Drug interactions
Clozapine + Methylenedioxymethamphetamine
Severity: Major
Clozapine and Methylenedioxymethamphetamine: 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
MDMA is a serotonin-releasing stimulant that causes tachycardia, hyperthermia and serotonin toxicity. Clozapine's receptor effects and its own cardiovascular and thermoregulatory effects may add to these risks, and clozapine is also a CYP2D6 and 1A2 substrate with variable effects.
What this interaction means in plain words
Clozapine and Methylenedioxymethamphetamine 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
Pharmacodynamic overlap of serotonergic and sympathomimetic effects with clozapine cardiovascular and receptor effects.
What to do
Advise patients to avoid MDMA. If exposure occurs, monitor temperature, heart rate, blood pressure and mental state, and seek emergency care for hyperthermia or agitation.
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
Frequently asked questions
Can I take Clozapine with Methylenedioxymethamphetamine?
MediHelp rates the interaction as major. Clozapine and Methylenedioxymethamphetamine 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. MDMA is a serotonin-releasing stimulant that causes tachycardia, hyperthermia and serotonin toxicity. Clozapine's receptor effects and its own cardiovascular and thermoregulatory effects may add to these risks, and clozapine is also a CYP2D6 and 1A2 substrate with variable effects.
How serious is the interaction between Clozapine and Methylenedioxymethamphetamine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Advise patients to avoid MDMA. If exposure occurs, monitor temperature, heart rate, blood pressure and mental state, and seek emergency care for hyperthermia or agitation.
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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