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Drug Interaction Report

4 potential interactions and/or warnings found for the following 2 drugs:

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Interactions between your drugs

Major

cloZAPine entacapone

Applies to: Denzapine (clozapine), entacapone

Consumer information for this interaction is not currently available.

GENERALLY AVOID: Agents with antidopaminergic activity such as quetiapine and clozapine may antagonize the pharmacologic effects of dopaminergic drugs, and vice versa. Quetiapine and clozapine may cause extrapyramidal reactions (i.e., acute dystonic reactions, tardive dyskinesia, akathisia, Parkinson-like symptoms) due to antidopaminergic effects. In addition, the central nervous system depressant and hypotensive effects of these agents may be additively or synergistically increased when taken together. However, some authorities have approved the use of clozapine in patients with psychosis in Parkinson's disease (PD) when other treatment strategies have failed (UK), and quetiapine is considered as possibly effective in the treatment of psychosis in PD patients by several authorities, although this remains an off-label use.

MANAGEMENT: Concomitant use of dopaminergic drugs with antidopaminergic agents such as clozapine or quetiapine should generally be avoided. Patients should be alerted to the possibility of excessive drowsiness and monitored for potentially diminished therapeutic response to both treatments. Patients treated for PD should generally avoid antidopaminergic agents, since these agents may cause extrapyramidal reactions and exacerbate the symptoms of PD. Consult the manufacturer's labeling and local guidelines for specific recommendations. When treatment for neuroleptic-induced extrapyramidal symptoms is required, anticholinergic anti-parkinsonian agents should be used in preference to levodopa. Likewise, patients with a major psychotic disorder should ordinarily not be treated with dopaminergic drugs because of the risk of exacerbating the psychosis with an increase in central dopaminergic tone.

Drug and food interactions

Moderate

cloZAPine food

Applies to: Denzapine (clozapine)

Alcohol can increase the nervous system side effects of cloZAPine 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 cloZAPine. Do not use more than the recommended dose of cloZAPine, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you. Talk to your doctor or pharmacist if you have any questions or concerns.

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Moderate

entacapone food

Applies to: entacapone

Alcohol can increase the nervous system side effects of entacapone 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 entacapone. Do not use more than the recommended dose of entacapone, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you. Talk to your doctor or pharmacist if you have any questions or concerns.

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Minor

cloZAPine food

Applies to: Denzapine (clozapine)

Information for this minor interaction is available on the professional version.

Therapeutic duplication warnings

No duplication 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.


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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.

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Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.