Drug interactions
Clozapine + Umeclidinium bromide / vilanterol inhaled
Severity: Moderate
Clozapine and Umeclidinium bromide / vilanterol inhaled: 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
Vilanterol, a long-acting beta-agonist, can cause tachycardia, hypokalemia and QT prolongation, which may add to the QT and cardiac effects of clozapine. Systemic exposure from inhalation is low, so the clinical risk is smaller than with oral agents, but it is still relevant in patients with cardiac risk factors.
What this interaction means in plain words
Clozapine and Umeclidinium bromide / vilanterol inhaled 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.
Why it happens
Additive pharmacodynamic effects on cardiac repolarization and heart rate (beta-2 agonism plus clozapine QT and tachycardic effects).
What to do
Monitor heart rate, ECG and serum potassium when starting or adjusting the combination. Use extra care in patients with known QT prolongation or other arrhythmia risk factors.
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
Frequently asked questions
Can I take Clozapine with Umeclidinium bromide / vilanterol inhaled?
MediHelp rates the interaction as moderate. Clozapine and Umeclidinium bromide / vilanterol inhaled 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. Vilanterol, a long-acting beta-agonist, can cause tachycardia, hypokalemia and QT prolongation, which may add to the QT and cardiac effects of clozapine. Systemic exposure from inhalation is low, so the clinical risk is smaller than with oral agents, but it is still relevant in patients with cardiac risk factors.
How serious is the interaction between Clozapine and Umeclidinium bromide / vilanterol inhaled?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor heart rate, ECG and serum potassium when starting or adjusting the combination. Use extra care in patients with known QT prolongation or other arrhythmia risk factors.
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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