Drug interactions
Clozapine + Sotalol
Severity: Major
Clozapine and Sotalol: 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 can prolong QT and cause myocarditis and tachycardia, and sotalol strongly prolongs QT. Together they raise the risk of torsades de pointes and sudden cardiac events.
What this interaction means in plain words
Clozapine and Sotalol 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; Sotalol belongs to Cardiovascular.
Why it happens
Additive QT prolongation through effects on cardiac repolarisation.
What to do
Avoid if possible; if used, monitor ECG with QTc and keep electrolytes normal.
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 Sotalol
- Arsenic trioxide + Sotalol Contraindicated
- Artemether / lumefantrine + Sotalol Contraindicated
- Disopyramide + Sotalol Contraindicated
- Dofetilide + Sotalol Contraindicated
- Dronedarone + Sotalol Contraindicated
- Droperidol + Sotalol 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 Sotalol?
MediHelp rates the interaction as major. Clozapine and Sotalol 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 can prolong QT and cause myocarditis and tachycardia, and sotalol strongly prolongs QT. Together they raise the risk of torsades de pointes and sudden cardiac events.
How serious is the interaction between Clozapine and Sotalol?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid if possible; if used, monitor ECG with QTc and keep electrolytes normal.
What other medicines interact with Sotalol?
MediHelp also lists interactions of Sotalol with, for example, Arsenic trioxide, Artemether / lumefantrine, Disopyramide. The full list is on the Sotalol page.
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