Drug interactions
Clozapine + Secobarbital
Severity: Major
Clozapine and Secobarbital: 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
Barbiturate enzyme induction can reduce clozapine concentrations and risk loss of psychotic symptom control. The combination also adds sedation and may increase respiratory depression and hypotension.
What this interaction means in plain words
Clozapine and Secobarbital 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; Secobarbital belongs to Central Nervous System.
Why it happens
Induction of CYP1A2 and CYP3A4 by secobarbital increases clozapine clearance, with additive CNS depression.
What to do
Monitor clinical response and clozapine levels, and watch for oversedation or respiratory depression. Adjust the clozapine dose and reassess if the barbiturate is stopped, since levels may rise.
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 Secobarbital
- Calcium / magnesium / potassium / sodium oxybates + Secobarbital Contraindicated
- Doravirine + Secobarbital Contraindicated
- Elbasvir / grazoprevir + Secobarbital Contraindicated
- Elvitegravir / cobicistat / emtricitabine / tenofovir df + Secobarbital Contraindicated
- Isavuconazonium + Secobarbital Contraindicated
- Lonafarnib + Secobarbital 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 Secobarbital?
MediHelp rates the interaction as major. Clozapine and Secobarbital 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. Barbiturate enzyme induction can reduce clozapine concentrations and risk loss of psychotic symptom control. The combination also adds sedation and may increase respiratory depression and hypotension.
How serious is the interaction between Clozapine and Secobarbital?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor clinical response and clozapine levels, and watch for oversedation or respiratory depression. Adjust the clozapine dose and reassess if the barbiturate is stopped, since levels may rise.
What other medicines interact with Secobarbital?
MediHelp also lists interactions of Secobarbital with, for example, Calcium / magnesium / potassium / sodium oxybates, Doravirine, Elbasvir / grazoprevir. The full list is on the Secobarbital page.
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