Use Caution/Monitor.anticholinergic/sedative combosMonitor Closely (3)anticholinergic/sedative combos decreases levels of clozapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. anticholinergic/sedative combos decreases levels of clozapine by pharmacodynamic antagonism. Use Caution/Monitor. clozapine increases effects of anticholinergic/sedative combos by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.apomorphineMonitor Closely (2)clozapine and apomorphine both increase sedation. Use Caution/Monitor. apomorphine and clozapine both increase QTc interval. Use Caution/Monitor.Serious - Use Alternative (1)clozapine decreases effects of apomorphine by pharmacodynamic antagonism. Avoid or Use Alternate Drug.aprepitantMonitor Closely (1)aprepitant will increase the level or effect of clozapine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.arformoterolMonitor Closely (2)clozapine increases and arformoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. arformoterol and clozapine both increase QTc interval. Use Caution/Monitor.aripiprazoleMonitor Closely (2)aripiprazole and clozapine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor. aripiprazole and clozapine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)aripiprazole and clozapine both increase QTc interval. Avoid or Use Alternate Drug.armodafinilMonitor Closely (3)armodafinil will decrease the level or effect of clozapine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor. armodafinil will decrease the level or effect of clozapine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. clozapine increases and armodafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.arsenic trioxideSerious - Use Alternative (1)clozapine and arsenic trioxide both increase QTc interval. Avoid or Use Alternate Drug.artemetherSerious - Use Alternative (1)artemether and clozapine both increase QTc interval. Avoid or Use Alternate Drug.artemether/lumefantrineMonitor Closely (1)artemether/lumefantrine will decrease the level or effect of clozapine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.Serious - Use Alternative (1)clozapine and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.asenapineMonitor Closely (1)asenapine and clozapine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)clozapine and asenapine both increase QTc interval. Avoid or Use Alternate Drug.asenapine transdermalMonitor Closely (1)asenapine transdermal and clozapine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)asenapine transdermal and clozapine both increase QTc interval. Avoid or Use Alternate Drug.atazanavirMonitor Closely (1)atazanavir will increase the level or effect of clozapine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.atomoxetineMonitor Closely (1)atomoxetine and clozapine both increase QTc interval. Use Caution/Monitor.atracuriumMonitor Closely (3)atracurium decreases levels of clozapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. atracurium decreases levels of clozapine by pharmacodynamic antagonism. Use Caution/Monitor. clozapine increases effects of atracurium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.atropineMonitor Closely (3)atropine decreases levels of clozapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. atropine decreases levels of clozapine by pharmacodynamic antagonism. Use Caution/Monitor. clozapine increases effects of atropine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.atropine IV/IMMonitor Closely (3)clozapine increases effects of atropine IV/IM by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. atropine IV/IM decreases levels of clozapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. atropine IV/IM decreases levels of clozapine by pharmacodynamic antagonism. Use Caution/Monitor.avapritinibMonitor Closely (1)avapritinib and clozapine both increase sedation. Use Caution/Monitor.azelastineMonitor Closely (1)azelastine and clozapine both increase sedation. Use Caution/Monitor.azithromycinSerious - Use Alternative (1)clozapine and azithromycin both increase QTc interval. Avoid or Use Alternate Drug.Minor (1)azithromycin increases toxicity of clozapine by unspecified interaction mechanism. Minor/Significance Unknown. Enhanced CNS toxicity.baclofenMonitor Closely (1)baclofen and clozapine both increase sedation. Use Caution/Monitor.bedaquilineMonitor Closely (1)clozapine and bedaquiline both increase QTc interval. Modify Therapy/Monitor Closely. ECG should be monitored closelybelladonna alkaloidsMonitor Closely (3)belladonna alkaloids decreases levels of clozapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. belladonna alkaloids decreases levels of clozapine by pharmacodynamic antagonism. Use Caution/Monitor. clozapine increases effects of belladonna alkaloids by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.belladonna and opiumMonitor Closely (4)belladonna and opium decreases levels of clozapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. belladonna and opium decreases levels of clozapine by pharmacodynamic antagonism. Use Caution/Monitor. clozapine increases effects of belladonna and opium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. belladonna and opium and clozapine both increase sedation. Use Caution/Monitor.benazeprilMonitor Closely (2)clozapine increases toxicity of benazepril by pharmacodynamic synergism. Use Caution/Monitor. Increases risk of hypotension. benazepril increases toxicity of clozapine by pharmacodynamic synergism. Use Caution/Monitor. Increases risk of hypotension.benperidolMonitor Closely (2)benperidol and clozapine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor. benperidol and clozapine both increase sedation. Use Caution/Monitor.benzhydrocodone/acetaminophenMonitor Closely (1)benzhydrocodone/acetaminophen and clozapine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)benzhydrocodone/acetaminophen, clozapine. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.benzphetamineMonitor Closely (1)clozapine increases and benzphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.benztropineMonitor Closely (1)clozapine increases effects of benztropine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic adverse effects may be seen with concurrent use. .bosentanMonitor Closely (1)bosentan will decrease the level or effect of clozapine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.brexanoloneMonitor Closely (1)brexanolone, clozapine. Either increases toxicity of the other by sedation. Use Caution/Monitor.brexpiprazoleMonitor Closely (2)clozapine will increase the level or effect of brexpiprazole by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. Administer a quarter of brexpiprazole dose if coadministered with a moderate CYP2D6 inhibitor PLUS a strong/moderate CYP3A4 inhibitor. brexpiprazole and clozapine both increase sedation. Use Caution/Monitor.brimonidineMonitor Closely (1)brimonidine and clozapine both increase sedation. Use Caution/Monitor.Minor (1)brimonidine increases effects of clozapine by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.brivaracetamMonitor Closely (1)brivaracetam and clozapine both increase sedation. Use Caution/Monitor.bromocriptineSerious - Use Alternative (1)clozapine decreases effects of bromocriptine by pharmacodynamic antagonism. Avoid or Use Alternate Drug.brompheniramineMonitor Closely (1)brompheniramine and clozapine both increase sedation. Use Caution/Monitor.budesonideMonitor Closely (1)budesonide will decrease the level or effect of clozapine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.buprenorphineMonitor Closely (1)buprenorphine and clozapine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)clozapine and buprenorphine both increase QTc interval. Avoid or Use Alternate Drug.buprenorphine buccalMonitor Closely (1)buprenorphine buccal and clozapine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)buprenorphine buccal and clozapine both increase QTc interval. Avoid or Use Alternate Drug.buprenorphine subdermal implantMonitor Closely (1)buprenorphine subdermal implant and clozapine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)buprenorphine subdermal implant and clozapine both increase QTc interval. Avoid or Use Alternate Drug.buprenorphine transdermalMonitor Closely (1)buprenorphine transdermal and clozapine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)buprenorphine transdermal and clozapine both increase QTc interval. Avoid or Use Alternate Drug.buprenorphine, long-acting injectionMonitor Closely (2)clozapine increases toxicity of buprenorphine, long-acting injection by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of buprenorphine and benzodiazepines or other CNS depressants increases risk of adverse reactions including overdose, respiratory depression, and death. Cessation of benzodiazepines or other CNS depressants is preferred in most cases. In some cases, monitoring at a higher level of care for tapering CNS depressants may be appropriate. In others, gradually tapering a patient off of a prescribed benzodiazepine or other CNS depressant or decreasing to the lowest effective dose may be appropriate. buprenorphine, long-acting injection and clozapine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)buprenorphine, long-acting injection and clozapine both increase QTc interval. Avoid or Use Alternate Drug.bupropionSerious - Use Alternative (1)clozapine increases toxicity of bupropion by unspecified interaction mechanism. Avoid or Use Alternate Drug. May lower seizure threshold; keep bupropion dose as low as possible.butabarbitalMonitor Closely (3)butabarbital will decrease the level or effect of clozapine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor. butabarbital will decrease the level or effect of clozapine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. butabarbital and clozapine both increase sedation. Use Caution/Monitor.butalbitalMonitor Closely (3)butalbital will decrease the level or effect of clozapine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor. butalbital will decrease the level or effect of clozapine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. butalbital and clozapine both increase sedation. Use Caution/Monitor.butorphanolMonitor Closely (1)butorphanol and clozapine both increase sedation. Use Caution/Monitor.cabergolineSerious - Use Alternative (1)clozapine decreases effects of cabergoline by pharmacodynamic antagonism. Contraindicated.caffeineMonitor Closely (1)clozapine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.calcium/magnesium/potassium/sodium oxybatesSerious - Use Alternative (1)clozapine, calcium/magnesium/potassium/sodium oxybates. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.captoprilMonitor Closely (1)clozapine increases toxicity of captopril by pharmacodynamic synergism. Use Caution/Monitor. Both drugs lower blood pressure. Monitor blood pressure.carbamazepineMonitor Closely (1)carbamazepine will decrease the level or effect of clozapine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.Serious - Use Alternative (2)carbamazepine will decrease the level or effect of clozapine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. carbamazepine, clozapine. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased risk of agranulocytosis.carbinoxamineMonitor Closely (1)carbinoxamine and clozapine both increase sedation. Use Caution/Monitor.carisoprodolMonitor Closely (1)carisoprodol and clozapine both increase sedation. Use Caution/Monitor.cenobamateMonitor Closely (1)cenobamate, clozapine. Either increases effects of the other by sedation. Use Caution/Monitor.ceritinibSerious - Use Alternative (1)ceritinib and clozapine both increase QTc interval. Avoid or Use Alternate Drug.chasteberryMinor (1)chasteberry decreases effects of clozapine by pharmacodynamic antagonism. Minor/Significance Unknown. (Theoretical interaction).chloral hydrateMonitor Closely (1)chloral hydrate and clozapine both increase sedation. Use Caution/Monitor.chlordiazepoxideMonitor Closely (1)chlordiazepoxide and clozapine both increase sedation. Use Caution/Monitor.chloroquineMonitor Closely (1)chloroquine increases toxicity of clozapine by QTc interval. Use Caution/Monitor.chlorpheniramineMonitor Closely (1)chlorpheniramine and clozapine both increase sedation. Use Caution/Monitor.chlorpromazineMonitor Closely (2)chlorpromazine and clozapine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor. chlorpromazine and clozapine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)clozapine and chlorpromazine both increase QTc interval. Avoid or Use Alternate Drug.chlorpropamideMonitor Closely (1)clozapine, chlorpropamide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.chlorzoxazoneMonitor Closely (1)chlorzoxazone and clozapine both increase sedation. Use Caution/Monitor.cigarette smokingMonitor Closely (1)cigarette smoking will decrease the level or effect of clozapine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.cilostazolMinor (1)clozapine increases levels of cilostazol by decreasing metabolism. Minor/Significance Unknown.cimetidineMonitor Closely (1)cimetidine will increase the level or effect of clozapine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.Serious - Use Alternative (1)cimetidine will increase the level or effect of clozapine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.cinnarizineMonitor Closely (1)cinnarizine and clozapine both increase sedation. Use Caution/Monitor.ciprofloxacinSerious - Use Alternative (2)ciprofloxacin will increase the level or effect of clozapine by affecting hepatic enzyme CYP1A2 metabolism. Avoid or Use Alternate Drug. Use caution when administering ciprofloxacin in patients receiving drugs that prolong the QT interval. At elevated serum concentrations, clozapine may produce clinically significant prolongation of the QTc interval. clozapine and ciprofloxacin both increase QTc interval. Avoid or Use Alternate Drug.cisaprideSerious - Use Alternative (1)clozapine and cisapride both increase QTc interval. Avoid or Use Alternate Drug.cisatracuriumMonitor Closely (3)cisatracurium decreases levels of clozapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. cisatracurium decreases levels of clozapine by pharmacodynamic antagonism. Use Caution/Monitor. clozapine increases effects of cisatracurium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.citalopramMonitor Closely (1)citalopram increases effects of clozapine by pharmacodynamic synergism. Use Caution/Monitor. Increased risk for serotonin syndrome.Serious - Use Alternative (1)citalopram and clozapine both increase QTc interval. Avoid or Use Alternate Drug.clarithromycinSerious - Use Alternative (2)clarithromycin will increase the level or effect of clozapine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. clarithromycin and clozapine both increase QTc interval. Avoid or Use Alternate Drug.clemastineMonitor Closely (1)clemastine and clozapine both increase sedation. Use Caution/Monitor.clobazamMonitor Closely (1)clozapine, clobazam. Other (see comment). Use Caution/Monitor. Comment: Concomitant administration can increase the potential for CNS effects (e.g., increased sedation or respiratory depression).clomipramineMonitor Closely (1)clozapine and clomipramine both increase sedation. Use Caution/Monitor.clonazepamMonitor Closely (1)clonazepam and clozapine both increase sedation. Use Caution/Monitor.clonidineMonitor Closely (1)clonidine, clozapine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Additive hypotensive effects; potential delirium.clorazepateMonitor Closely (1)clorazepate and clozapine both increase sedation. Use Caution/Monitor.codeineMonitor Closely (2)codeine and clozapine