Ziproc-25/Ziproc-100 Drug Interactions

Clozapine may enhance the central effects of CNS depressants including alcohol, benzodiazepines and MAOIs.
Clozapine should not be used concurrently with drugs which carry a high risk of bone-marrow suppression including carbamazepine, cotrimoxazole, chloramphenicol, penicillamine, sulfonamides, antineoplastics or pyrazalone analgesics such as azapropazone. Long acting depot antipsychotics should not be used with clozapine as they cannot be withdrawn rapidly when neutropenia occur. Additive effects may occur when clozapine is given with drugs that possesses antimuscarinic, hypotensive, or respiratory depressant effects.
Clozapine may reduce the effects of alpha-adrenoceptor agonists such as noradrenaline. The metabolism of clozapine is mediated mainly by the cytochrome P450 isoenzyme CYP1A2. Concomitant use of drugs that inhibit or act as a substrate to this isoenzyme may affect plasma concentrations of clozapine and the dose of clozapine may need to be altered. Increased plasma-clozapine concentrations, with an increased risk of adverse effects, may be seen in patients who suddenly stop smoking. Use with phenytoin or other enzyme-inducing drugs may accelerate the metabolism of clozapine and reduce its plasma concentrations.