both increase sedation. Use Caution/Monitor. clozapine decreases effects of codeine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Prevents conversion of codeine to its active metabolite morphine.conivaptanMonitor Closely (1)conivaptan will increase the level or effect of clozapine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.cortisoneMonitor Closely (1)cortisone will decrease the level or effect of clozapine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.crizotinibSerious - Use Alternative (1)clozapine and crizotinib both increase QTc interval. Avoid or Use Alternate Drug.cyclizineMonitor Closely (4)cyclizine decreases levels of clozapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. cyclizine decreases levels of clozapine by pharmacodynamic antagonism. Use Caution/Monitor. clozapine increases effects of cyclizine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. cyclizine and clozapine both increase sedation. Use Caution/Monitor.cyclobenzaprineMonitor Closely (4)cyclobenzaprine decreases levels of clozapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. cyclobenzaprine decreases levels of clozapine by pharmacodynamic antagonism. Use Caution/Monitor. clozapine increases effects of cyclobenzaprine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. cyclobenzaprine and clozapine both increase sedation. Use Caution/Monitor.cyclosporineMonitor Closely (1)cyclosporine will increase the level or effect of clozapine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.cyproheptadineMonitor Closely (1)cyproheptadine and clozapine both increase sedation. Use Caution/Monitor.dantroleneMonitor Closely (1)dantrolene and clozapine both increase sedation. Use Caution/Monitor.daridorexantMonitor Closely (1)clozapine and daridorexant both increase sedation. Modify Therapy/Monitor Closely. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment. darifenacinMonitor Closely (4)darifenacin will increase the level or effect of clozapine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. darifenacin decreases levels of clozapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. darifenacin decreases levels of clozapine by pharmacodynamic antagonism. Use Caution/Monitor. clozapine increases effects of darifenacin by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.darunavirMonitor Closely (1)darunavir will increase the level or effect of clozapine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.dasatinibMonitor Closely (1)dasatinib will increase the level or effect of clozapine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.Serious - Use Alternative (1)clozapine and dasatinib both increase QTc interval. Avoid or Use Alternate Drug.deferasiroxMonitor Closely (1)deferasirox increases levels of clozapine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.deferiproneSerious - Use Alternative (1)deferiprone, clozapine. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Avoid use of deferiprone with other drugs known to be associated with neutropenia or agranulocytosis; if an alternative is not possible, monitor absolute neutrophil count more frequently.degarelixMonitor Closely (1)clozapine and degarelix both increase QTc interval. Use Caution/Monitor.desfluraneMonitor Closely (1)desflurane and clozapine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)desflurane and clozapine both increase QTc interval. Avoid or Use Alternate Drug.desipramineMonitor Closely (2)clozapine and desipramine both increase sedation. Use Caution/Monitor. clozapine and desipramine both increase QTc interval. Use Caution/Monitor.deutetrabenazineMonitor Closely (3)clozapine and deutetrabenazine both increase sedation. Use Caution/Monitor. clozapine and deutetrabenazine both increase QTc interval. Use Caution/Monitor. At the maximum recommended dose, deutetrabenazine does not prolong QT interval to a clinically relevant extent. Certain circumstances may increase risk of torsade de pointes and/or sudden death in association with drugs that prolong the QTc interval (eg, bradycardia, hypokalemia or hypomagnesemia, coadministration with other drugs that prolong QTc interval, presence of congenital QT prolongation). clozapine and deutetrabenazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Modify Therapy/Monitor Closely. The risk for parkinsonism, neuroleptic malignant syndrome, and akathisia may be increased by concomitant use of deutetrabenazine and dopamine antagonists or antipsychotics.dexamethasoneMonitor Closely (1)dexamethasone will decrease the level or effect of clozapine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.dexchlorpheniramineMonitor Closely (1)dexchlorpheniramine and clozapine both increase sedation. Use Caution/Monitor.dexfenfluramineMonitor Closely (1)clozapine increases and dexfenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.dexmedetomidineMonitor Closely (1)dexmedetomidine and clozapine both increase sedation. Use Caution/Monitor.dexmethylphenidateMonitor Closely (1)clozapine increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.dextroamphetamineMonitor Closely (1)clozapine increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.dextromethorphanMonitor Closely (1)dextromethorphan, clozapine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).dextromoramideMonitor Closely (1)dextromoramide and clozapine both increase sedation. Use Caution/Monitor.DHEA, herbalMonitor Closely (1)DHEA, herbal will increase the level or effect of clozapine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.diamorphineMonitor Closely (1)diamorphine and clozapine both increase sedation. Use Caution/Monitor.diazepamMonitor Closely (2)diazepam, clozapine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Possible risk of cardiorespiratory collapse. diazepam and clozapine both increase sedation. Use Caution/Monitor.dicyclomineMonitor Closely (3)dicyclomine decreases levels of clozapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. dicyclomine decreases levels of clozapine by pharmacodynamic antagonism. Use Caution/Monitor. clozapine increases effects of dicyclomine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.diethylpropionMonitor Closely (1)clozapine increases and diethylpropion decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.difelikefalinMonitor Closely (1)difelikefalin and clozapine both increase sedation. Use Caution/Monitor.difenoxin hclMonitor Closely (1)difenoxin hcl and clozapine both increase sedation. Use Caution/Monitor.dihydroergotamineMonitor Closely (1)dihydroergotamine, clozapine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).diltiazemMonitor Closely (1)diltiazem will increase the level or effect of clozapine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Concomitant treatment with clozapine and CYP2D6 or CYP3A4 inhibitors can increase clozapine levels and lead to adverse reactions. Use caution and monitor patients closely when using such inhibitors. Consider reducing clozapine dose.dimenhydrinateMonitor Closely (1)dimenhydrinate and clozapine both increase sedation. Use Caution/Monitor.diphenhydramineMonitor Closely (4)diphenhydramine decreases levels of clozapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. diphenhydramine decreases levels of clozapine by pharmacodynamic antagonism. Use Caution/Monitor. clozapine increases effects of diphenhydramine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. diphenhydramine and clozapine both increase sedation. Use Caution/Monitor.diphenoxylate hclMonitor Closely (1)diphenoxylate hcl and clozapine both increase sedation. Use Caution/Monitor.dipipanoneMonitor Closely (1)dipipanone and clozapine both increase sedation. Use Caution/Monitor.disopyramideSerious - Use Alternative (1)clozapine and disopyramide both increase QTc interval. Avoid or Use Alternate Drug.dobutamineMonitor Closely (1)clozapine increases and dobutamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.dofetilideSerious - Use Alternative (1)dofetilide increases toxicity of clozapine by QTc interval. Avoid or Use Alternate Drug.dolasetronMonitor Closely (1)clozapine and dolasetron both increase QTc interval. Use Caution/Monitor.donepezilMonitor Closely (1)donepezil and clozapine both increase QTc interval. Use Caution/Monitor.dopamineMonitor Closely (1)clozapine increases and dopamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)clozapine decreases effects of dopamine by pharmacodynamic antagonism. Contraindicated.dopexamineMonitor Closely (1)clozapine increases and dopexamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.dosulepinMonitor Closely (1)clozapine and dosulepin both increase sedation. Use Caution/Monitor.doxepinMonitor Closely (2)clozapine and doxepin both increase sedation. Use Caution/Monitor. doxepin and clozapine both increase QTc interval. Use Caution/Monitor.doxylamineMonitor Closely (1)doxylamine and clozapine both increase sedation. Use Caution/Monitor.dronedaroneContraindicated (1)clozapine and dronedarone both increase QTc interval. Contraindicated.Monitor Closely (1)dronedarone will increase the level or effect of clozapine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.droperidolMonitor Closely (2)clozapine and droperidol both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor. clozapine and droperidol both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)clozapine and droperidol both increase QTc interval. Avoid or Use Alternate Drug.efavirenzMonitor Closely (2)efavirenz will decrease the level or effect of clozapine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. efavirenz and clozapine both increase QTc interval. Use Caution/Monitor.eletriptanMonitor Closely (1)eletriptan, clozapine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).eliglustatContraindicated (1)clozapine increases levels of eliglustat by affecting hepatic enzyme CYP2D6 metabolism. Contraindicated. If coadministered with strong or moderate CYP2D6 inhibitors, reduce eliglustat dose from 84 mg BID to 84 mg once daily in extensive and intermediate metabolizers; eliglustat is contraindiated if strong or moderate CYP2D6 inhibitors are given concomitantly with strong or moderate CYP3A inhibitors.Serious - Use Alternative (1)clozapine and eliglustat both increase QTc interval. Avoid or Use Alternate Drug.encorafenibSerious - Use Alternative (1)clozapine and encorafenib both increase QTc interval. Avoid or Use Alternate Drug.entrectinibSerious - Use Alternative (1)clozapine and entrectinib both increase QTc interval. Avoid or Use Alternate Drug.epcoritamabMonitor Closely (1)epcoritamab, clozapine. affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor. Epcoritamab causes release of cytokines that may suppress activity of CYP enzymes, resulting in increased exposure of CYP substrates. For certain CYP substrates, minimal changes in their concentration may lead to serious adverse reactions. If needed, modify therapy as recommended in the substrate's prescribing information. .ephedrineMonitor Closely (1)clozapine increases and ephedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.epinephrineMonitor Closely (2)clozapine decreases effects of epinephrine by pharmacodynamic antagonism. Use Caution/Monitor. Block pressor response to epinephrine, which may result in severe hypotension and tachycardia. clozapine increases and epinephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.epinephrine racemicMonitor Closely (2)clozapine decreases effects of epinephrine racemic by pharmacodynamic antagonism. Use Caution/Monitor. Block pressor response to epinephrine, which may result in severe hypotension and tachycardia. clozapine increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.ergoloid mesylatesMonitor Closely (1)ergoloid mesylates, clozapine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).ergotamineMonitor Closely (1)ergotamine, clozapine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).eribulinSerious - Use Alternative (1)clozapine and eribulin both increase QTc interval. Avoid or Use Alternate Drug.erythromycin baseMonitor Closely (1)erythromycin base will increase the level or effect of clozapine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.Serious - Use Alternative (2)erythromycin base will increase the level or effect of clozapine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. clozapine and erythromycin base both increase QTc interval. Avoid or Use Alternate Drug.erythromycin ethylsuccinateMonitor Closely (1)erythromycin ethylsuccinate will increase the level or effect of clozapine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.Serious - Use Alternative (2)erythromycin ethylsuccinate will increase the level or effect of clozapine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. clozapine and erythromycin ethylsuccinate both increase QTc interval. Avoid or Use Alternate Drug.erythromycin lactobionateMonitor Closely (1)erythromycin lactobionate will increase the level or effect of clozapine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.Serious - Use Alternative (2)erythromycin lactobionate will increase the level or effect of clozapine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. clozapine and erythromycin lactobionate both increase QTc interval. Avoid or Use Alternate Drug.erythromycin stearateMonitor Closely (1)erythromycin stearate will increase the level or effect of clozapine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.Serious - Use Alternative (2)erythromycin stearate will increase the level or effect of clozapine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. clozapine and erythromycin stearate both increase QTc interval. Avoid or Use Alternate Drug.escitalopramMonitor Closely (2)escitalopram increases levels of clozapine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Plasma levels of clozapine may be increased, resulting in increased pharmacologic and toxic effects. Adjust clozapine dose as needed when initiating or discontinuing certain SSRIs. . escitalopram increases toxicity of clozapine by QTc