Clozapine has 46 known drug interactions based on U.S. FDA drug labeling data. Of these, 5 are contraindicated combinations that should be avoided entirely. 5 are classified as major interactions requiring close medical supervision. Notable interactions include combinations with Carbamazepine, Lorazepam, Phenytoin. Patients taking Clozapine should inform their healthcare provider of all current medications — including over-the-counter drugs and supplements — to avoid potentially harmful combinations. Data sourced from OpenFDA and the NIH National Library of Medicine.
- Total
- 46
- Contraindicated
- 5
- Major
- 5
- Moderate
- 32
Contraindicated (5)
- Clozapine + Carbamazepine— Strong CYP3A4 inducer that decreases clozapine plasma concentration. Concomitant use is not recommended due to decreased…
- Clozapine + Lorazepam— Concomitant use may produce marked sedation, excessive salivation, hypotension, ataxia, delirium, and respiratory arrest…
- Clozapine + Phenytoin— Strong CYP3A4 inducer that decreases clozapine plasma concentration. Concomitant use is not recommended due to decreased…
- Clozapine + Rifampin— Strong CYP3A4 inducer that decreases clozapine plasma concentration. Concomitant use is not recommended due to decreased…
- Clozapine + St. John'S Wort— Strong CYP3A4 inducer that decreases clozapine plasma concentration. Concomitant use is not recommended due to decreased…
Major (5)
- Clozapine + Ciprofloxacin— Strong CYP1A2 inhibitor that increases clozapine plasma levels, potentially resulting in adverse reactions. Requires dos…
- Clozapine + Enoxacin— Strong CYP1A2 inhibitor that increases clozapine plasma levels, potentially resulting in adverse reactions. Requires dos…
- Clozapine + Fluoxetine Hydrochloride— Potential for elevation of clozapine levels with risk of toxicity.
- Clozapine + Fluvoxamine— Strong CYP1A2 inhibitor that increases clozapine plasma levels, potentially resulting in adverse reactions. Requires dos…
- Clozapine + Insulin Glargine— May decrease blood glucose lowering effect of LANTUS. Dosage increases and increased glucose monitoring may be required.
Moderate (32)
- Clozapine + Bupropion— CYP2D6 or CYP3A4 inhibitor that can increase clozapine levels and lead to adverse reactions. Close monitoring and dose r…
- Clozapine + Caffeine— Moderate or weak CYP1A2 inhibitor that may increase clozapine levels. Monitor patients closely and consider dose reducti…
- Clozapine + Cimetidine— CYP2D6 or CYP3A4 inhibitor that can increase clozapine levels and lead to adverse reactions. Close monitoring and dose r…
- Clozapine + Duloxetine— CYP2D6 or CYP3A4 inhibitor that can increase clozapine levels and lead to adverse reactions. Close monitoring and dose r…
- Clozapine + Erythromycin— CYP2D6 or CYP3A4 inhibitor that can increase clozapine levels and lead to adverse reactions. Close monitoring and dose r…
- Clozapine + Escitalopram— CYP2D6 or CYP3A4 inhibitor that can increase clozapine levels and lead to adverse reactions. Close monitoring and dose r…
- Clozapine + Fluoxetine— Potential for elevation of clozapine levels.
- Clozapine + Glimepiride— Atypical antipsychotic that may reduce glucose-lowering effect of glimepiride, leading to worsening glycemic control.
- Clozapine + Glipizide— May reduce glucose-lowering effect of glipizide, leading to worsening glycemic control; monitor closely.
- Clozapine + Insulin Aspart Injection— Atypical antipsychotic that may decrease the blood glucose lowering effect. Dose adjustment and increased glucose monito…
- Clozapine + Insulin Aspart-Szjj— May decrease blood glucose lowering effect. Dose adjustment and increased glucose monitoring may be required.
- Clozapine + Insulin Degludec— Atypical antipsychotic that may decrease blood glucose lowering effect. Dosage increases and increased glucose monitorin…
- Clozapine + Insulin Degludec And Liraglutide— Atypical antipsychotic that may decrease blood glucose-lowering effect; dosage increases and increased glucose monitorin…
- Clozapine + Insulin Detemir— May decrease blood glucose lowering effect of insulin detemir. Dosage increases and increased glucose monitoring may be …
- Clozapine + Insulin Glargine And Lixisenatide— Atypical antipsychotic that may decrease the blood glucose lowering effect. Dose increases and increased glucose monitor…
- Clozapine + Insulin Glargine-Aglr— Atypical antipsychotic that may decrease blood glucose lowering effect. Dosage increases and increased glucose monitorin…
- Clozapine + Insulin Glargine-Yfgn— Atypical antipsychotic that may decrease blood glucose lowering effect. Dosage increases and increased glucose monitorin…
- Clozapine + Insulin Human— Atypical antipsychotic that may decrease blood glucose lowering effect; dose adjustment and increased glucose monitoring…
- Clozapine + Insulin Icodec-Abae— May decrease blood glucose lowering effect of Awiqli. Dose increases and increased glucose monitoring may be required.
- Clozapine + Insulin Lispro— Atypical antipsychotic that may decrease blood glucose lowering effect; dose adjustment and increased glucose monitoring…
- Clozapine + Insulin Lispro-Aabc— Atypical antipsychotic that may decrease blood glucose lowering effect. Dose increases and increased glucose monitoring …
- Clozapine + Olanzapine And Fuoxetine— May elevate clozapine levels.
- Clozapine + Oral Contraceptives— Moderate or weak CYP1A2 inhibitor that may increase clozapine levels. Monitor patients closely and consider dose reducti…
- Clozapine + Paroxetine— CYP2D6 or CYP3A4 inhibitor that can increase clozapine levels and lead to adverse reactions. Close monitoring and dose r…
- Clozapine + Quinidine— CYP2D6 or CYP3A4 inhibitor that can increase clozapine levels and lead to adverse reactions. Close monitoring and dose r…
- Clozapine + Repaglinide— Atypical antipsychotic that may decrease blood glucose lowering effect. Repaglinide dose increases and increased glucose…
- Clozapine + Risperidone— Chronic administration of clozapine may decrease the clearance of risperidone.
- Clozapine + Sertraline— CYP2D6 or CYP3A4 inhibitor that can increase clozapine levels and lead to adverse reactions. Close monitoring and dose r…
- Clozapine + Terbinafine— CYP2D6 or CYP3A4 inhibitor that can increase clozapine levels and lead to adverse reactions. Close monitoring and dose r…
- Clozapine + Tobacco Smoke— Moderate CYP1A2 inducer that can decrease clozapine plasma concentration. Consider increasing clozapine dose or monitori…
- Clozapine + Vasopressin— Suspected of causing diabetes insipidus; may decrease pressor and antidiuretic effects of vasopressin. Hemodynamic monit…
- Clozapine + Vasopressin In 0.9% Sodium Chloride— May cause diabetes insipidus, decreasing pressor and antidiuretic effects of vasopressin. Hemodynamic monitoring recomme…