Drug interactions
Clozapine + Pipemidic acid
Severity: Major
Clozapine and Pipemidic acid: major 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
Pipemidic acid inhibits CYP1A2 and can raise clozapine concentrations, increasing the risk of sedation, hypotension, seizures and other dose-related toxicity. Quinolones have been reported to cause this effect.
What this interaction means in plain words
Clozapine and Pipemidic acid 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.
Why it happens
Inhibition of CYP1A2-mediated clozapine metabolism.
What to do
Prefer a non-CYP1A2-inhibiting antibiotic. If used, monitor for clozapine toxicity, consider a plasma level and reduce the dose as needed.
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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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 Pipemidic acid?
MediHelp rates the interaction as major. Clozapine and Pipemidic acid 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. Pipemidic acid inhibits CYP1A2 and can raise clozapine concentrations, increasing the risk of sedation, hypotension, seizures and other dose-related toxicity. Quinolones have been reported to cause this effect.
How serious is the interaction between Clozapine and Pipemidic acid?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Prefer a non-CYP1A2-inhibiting antibiotic. If used, monitor for clozapine toxicity, consider a plasma level and reduce the dose as needed.
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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