Can you take Klonopin Wafer with Levodopa?
1 drug interaction and 31 additional warnings found for the following 2 drugs:
- Klonopin Wafer (clonazepam)
- levodopa
Drug interactions
Moderate drug interactions
Moderate:
clonazePAM levodopa
Applies to: Klonopin Wafer (clonazepam) and levodopa
ClonazePAM can decrease the effects of levodopa in some people. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. Contact your doctor if your Parkinson symptoms worsen. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Food/lifestyle interactions
Moderate food/lifestyle interactions
Moderate:
levodopa Food/Lifestyle
Applies to: levodopa
Alcohol can increase the nervous system side effects of levodopa such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with levodopa. You may experience reduced effectiveness of levodopa in the presence of foods or enteral (tube) feedings with a high protein content. This may make the symptoms of Parkinson's disease worse. Talk with your doctor or nutrition counselor about the best foods to eat while you are taking this medication. Contact your doctor if your condition changes.
Moderate:
clonazePAM Alcohol (Ethanol)
Applies to: Klonopin Wafer (clonazepam)
Using clonazePAM together with ethanol (alcohol) can increase nervous system side effects such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with clonazePAM. Do not use more than the recommended dose of clonazePAM, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medication without first talking to your doctor.
Moderate:
levodopa multivitamins with minerals
Applies to: levodopa
Levodopa and multivitamins with minerals should not be taken orally at the same time. Products that contain iron may interfere with the absorption of levodopa and reduce its effectiveness. You should separate the dosing of these medications by as much as possible. Contact your doctor if your Parkinson symptoms worsen. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Disease interactions
28 potential interactions Applies to: 20 conditions, including Depression, Weight Loss, Asthma, COPD, and Seizures.
Acute Alcohol Intoxication
Major:
Klonopin Wafer
The clonazePAM in Klonopin Wafer has a major potential interaction with Acute Alcohol Intoxication.
The use of benzodiazepines with alcohol is not recommended. Patients with acute alcohol intoxication exhibit depressed vital signs. The central nervous system depressant effects of benzodiazepines may be additive with those of alcohol, and severe respiratory depression and death may occur. Therapy with benzodiazepines should be administered cautiously in patients who might be prone to acute alcohol intake.
Asphyxia
Major:
Klonopin Wafer
The clonazePAM in Klonopin Wafer has a major potential interaction with Asphyxia.
Benzodiazepines may cause respiratory depression and apnea, usually when given in high dosages and/or by intravenous administration. However, some patients may be susceptible at commonly used dosages, including the elderly, debilitated or severely ill patients, those receiving other CNS depressants, and those with limited ventilatory reserve, chronic pulmonary insufficiency or other respiratory disorders. Therapy with benzodiazepines should be administered cautiously in these patients. Appropriate monitoring and individualization of dosage are particularly important, and equipment for resuscitation should be immediately available if the parenteral route is used. Benzodiazepines, especially injectable formulations, should generally be avoided in patients with sleep apnea, severe respiratory insufficiency, or hypoxia.
Asthma
Major:
levodopa
Levodopa has a major potential interaction with Asthma.
Because of the risk of bronchospasm, use of levodopa in patients with asthma, COPD, or other chronic underlying lung disease is not recommended.
Cardiovascular Conditions and Disorders
Major:
levodopa
Levodopa has a major potential interaction with Cardiovascular Conditions and Disorders.
Cardiac irregularities occur infrequently in patients on dopamine agonists. The initial administration and titration is recommended to occur under close cardiac monitoring in a facility equipped for intensive cardiac care. Adverse cardiac affects may include palpitation, sinus tachycardia, ventricular tachycardia, extrasystole, atrial flutter or fibrillation, or block of AV conduction.
COPD
Major:
levodopa
Levodopa has a major potential interaction with COPD.
Because of the risk of bronchospasm, use of levodopa in patients with asthma, COPD, or other chronic underlying lung disease is not recommended.
Depression
Moderate:
Klonopin Wafer
The clonazePAM in Klonopin Wafer has a moderate potential interaction with Depression.
Benzodiazepines depress the central nervous system and may cause or exacerbate mental depression and cause suicidal behavior and ideation. Episodes of mania and hypomania have also been reported in depressed patients treated with some of these agents. Therapy with benzodiazepines should be administered cautiously in patients with a history of depression or other psychiatric disorders. Patients should be monitored for any changes in mood or behavior. It may be prudent to refrain from dispensing large quantities of medication to these patients.
Moderate:
Klonopin Wafer
The clonazePAM in Klonopin Wafer has a moderate potential interaction with Depression.
Antiepileptic drugs (AEDs) have been associated with an increased risk of suicidal thoughts or behavior in patients taking these drugs for any indication. Pooled analyses of 199 placebo-controlled clinical studies involving the use of 11 different AEDs showed that patients receiving AEDs had approximately twice the risk of suicidal thinking or behavior compared to patients receiving placebo. AEDs should be administered cautiously in patients with depression or other psychiatric disorders; phentermine-topiramate should be avoided in patients with history of suicidal attempts or active suicidal ideation. The risk of suicidal thoughts and behavior should be carefully assessed against the risk of untreated illness, bearing in mind that epilepsy and many other conditions for which AEDs are prescribed are themselves associated with morbidity and mortality and an increased risk of suicidal thoughts and behavior. Patients, caregivers, and families should be alert to the emergence or worsening of signs and symptoms of depression, any unusual changes in mood or behavior, or the emergence of suicidal thoughts or behavior. If patients have symptoms of suicidal ideation or behavior, a dosage reduction or treatment discontinuation should be considered.
Drug Dependence
Major:
Klonopin Wafer
The clonazePAM in Klonopin Wafer has a major potential interaction with Drug Dependence.
Benzodiazepines have the potential to cause dependence and abuse. Tolerance as well as physical and psychological dependence can develop, particularly after prolonged use and/or excessive dosages. However, abrupt cessation following continual use of as few as 6 weeks at therapeutic levels has occasionally precipitated withdrawal symptoms. Addiction- prone individuals, such as those with a history of alcohol or substance abuse, should be under careful surveillance when treated with benzodiazepines. It may be prudent to refrain from dispensing large quantities of medication to these patients. After prolonged use or if dependency is suspected, withdrawal of benzodiazepine therapy should be undertaken gradually using a dosage- tapering schedule. If withdrawal symptoms occur, temporary reinstitution of benzodiazepines may be necessary.
Gastrointestinal Hemorrhage
Moderate:
levodopa
Levodopa has a moderate potential interaction with Gastrointestinal Hemorrhage.
The use of levodopa, especially in combinations with carbidopa, has been associated with an increase in the frequency of gastrointestinal hemorrhage. Therapy with levodopa should be administered cautiously in patients with a history of peptic ulcer disease or gastrointestinal hemorrhage.
Glaucoma/Intraocular Hypertension
Major:
Klonopin Wafer
The clonazePAM in Klonopin Wafer has a major potential interaction with Glaucoma/Intraocular Hypertension.
The manufacturers consider the use of benzodiazepines to be contraindicated in patients with acute angle-closure glaucoma or untreated open-angle glaucoma. These agents do not possess anticholinergic activity but have very rarely been associated with increased intraocular pressure.
Major:
levodopa
Levodopa has a major potential interaction with Glaucoma/Intraocular Hypertension.
The use of levodopa is contraindicated in patients with acute closed-angle glaucoma. Levodopa (with or without carbidopa) may be used in patients with open-angle glaucoma who are receiving appropriate therapy.
Hyperkinetic Syndrome of Childhood
Moderate:
Klonopin Wafer
The clonazePAM in Klonopin Wafer has a moderate potential interaction with Hyperkinetic Syndrome of Childhood.
Paradoxical reactions, including excitability, irritability, aggressive behavior, agitation, nervousness, hostility, anxiety, sleep disturbances, nightmares and vivid dreams, have been reported with the use of benzodiazepines in psychiatric patients and pediatric patients with hyperactive aggressive disorders. Such patients should be monitored for signs of paradoxical stimulation during therapy with benzodiazepines. The manufacturers do not recommend the use of benzodiazepines for the treatment of psychosis.
Hypotension
Moderate:
levodopa
Levodopa has a moderate potential interaction with Hypotension.
Dopamine agonists may impair the systemic regulation of blood pressure, with resultant orthostatic hypotension at any time, but especially during dose escalation. Additionally, patients with Parkinson's disease may have an impaired capacity to respond to an orthostatic challenge. For these reasons, patients with Parkinson's disease (or restless legs syndrome) who are being treated with dopaminergic agonists typically require careful monitoring for signs/symptoms of orthostatic hypotension, especially during dose escalation, and should be advised of this risk.
Liver Disease
Major:
Klonopin Wafer
The clonazePAM in Klonopin Wafer has a major potential interaction with Liver Disease.
The use of some benzodiazepines such as clonazepam and diazepam (oral tablets), is considered by the manufacturer to be contraindicated in patients with clinical or biochemical evidence of significant liver disease. These drugs are primarily metabolized by the liver and there is a risk of excess accumulation. Although all benzodiazepines may worsen hepatic encephalopathy, the manufacturer specifically recommends that lorazepam should be avoided in these patients.
Major:
levodopa
Levodopa has a major potential interaction with Liver Disease.
The pharmacokinetics of levodopa have not been studied in patients with hepatic or renal impairment. Therapy with levodopa should be administered cautiously in patients with liver or disease. Periodic monitoring of hepatic and renal function is recommended during extended therapy.
Psychosis
Major:
levodopa
Levodopa has a major potential interaction with Psychosis.
The use of dopamine agonists has been associated with psychiatric effects such as hallucinations, psychosis, confusion, anxiety, mania, hypomania, depression, rapid mood cycling, nightmares, and hypersexuality. Therapy with dopamine agonists should be administered cautiously in psychotic patients and all patients should be carefully observed for development of depression and suicidal tendencies.
Moderate:
Klonopin Wafer
The clonazePAM in Klonopin Wafer has a moderate potential interaction with Psychosis.
Benzodiazepines depress the central nervous system and may cause or exacerbate mental depression and cause suicidal behavior and ideation. Episodes of mania and hypomania have also been reported in depressed patients treated with some of these agents. Therapy with benzodiazepines should be administered cautiously in patients with a history of depression or other psychiatric disorders. Patients should be monitored for any changes in mood or behavior. It may be prudent to refrain from dispensing large quantities of medication to these patients.
Moderate:
Klonopin Wafer
The clonazePAM in Klonopin Wafer has a moderate potential interaction with Psychosis.
Paradoxical reactions, including excitability, irritability, aggressive behavior, agitation, nervousness, hostility, anxiety, sleep disturbances, nightmares and vivid dreams, have been reported with the use of benzodiazepines in psychiatric patients and pediatric patients with hyperactive aggressive disorders. Such patients should be monitored for signs of paradoxical stimulation during therapy with benzodiazepines. The manufacturers do not recommend the use of benzodiazepines for the treatment of psychosis.
Moderate:
Klonopin Wafer
The clonazePAM in Klonopin Wafer has a moderate potential interaction with Psychosis.
Antiepileptic drugs (AEDs) have been associated with an increased risk of suicidal thoughts or behavior in patients taking these drugs for any indication. Pooled analyses of 199 placebo-controlled clinical studies involving the use of 11 different AEDs showed that patients receiving AEDs had approximately twice the risk of suicidal thinking or behavior compared to patients receiving placebo. AEDs should be administered cautiously in patients with depression or other psychiatric disorders; phentermine-topiramate should be avoided in patients with history of suicidal attempts or active suicidal ideation. The risk of suicidal thoughts and behavior should be carefully assessed against the risk of untreated illness, bearing in mind that epilepsy and many other conditions for which AEDs are prescribed are themselves associated with morbidity and mortality and an increased risk of suicidal thoughts and behavior. Patients, caregivers, and families should be alert to the emergence or worsening of signs and symptoms of depression, any unusual changes in mood or behavior, or the emergence of suicidal thoughts or behavior. If patients have symptoms of suicidal ideation or behavior, a dosage reduction or treatment discontinuation should be considered.
Moderate:
levodopa
Levodopa has a moderate potential interaction with Psychosis.
Ordinarily, patients with major psychotic disorder should not be treated with dopaminergic antiparkinsonian agents, because of the risk of exacerbating psychosis. Hallucinations and psychotic-like behavior have been reported with dopaminergic medications. In addition, certain medications used to treat psychosis may exacerbate the symptoms of Parkinson's disease and may decrease the effectiveness of these drugs. The use of bromocriptine in patients with severe psychotic disorders is not recommended.
Pulmonary Impairment
Major:
Klonopin Wafer
The clonazePAM in Klonopin Wafer has a major potential interaction with Pulmonary Impairment.
Benzodiazepines may cause respiratory depression and apnea, usually when given in high dosages and/or by intravenous administration. However, some patients may be susceptible at commonly used dosages, including the elderly, debilitated or severely ill patients, those receiving other CNS depressants, and those with limited ventilatory reserve, chronic pulmonary insufficiency or other respiratory disorders. Therapy with benzodiazepines should be administered cautiously in these patients. Appropriate monitoring and individualization of dosage are particularly important, and equipment for resuscitation should be immediately available if the parenteral route is used. Benzodiazepines, especially injectable formulations, should generally be avoided in patients with sleep apnea, severe respiratory insufficiency, or hypoxia.
Renal Dysfunction
Major:
levodopa
Levodopa has a major potential interaction with Renal Dysfunction.
The pharmacokinetics of levodopa have not been studied in patients with hepatic or renal impairment. Therapy with levodopa should be administered cautiously in patients with liver or disease. Periodic monitoring of hepatic and renal function is recommended during extended therapy.
Moderate:
Klonopin Wafer
The clonazePAM in Klonopin Wafer has a moderate potential interaction with Renal Dysfunction.
Benzodiazepines are excreted by the kidneys and should be used with caution in patients with impaired renal function and end-stage kidney disease.
Respiratory Arrest
Major:
Klonopin Wafer
The clonazePAM in Klonopin Wafer has a major potential interaction with Respiratory Arrest.
Benzodiazepines may cause respiratory depression and apnea, usually when given in high dosages and/or by intravenous administration. However, some patients may be susceptible at commonly used dosages, including the elderly, debilitated or severely ill patients, those receiving other CNS depressants, and those with limited ventilatory reserve, chronic pulmonary insufficiency or other respiratory disorders. Therapy with benzodiazepines should be administered cautiously in these patients. Appropriate monitoring and individualization of dosage are particularly important, and equipment for resuscitation should be immediately available if the parenteral route is used. Benzodiazepines, especially injectable formulations, should generally be avoided in patients with sleep apnea, severe respiratory insufficiency, or hypoxia.
Seizures
Major:
Klonopin Wafer
The clonazePAM in Klonopin Wafer has a major potential interaction with Seizures.
The use of benzodiazepines in patients with seizure disorders may increase the incidence or precipitate the onset of generalized tonic-clonic seizures (grand mal). Appropriate anticonvulsant medication might need to be initiated or the dosage increased. Abrupt cessation of benzodiazepine therapy may precipitate seizures and other withdrawal symptoms, particularly after prolonged use and/or excessive dosages. Status epilepticus may occur in patients with a history of seizures withdrawn rapidly from benzodiazepine therapy. Following chronic administration, cessation of benzodiazepine therapy should occur gradually with incrementally reduced dosages. Patients should be advised not to discontinue medication without first consulting with the physician.
Skin Cancer
Major:
levodopa
Levodopa has a major potential interaction with Skin Cancer.
The use of levodopa is considered by manufacturers to be contraindicated in patients with a history of melanoma or in patients with suspicious, undiagnosed skin lesions. Levodopa reportedly may activate malignant melanoma, although some investigators have found a causal relationship to be tenuous.
Sleep Disorders
Moderate:
levodopa
Levodopa has a moderate potential interaction with Sleep Disorders.
Patients treated with products containing carbidopa and levodopa report excessive somnolence and falling asleep while engaged in daily activities, sometimes with no warning sign of drowsiness. Advise patients about the risks, especially those suffering from sleep disorders or using concomitant sedating medications.
Weight Loss
Moderate:
Klonopin Wafer
The clonazePAM in Klonopin Wafer has a moderate potential interaction with Weight Loss.
The plasma half-lives of benzodiazepines may be prolonged in obese patients, presumably due to increased distribution into fat. Marked increases in distribution (> 100%) have been reported for diazepam and midazolam, and moderate increases (25% to 100%) for alprazolam, lorazepam, and oxazepam. Therapy with benzodiazepines should be administered cautiously in obese patients, with careful monitoring of CNS status. Longer dosing intervals may be appropriate. When dosing by weight, loading doses should be based on actual body weight, while maintenance dose should be based on ideal body weight to avoid toxicity.
More resources
Klonopin Wafer
A total of 553 drugs are known to interact with Klonopin Wafer.
- Klonopin wafer is in the following drug classes: benzodiazepine anticonvulsants, benzodiazepines.
- Klonopin wafer is used to treat the following conditions:
levodopa
A total of 532 drugs are known to interact with levodopa.
- Levodopa is in the drug class dopaminergic antiparkinsonism agents.
- Levodopa is used to treat the following conditions:
Drug Interaction Classification
| Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
| Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
| 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. | |
| No interaction information available. |
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.