Drug interactions
Clozapine + Valproic acid
Severity: Moderate
Clozapine and Valproic acid: 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
Valproate has been reported to change clozapine concentrations variably, with most reports showing reductions. Combined use also raises the risk of sedation, weight gain, and hepatic effects, and has been associated with reports of seizures and neutropenia.
What this interaction means in plain words
Clozapine and Valproic acid 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; Valproic acid belongs to Central Nervous System.
Why it happens
Probable pharmacokinetic effect on clozapine metabolism; protein binding displacement is not a convincing mechanism.
What to do
Monitor clozapine levels, clinical response, liver function, and blood counts when valproate is started or stopped. Adjust the clozapine dose based on response and levels.
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 Valproic acid
- Ertapenem + Valproic acid Contraindicated
- Imipenem / cilastatin / relebactam + Valproic acid Contraindicated
- Imipenem / cilastatin + Valproic acid Contraindicated
- Meropenem / vaborbactam + Valproic acid Contraindicated
- Meropenem + Valproic acid Contraindicated
- Calcium / magnesium / potassium / sodium oxybates + Valproic acid Major
Frequently asked questions
Can I take Clozapine with Valproic acid?
MediHelp rates the interaction as moderate. Clozapine and Valproic acid 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. Valproate has been reported to change clozapine concentrations variably, with most reports showing reductions. Combined use also raises the risk of sedation, weight gain, and hepatic effects, and has been associated with reports of seizures and neutropenia.
How serious is the interaction between Clozapine and Valproic acid?
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 clozapine levels, clinical response, liver function, and blood counts when valproate is started or stopped. Adjust the clozapine dose based on response and levels.
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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