Drug interactions
Clozapine + Midostaurin
Severity: Major
Clozapine and Midostaurin: major interaction.
Last updated Sources: UK SmPC
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 agents can prolong the QT interval, so combined use may raise the risk of serious ventricular arrhythmias. Midostaurin and clozapine can also both cause myelosuppression, which complicates the risk assessment.
What this interaction means in plain words
Clozapine and Midostaurin 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; Midostaurin belongs to Oncology.
Why it happens
Additive QTc prolongation, with overlapping hematologic toxicity.
What to do
Avoid if possible; otherwise monitor ECG, electrolytes and blood counts regularly. Correct potassium and magnesium before and during treatment.
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
- Clozapine Viatris 100 mg Orodispersible Tablets - SmPC sections 4.3/4.5 (class statement: medicines known to increase QTc interval; "caution should be exercised when clozapine is prescribed with medicines known to increase QTc interval, or causing electrolyte imbalance.") — electronic medicines compendium (UK SmPC)
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 Midostaurin
Frequently asked questions
Can I take Clozapine with Midostaurin?
MediHelp rates the interaction as major. Clozapine and Midostaurin 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 agents can prolong the QT interval, so combined use may raise the risk of serious ventricular arrhythmias. Midostaurin and clozapine can also both cause myelosuppression, which complicates the risk assessment.
How serious is the interaction between Clozapine and Midostaurin?
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 if possible; otherwise monitor ECG, electrolytes and blood counts regularly. Correct potassium and magnesium before and during treatment.
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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