Drug interactions
Clozapine + Selegiline
Severity: Moderate
Clozapine and Selegiline: 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
Selegiline is an MAO-B inhibitor that can lose selectivity at higher doses, and combined with clozapine there is a theoretical risk of serotonin toxicity. Dopaminergic stimulation from selegiline may also oppose clozapine's antipsychotic effect and aggravate psychosis.
What this interaction means in plain words
Clozapine and Selegiline 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; Selegiline belongs to Central Nervous System.
Why it happens
Pharmacodynamic opposition at dopamine receptors and possible additive serotonergic effects through MAO inhibition.
What to do
Keep selegiline at the lowest effective dose and monitor for worsening psychosis, hyperthermia, rigidity and autonomic instability.
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
Other interactions of Selegiline
- Amitriptyline + Selegiline Contraindicated
- Amoxapine + Selegiline Contraindicated
- Atomoxetine + Selegiline Contraindicated
- Benzphetamine + Selegiline Contraindicated
- Brimonidine + Selegiline Contraindicated
- Buprenorphine long-acting + Selegiline Contraindicated
Frequently asked questions
Can I take Clozapine with Selegiline?
MediHelp rates the interaction as moderate. Clozapine and Selegiline 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. Selegiline is an MAO-B inhibitor that can lose selectivity at higher doses, and combined with clozapine there is a theoretical risk of serotonin toxicity. Dopaminergic stimulation from selegiline may also oppose clozapine's antipsychotic effect and aggravate psychosis.
How serious is the interaction between Clozapine and Selegiline?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Keep selegiline at the lowest effective dose and monitor for worsening psychosis, hyperthermia, rigidity and autonomic instability.
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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