Drug interactions
Clozapine + Nefazodone
Severity: Moderate
Clozapine and Nefazodone: 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
Nefazodone is a strong CYP3A4 inhibitor, and CYP3A4 contributes to clozapine metabolism, so clozapine exposure may rise. Higher levels increase the risk of sedation, hypotension, seizures and cardiac effects. Nefazodone also adds serotonergic and sedative effects.
What this interaction means in plain words
Clozapine and Nefazodone 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.
Why it happens
Inhibition of CYP3A4-mediated clozapine metabolism, with additive sedation and serotonergic effects.
What to do
Monitor for clozapine adverse effects and consider checking plasma levels, reducing the dose if needed. Be aware of hepatotoxicity risk with nefazodone.
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 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 Nefazodone?
MediHelp rates the interaction as moderate. Clozapine and Nefazodone 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. Nefazodone is a strong CYP3A4 inhibitor, and CYP3A4 contributes to clozapine metabolism, so clozapine exposure may rise. Higher levels increase the risk of sedation, hypotension, seizures and cardiac effects. Nefazodone also adds serotonergic and sedative effects.
How serious is the interaction between Clozapine and Nefazodone?
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 clozapine adverse effects and consider checking plasma levels, reducing the dose if needed. Be aware of hepatotoxicity risk with nefazodone.
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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