Drug interactions
Clozapine + Pentazocine
Severity: Major
Clozapine and Pentazocine: major interaction.
Last updated Sources: US FDA label
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 highly sedating and can cause orthostatic hypotension and, rarely, respiratory or circulatory collapse, especially at initiation. Adding pentazocine can heighten sedation, hypotension and respiratory depression.
What this interaction means in plain words
Clozapine and Pentazocine 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; Pentazocine belongs to Musculoskeletal.
Why it happens
Additive central nervous system and respiratory depression, with additive hypotensive effects.
What to do
Use the lowest effective doses and monitor sedation, blood pressure and respiratory status, especially when starting or titrating either drug. Consider a non-opioid analgesic where feasible.
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
Other interactions of Pentazocine
- Calcium / magnesium / potassium / sodium oxybates + Pentazocine Contraindicated
- Olanzapine / samidorphan + Pentazocine Contraindicated
- Pentazocine + Phenelzine Contraindicated
- Pentazocine + Tranylcypromine Contraindicated
- Alfentanil + Pentazocine Major
- Alprazolam + Pentazocine Major
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 Pentazocine?
MediHelp rates the interaction as major. Clozapine and Pentazocine 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 is highly sedating and can cause orthostatic hypotension and, rarely, respiratory or circulatory collapse, especially at initiation. Adding pentazocine can heighten sedation, hypotension and respiratory depression.
How serious is the interaction between Clozapine and Pentazocine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use the lowest effective doses and monitor sedation, blood pressure and respiratory status, especially when starting or titrating either drug. Consider a non-opioid analgesic where feasible.
What other medicines interact with Pentazocine?
MediHelp also lists interactions of Pentazocine with, for example, Calcium / magnesium / potassium / sodium oxybates, Olanzapine / samidorphan, Phenelzine. The full list is on the Pentazocine page.
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