Drug interactions
Clozapine + Iloperidone
Severity: Major
Clozapine and Iloperidone: 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
Both antipsychotics can prolong the QT interval, and iloperidone carries a specific warning about this. Combining them increases the risk of torsades de pointes. Additive sedation and orthostatic hypotension are also likely.
What this interaction means in plain words
Clozapine and Iloperidone 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; Iloperidone belongs to Central Nervous System.
Why it happens
Additive prolongation of cardiac repolarisation, plus additive alpha-adrenergic blockade and sedation.
What to do
Avoid antipsychotic polypharmacy where possible. If it is necessary, obtain a baseline ECG, correct electrolytes, and monitor the ECG and blood pressure.
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 Iloperidone
- Iloperidone + Thioridazine Contraindicated
- Alfuzosin + Iloperidone Major
- Amiodarone + Iloperidone Major
- Amisulpride + Iloperidone Major
- Amitriptyline + Iloperidone Major
- Anagrelide + Iloperidone Major
Frequently asked questions
Can I take Clozapine with Iloperidone?
MediHelp rates the interaction as major. Clozapine and Iloperidone 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. Both antipsychotics can prolong the QT interval, and iloperidone carries a specific warning about this. Combining them increases the risk of torsades de pointes. Additive sedation and orthostatic hypotension are also likely.
How serious is the interaction between Clozapine and Iloperidone?
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 antipsychotic polypharmacy where possible. If it is necessary, obtain a baseline ECG, correct electrolytes, and monitor the ECG and blood pressure.
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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