Cloril Drug Interactions

Clozapine should not be used with other agents having a known potential to suppress bone marrow function.
Clozapine should not be used concurrently with any CNS suppressants such as alcohol, MAOIs, opiates, antihistamines and benzodiazepines as it may enhance the CNS suppressants effect.
The possibility of additive effect may occur if the concomitant administration of drugs possessing anticholinergic, hypotensive or respiratory depressant effects.
Concomitant use of lithium or other CNS-active agents may increase the risk of development of neuroleptic malignant syndrome (NMS).
Seizures may occur, including onset of seizures in non-epileptic patients, and isolated cases of delirium where Clozapine was co-administered with valproic acid have been reported.
Caution should be used in concomitant administering of drugs which are either inhibitor or inducer of enzyme CYP4501A2, CYP3A4 and CYP4502D6. Because these enzymes are involved in the metabolism of Clozapine.
Elevated Clozapine plasma concentration have been reported in patients receiving the drug in combination with SSRIs (selective serotonin re-uptake inhibitors) such as paroxetine or fluvoxamine, cimetidine, erythromycin.
Concomitant administration of phenytoin or carbamazepine or rifampicin may cause interactions with Clozapine and may decreased level of the Clozapine treatment.
Clozapine has anti-α-adrenergic properties which may reduce the blood pressure-increasing effect of norepinephrine or other α-adrenergic agents and reverse the pressor effect of epinephrine.
The plasma concentration of Clozapine is increased by caffeine intake and decreased when the caffeine is discontinued.
Potent inhibitors of CYP3A, such as a azole antimycotics and protease inhibitors, could potentially also increase Clozapine plasma.
Cases have been reported of an interaction between citalopram and clozapine, which may increase the risk of adverse events associated with clozapine. CLORIL can potentiate the hypotensive effects of antihypertensives drugs due to its sympathomimetic antagonistic effects. CLORIL may cause an increase in plasma concentration of highly protein bound drugs (e.g. warfarin and digoxin, due to displacement from plasma proteins.