ECG and electrolytes and correct hypokalaemia and hypomagnesaemia.
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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