Clopixol-Acuphase Drug Interactions

Combinations requiring precautions for use: Zuclopenthixol acetate may enhance the sedative effect of alcohol and the effects of barbiturates and other CNS depressants.
Neuroleptics may increase or reduce the effect of antihypertensive drugs; the antihypertensive effect of guanethidine and similar acting compounds is reduced.
Concomitant use of neuroleptics and lithium increases the risk of neurotoxicity.
Tricyclic antidepressants and neuroleptics mutually inhibit the metabolism of each other. Zuclopenthixol acetate may reduce the effect of levodopa and the effect of adrenergic drugs. Concomitant use of metoclopramide and piperazine increases the risk of extrapyramidal disorder.
Since zuclopenthixol is partly metabolised by CYP2D6 concomitant use of drugs known to inhibit this enzyme may lead to decreased clearance of zuclopenthixol.
Increases in the QT interval related to antipsychotic treatment may be exacerbated by the co-administration of other drugs known to significantly increase the QT interval. Co-administration of such drugs should be avoided. Relevant classes include: class Ia and III antiarrhythmics (e.g. quinidine, amiodarone, sotalol, dofetilide); some antipsychotics (e.g. thioridazine); some macrolides (e.g. erythromycin); some antihistamines (e.g. terfenadine, astemizole); some quinolone antibiotics (e.g. gatifloxacin, moxifloxacin).
The previous list is not exhaustive and other individual drugs known to significantly increase QT interval (e.g. cisapride, lithium) should be avoided.
Drugs known to cause electrolyte disturbances such as thiazide diuretics (hypokalemia) and drugs known to increase the plasma concentration of zuclopenthixol acetate should also be used with caution as they may increase the risk of QT prolongation and malignant arrhythmias (see Precautions).