Drug interactions
Clozapine + Paroxetine
Severity: Moderate
Clozapine and Paroxetine: 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
Paroxetine can raise clozapine plasma concentrations by inhibiting CYP2D6, a minor clozapine pathway. Higher exposure may increase sedation, hypotension, anticholinergic effects and seizure risk, and serotonin syndrome is also possible.
What this interaction means in plain words
Clozapine and Paroxetine 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; Paroxetine belongs to Central Nervous System.
Why it happens
CYP2D6 inhibition by paroxetine reduces clozapine clearance, plus additive serotonergic effects.
What to do
Monitor clozapine levels and clinical response when paroxetine is started or stopped, adjusting the clozapine dose as needed. Watch for sedation, seizures and serotonin toxicity.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Clozapine and Paroxetine, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
Other interactions of Paroxetine
- Isocarboxazid + Paroxetine Contraindicated
- Methylene blue + Paroxetine Contraindicated
- Paroxetine + Phenelzine Contraindicated
- Paroxetine + Pimozide Contraindicated
- Paroxetine + Procarbazine Contraindicated
- Paroxetine + Selegiline 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 Paroxetine?
MediHelp rates the interaction as moderate. Clozapine and Paroxetine 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. Paroxetine can raise clozapine plasma concentrations by inhibiting CYP2D6, a minor clozapine pathway. Higher exposure may increase sedation, hypotension, anticholinergic effects and seizure risk, and serotonin syndrome is also possible.
How serious is the interaction between Clozapine and Paroxetine?
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 clozapine levels and clinical response when paroxetine is started or stopped, adjusting the clozapine dose as needed. Watch for sedation, seizures and serotonin toxicity.
What other medicines interact with Paroxetine?
MediHelp also lists interactions of Paroxetine with, for example, Isocarboxazid, Methylene blue, Phenelzine. The full list is on the Paroxetine page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
