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Drug Interactions between Clopine and fluvoxamine

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Moderate

cloZAPine fluvoxaMINE

Applies to: Clopine (clozapine) and fluvoxamine

MONITOR: Clozapine serum levels and associated toxicity may be increased with the concomitant use of certain selective serotonin reuptake inhibitors. The proposed mechanism is inhibition of the metabolism of clozapine by CYP450 1A2 and/or 2D6.

MANAGEMENT: Patients should be monitored for altered efficacy and safety (e.g., worsening of psychosis/obsessive-compulsive symptoms, seizures, and orthostatic hypotension). Dose adjustments may be required if an interaction is suspected.

References

  1. Brosen K, Skjelbo E, Rasmussen BB, Poulsen HE, Loft S (1993) "Fluvoxamine is a potent inhibitor of cytochrome P4501A2." Biochem Pharmacol, 45, p. 1211-4
  2. Jerling M, Lindstrom L, Bondesson U, Bertilsson L (1994) "Fluvoxamine inhibition and carbamazepine induction of the metabolism of clozapine - evidence from a therapeutic drug monitoring service." Ther Drug Monit, 16, p. 368-74
  3. Markowitz JS, Gill HS, Lavia M, Brewerton TD, Devane CL (1996) "Fluvoxamine-clozapine dose-dependent interaction." Can J Psychiatry, 41, p. 670-1
  4. Chong SA, Tan CH, Lee HS (1997) "Worsening of psychosis with clozapine and selective serotonin reuptake inhibitor combination: two case reports." J Clin Psychopharmacol, 17, p. 68-9
  5. Pinninti NR, de Leon J (1997) "Interaction of sertraline with clozapine." J Clin Psychopharmacol, 17, p. 119
  6. Olesen OV, Linnet K (2000) "Fluvoxamine-clozapine drug interaction: Inhibition in vitro of five cytochrome P450 isoforms involved in clozapine metabolism." J Clin Psychopharmacol, 20, p. 35-42
View all 6 references

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Drug and food interactions

Moderate

cloZAPine food

Applies to: Clopine (clozapine)

GENERALLY AVOID: Alcohol may potentiate some of the pharmacologic effects of CNS-active agents. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.

MANAGEMENT: Patients receiving CNS-active agents should be warned of this interaction and advised to avoid or limit consumption of alcohol. Ambulatory patients should be counseled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.

References

  1. Warrington SJ, Ankier SI, Turner P (1986) "Evaluation of possible interactions between ethanol and trazodone or amitriptyline." Neuropsychobiology, 15, p. 31-7
  2. Gilman AG, eds., Nies AS, Rall TW, Taylor P (1990) "Goodman and Gilman's the Pharmacological Basis of Therapeutics." New York, NY: Pergamon Press Inc.
  3. (2012) "Product Information. Fycompa (perampanel)." Eisai Inc
  4. (2015) "Product Information. Rexulti (brexpiprazole)." Otsuka American Pharmaceuticals Inc
View all 4 references

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Moderate

fluvoxaMINE food

Applies to: fluvoxamine

GENERALLY AVOID: Alcohol may potentiate some of the pharmacologic effects of CNS-active agents. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.

MANAGEMENT: Patients receiving CNS-active agents should be warned of this interaction and advised to avoid or limit consumption of alcohol. Ambulatory patients should be counseled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.

References

  1. Warrington SJ, Ankier SI, Turner P (1986) "Evaluation of possible interactions between ethanol and trazodone or amitriptyline." Neuropsychobiology, 15, p. 31-7
  2. Gilman AG, eds., Nies AS, Rall TW, Taylor P (1990) "Goodman and Gilman's the Pharmacological Basis of Therapeutics." New York, NY: Pergamon Press Inc.
  3. (2012) "Product Information. Fycompa (perampanel)." Eisai Inc
  4. (2015) "Product Information. Rexulti (brexpiprazole)." Otsuka American Pharmaceuticals Inc
View all 4 references

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Minor

cloZAPine food

Applies to: Clopine (clozapine)

Caffeine may increase clozapine serum concentrations and exacerbate psychotic symptoms. The mechanism is unknown but may be related to competition for the same metabolic pathway. No specific intervention is necessary; however, if an interaction is suspected it is recommended that caffeine intake be avoided.

References

  1. Carrillo JA, Jerling M, Bertilsson L (1995) "Interaction between caffeine and clozapine - comment." J Clin Psychopharmacol, 15, p. 376-7
  2. Odom-White A, de Leon J (1996) "Clozapine levels and caffeine." J Clin Psychiatry, 57, p. 175-6
  3. Vainer JL, Chouinard G (1994) "Interaction between caffeine and clozapine." J Clin Psychopharmacol, 14, p. 284
  4. Hagg S, Spiset O, Mjorndal T, Dalqvist R (2000) "Effect of caffeine on clozapine pharmacokinetics in healthy volunteers." Br J Clin Pharmacol, 49, p. 59-63
View all 4 references

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Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

See also

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

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