Drug interactions
Clozapine + Meperidine
Severity: Major
Clozapine and Meperidine: 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 drugs are CNS depressants, and clozapine may add markedly to opioid sedation, hypotension, and respiratory depression. Meperidine's serotonergic activity and clozapine's receptor effects may rarely lead to serotonin toxicity, and neuroleptic malignant syndrome is also a concern. Anticholinergic effects may add up.
What this interaction means in plain words
Clozapine and Meperidine 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; Meperidine belongs to Musculoskeletal.
Why it happens
Additive CNS and respiratory depression with overlapping serotonergic and anticholinergic effects.
What to do
Use reduced opioid doses and monitor sedation, respiratory rate, and blood pressure. Watch for serotonin toxicity or neuroleptic malignant syndrome and consider a non-serotonergic opioid.
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 Meperidine
- Alvimopan + Meperidine Contraindicated
- Isocarboxazid + Meperidine Contraindicated
- Meperidine + Methylene blue Contraindicated
- Meperidine + Olanzapine / samidorphan Contraindicated
- Meperidine + Phenelzine Contraindicated
- Meperidine + Procarbazine Contraindicated
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 Meperidine?
MediHelp rates the interaction as major. Clozapine and Meperidine 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 drugs are CNS depressants, and clozapine may add markedly to opioid sedation, hypotension, and respiratory depression. Meperidine's serotonergic activity and clozapine's receptor effects may rarely lead to serotonin toxicity, and neuroleptic malignant syndrome is also a concern. Anticholinergic effects may add up.
How serious is the interaction between Clozapine and Meperidine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use reduced opioid doses and monitor sedation, respiratory rate, and blood pressure. Watch for serotonin toxicity or neuroleptic malignant syndrome and consider a non-serotonergic opioid.
What other medicines interact with Meperidine?
MediHelp also lists interactions of Meperidine with, for example, Alvimopan, Isocarboxazid, Methylene blue. The full list is on the Meperidine page.
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