Drug interactions
Clozapine + Mechlorethamine
Severity: Major
Clozapine and Mechlorethamine: major 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
Clozapine can cause neutropenia and agranulocytosis, and mechlorethamine is a myelosuppressive alkylating agent. Together the risk of severe bone marrow suppression and infection may rise, and the neutrophil count may be harder to interpret.
What this interaction means in plain words
Clozapine and Mechlorethamine 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; Mechlorethamine belongs to Oncology.
Why it happens
Additive bone marrow suppression.
What to do
Avoid the combination where possible, or monitor absolute neutrophil count closely and more often than the standard clozapine schedule. Involve the oncologist and prescriber of clozapine in decisions about continuation.
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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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 Mechlorethamine
Frequently asked questions
Can I take Clozapine with Mechlorethamine?
MediHelp rates the interaction as major. Clozapine and Mechlorethamine 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 can cause neutropenia and agranulocytosis, and mechlorethamine is a myelosuppressive alkylating agent. Together the risk of severe bone marrow suppression and infection may rise, and the neutrophil count may be harder to interpret.
How serious is the interaction between Clozapine and Mechlorethamine?
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 where possible, or monitor absolute neutrophil count closely and more often than the standard clozapine schedule. Involve the oncologist and prescriber of clozapine in decisions about continuation.
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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