Drug interactions
Clozapine + Topiramate
Severity: Moderate
Clozapine and Topiramate: 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
Topiramate adds to clozapine's sedation, cognitive slowing and confusion. Topiramate may also cause weight loss and has weak enzyme-inducing effects, but a significant change in clozapine levels is not well established.
What this interaction means in plain words
Clozapine and Topiramate 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; Topiramate belongs to Central Nervous System.
Why it happens
Additive CNS depression, with possible weak enzyme induction by topiramate.
What to do
Titrate topiramate slowly and monitor sedation, cognition and psychiatric response. Check clozapine levels if control changes.
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 Topiramate
Frequently asked questions
Can I take Clozapine with Topiramate?
MediHelp rates the interaction as moderate. Clozapine and Topiramate 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. Topiramate adds to clozapine's sedation, cognitive slowing and confusion. Topiramate may also cause weight loss and has weak enzyme-inducing effects, but a significant change in clozapine levels is not well established.
How serious is the interaction between Clozapine and Topiramate?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Titrate topiramate slowly and monitor sedation, cognition and psychiatric response. Check clozapine levels if control changes.
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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