Drug interactions
Clozapine + Miconazole
Severity: Moderate
Clozapine and Miconazole: moderate 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 is metabolized mainly by CYP1A2 with contribution from CYP3A4 and CYP2D6. Miconazole may raise clozapine levels modestly through CYP3A4 inhibition. Higher levels increase the risk of sedation, hypotension, seizures and cardiac effects.
What this interaction means in plain words
Clozapine and Miconazole can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Clozapine belongs to Central Nervous System; Miconazole belongs to Anti Fungals.
Why it happens
Miconazole inhibits CYP3A4, a secondary clearance pathway for clozapine.
What to do
Monitor for sedation, hypotension and other clozapine toxicity during miconazole therapy. Check a clozapine level if symptoms develop or treatment is prolonged.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Miconazole
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 Miconazole?
MediHelp rates the interaction as moderate. Clozapine and Miconazole can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Clozapine is metabolized mainly by CYP1A2 with contribution from CYP3A4 and CYP2D6. Miconazole may raise clozapine levels modestly through CYP3A4 inhibition. Higher levels increase the risk of sedation, hypotension, seizures and cardiac effects.
How serious is the interaction between Clozapine and Miconazole?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for sedation, hypotension and other clozapine toxicity during miconazole therapy. Check a clozapine level if symptoms develop or treatment is prolonged.
What other medicines interact with Miconazole?
MediHelp also lists interactions of Miconazole with, for example, Cabazitaxel, Dihydroergotamine intranasal, Dihydroergotamine. The full list is on the Miconazole page.
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