Clozapine/Carbamazepine
This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.
Medical warning:
Serious. These medicines may interact and cause very harmful effects. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.
How the interaction occurs:
When these two medicines are taken together, your body may not process clozapine properly. Additionally, a toxic effect of both medicines may increase.
What might happen:
The beneficial effects of clozapine may decrease. You may experience a toxic effect causing sore throat or fever.
What you should do about this interaction:
Contact your healthcare professionals (e.g. doctor or pharmacist) as soon as possible about taking these two medicines together. They may already be aware of the drug interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.
References:
1.Clozaril (clozapine tablets) US prescribing information. Novartis Pharmaceuticals Corporation October, 2011.
2.Gerson SL, Lieberman JA, Friedenberg WR, Lee D, Marx JJ Jr, Meltzer H. Polypharmacy in fatal clozapine-associated agranulocytosis. Lancet 1991 Jul 27;338(8761):262-3.
3.Muller T, Becker T, Fritze J. Neuroleptic malignant syndrome after clozapine plus carbamazepine. Lancet 1988 Dec 24-31;2(8626-8627):1500.
4.Raitasuo V, Lehtovaara R, Huttunen MO. Carbamazepine and plasma levels of clozapine. Am J Psychiatry 1993 Jan;150(1):169.
5.Raitasuo V, Lehtovaara R, Huttunen MO. Effect of switching carbamazepine to oxcarbazepine on the plasma levels of neuroleptics. A case report. Psychopharmacology (Berl) 1994 Sep;116(1):115-6.
6.Jerling M, Lindstrom L, Bondesson U, Bertilsson L. Fluvoxamine inhibition and carbamazepine induction of the metabolism of clozapine: evidence from a therapeutic drug monitoring service. Ther Drug Monit 1994 Aug; 16(4):368-74.
