Clobazam interactions
Clobazam (Onfi, Sympazan), a benzodiazepine has 265 documented interactions across the FDA labels and fact sheets we index: 116 major, 129 moderate, 19 minor, and 1 where a label reports no significant interaction. Each entry below quotes the sentence behind it. This drug page is a starting point, not a verdict for your situation.
Major interactions (116)
Abuse and misuse of benzodiazepines commonly involve concomitant use of other medications, alcohol, and/or illicit substances, which is associated with an increased frequency of serious adverse outcomes. (Clobazam label, Boxed warning)
Alprazolam XR is contraindicated in patients: • with known hypersensitivity to alprazolam or other benzodiazepines. (Alprazolam label, Contraindications)
If serotonin syndrome occurs, discontinue ADDERALL XR and the CYP2D6 inhibitor [see Warnings and Precautions ( 5.8 ), Overdosage ( 10 )] . (Amphetamine and dextroamphetamine label, Drug interactions)
• Simultaneous use of combined P-gp and strong CYP3A4 inducers reduces blood levels of apixaban: Avoid concomitant use. (Apixaban label, Drug interactions)
- ApremilastPDE4 inhibitorMajor
Drug Interactions : Use with strong cytochrome P450 enzyme inducers (e.g., rifampin, phenobarbital, carbamazepine, phenytoin) is not recommended because loss of efficacy may occur ( 5.5 , 7.1 ) (Apremilast label, Warnings and precautions)
Prescribe the lowest effective dosage; avoid or minimize concomitant use of CNS depressants and other substances associated with abuse, misuse, and addiction (e.g., opioid analgesics, stimulants); and advise patients on the proper disposal of unused drug. (Clobazam label, Warnings and precautions)
- AsenapineantipsychoticMajor
Prescribe the lowest effective dosage; avoid or minimize concomitant use of CNS depressants and other substances associated with abuse, misuse, and addiction (e.g., opioid analgesics, stimulants); and advise patients on the proper disposal of unused drug. (Clobazam label, Warnings and precautions)
Prescribe the lowest effective dosage; avoid or minimize concomitant use of CNS depressants and other substances associated with abuse, misuse, and addiction (e.g., opioid analgesics, stimulants); and advise patients on the proper disposal of unused drug. (Clobazam label, Warnings and precautions)
- Bictegravir, emtricitabine, and tenofovir alafenamideantiretroviralMajor
Concomitant administration of BIXLENVO is contraindicated with: dofetilide due to the potential for increased dofetilide plasma concentrations and associated serious and/or life-threatening events. strong CYP3A inducers due to decreased plasma concentrations of BIC and LEN, which may result in the loss of therapeutic effect and development of resistance to BIXLENVO. (Bictegravir, emtricitabine, and tenofovir alafenamide label, Contraindications)
- BrexpiprazoleantipsychoticMajor
Prescribe the lowest effective dosage; avoid or minimize concomitant use of CNS depressants and other substances associated with abuse, misuse, and addiction (e.g., opioid analgesics, stimulants); and advise patients on the proper disposal of unused drug. (Clobazam label, Warnings and precautions)
WARNING: RISKS FROM CONCOMITANT USE WITH OPIOIDS ; ABUSE, MISUSE, AND ADDICTION; and DEPENDENCE AND WITHDRAWAL REACTIONS Concomitant use of benzodiazepines and opioids may result in profound sedation, respiratory depression, coma, and death. (Clobazam label, Boxed warning)
WARNING: RISKS FROM CONCOMITANT USE WITH OPIOIDS ; ABUSE, MISUSE, AND ADDICTION; and DEPENDENCE AND WITHDRAWAL REACTIONS Concomitant use of benzodiazepines and opioids may result in profound sedation, respiratory depression, coma, and death. (Clobazam label, Boxed warning)
Bupropion hydrochloride extended-release tablets (XL) are contraindicated in patients undergoing abrupt discontinuation of alcohol, benzodiazepines, barbiturates, and antiepileptic drugs [see Warnings and Precautions (5.3) and Drug Interactions (7.3)] . (Bupropion label, Contraindications)
- Butalbital, acetaminophen, and caffeinebarbiturateMajor
Prescribe the lowest effective dosage; avoid or minimize concomitant use of CNS depressants and other substances associated with abuse, misuse, and addiction (e.g., opioid analgesics, stimulants); and advise patients on the proper disposal of unused drug. (Clobazam label, Warnings and precautions)
- ButorphanolopioidMajor
WARNING: RISKS FROM CONCOMITANT USE WITH OPIOIDS ; ABUSE, MISUSE, AND ADDICTION; and DEPENDENCE AND WITHDRAWAL REACTIONS Concomitant use of benzodiazepines and opioids may result in profound sedation, respiratory depression, coma, and death. (Clobazam label, Boxed warning)
- Cannabidiol (prescription)anticonvulsantMajor
Prescribe the lowest effective dosage; avoid or minimize concomitant use of CNS depressants and other substances associated with abuse, misuse, and addiction (e.g., opioid analgesics, stimulants); and advise patients on the proper disposal of unused drug. (Clobazam label, Warnings and precautions)
CNS Depressants The concomitant use of EQUETRO and other CNS depressants can increase the risk of respiratory depression, profound sedation, hypotension, and syncope. (Carbamazepine label, Drug interactions)
- CariprazineantipsychoticMajor
Prescribe the lowest effective dosage; avoid or minimize concomitant use of CNS depressants and other substances associated with abuse, misuse, and addiction (e.g., opioid analgesics, stimulants); and advise patients on the proper disposal of unused drug. (Clobazam label, Warnings and precautions)
Prescribe the lowest effective dosage; avoid or minimize concomitant use of CNS depressants and other substances associated with abuse, misuse, and addiction (e.g., opioid analgesics, stimulants); and advise patients on the proper disposal of unused drug. (Clobazam label, Warnings and precautions)
Avoid concurrent use of QUZYTTIR with alcohol or other CNS depressants because additional reduction in alertness and additional impairment of CNS performance may occur. (Cetirizine label, Warnings and precautions)
- ChlorpheniramineantihistamineMajor
…have a breathing problem such as emphysema or chronic bronchitis glaucoma trouble urinating due to an enlarged prostate gland Ask a doctor or pharmacist before use if you are taking sedatives or tranquilizers When using this product excitability may occur, especially in children drowsiness may occur avoid alcoholic beverages alchohol, sedatives and tranquilizers… (Chlorpheniramine label, Warnings)
- ChlorpromazineantipsychoticMajor
Prescribe the lowest effective dosage; avoid or minimize concomitant use of CNS depressants and other substances associated with abuse, misuse, and addiction (e.g., opioid analgesics, stimulants); and advise patients on the proper disposal of unused drug. (Clobazam label, Warnings and precautions)
Table 8: Drugs That are Affected by and Affecting Ciprofloxacin Drugs That are Affected by Ciprofloxacin Drug(s) Recommendation Comments Tizanidine Contraindicated Concomitant administration of tizanidine and ciprofloxacin is contraindicated due to the potentiation of hypotensive and sedative effects of tizanidine [see Contraindications ( 4.2 )]. (Ciprofloxacin label, Drug interactions)
Avoid use with other central nervous system (CNS) depressants ( 5.3 ) (Clonidine label, Warnings and precautions)
- ClozapineantipsychoticMajor
Prescribe the lowest effective dosage; avoid or minimize concomitant use of CNS depressants and other substances associated with abuse, misuse, and addiction (e.g., opioid analgesics, stimulants); and advise patients on the proper disposal of unused drug. (Clobazam label, Warnings and precautions)
- CodeineopioidMajor
WARNING: RISKS FROM CONCOMITANT USE WITH OPIOIDS ; ABUSE, MISUSE, AND ADDICTION; and DEPENDENCE AND WITHDRAWAL REACTIONS Concomitant use of benzodiazepines and opioids may result in profound sedation, respiratory depression, coma, and death. (Clobazam label, Boxed warning)
Prescribe the lowest effective dosage; avoid or minimize concomitant use of CNS depressants and other substances associated with abuse, misuse, and addiction (e.g., opioid analgesics, stimulants); and advise patients on the proper disposal of unused drug. (Clobazam label, Warnings and precautions)
- Dantrolenemuscle relaxantMajor
Prescribe the lowest effective dosage; avoid or minimize concomitant use of CNS depressants and other substances associated with abuse, misuse, and addiction (e.g., opioid analgesics, stimulants); and advise patients on the proper disposal of unused drug. (Clobazam label, Warnings and precautions)
- Daridorexantsedative-hypnoticMajor
Prescribe the lowest effective dosage; avoid or minimize concomitant use of CNS depressants and other substances associated with abuse, misuse, and addiction (e.g., opioid analgesics, stimulants); and advise patients on the proper disposal of unused drug. (Clobazam label, Warnings and precautions)
Coadministration of diltiazem with rifampin or any known CYP3A4 inducer should be avoided when possible, and alternative therapy considered [see Clinical Pharmacology (12.3)]. a Strong and moderate inhibitors increase the AUC of sensitive substrates of CYP3A4 by ≥ 5 and ≥ 2-fold, respectively b These examples are a guide and not considered a comprehensive list… (Diltiazem label, Drug interactions)
Children under the age of two years are at a considerably increased risk of developing fatal hepatotoxicity, especially those on multiple anticonvulsants, those with congenital metabolic disorders, those with severe seizure disorders accompanied by mental retardation, and those with organic brain disease. (Divalproex (valproate) label, Boxed warning)
- DoxylamineantihistamineMajor
…breathing problem such as emphysema or chronic bronchitis • glaucoma • trouble urinating due to an enlarged prostate gland Ask a doctor or pharmacist before use if you are taking • a sedative or any other sleep-aid • tranquilizers • any other antihistamines • any other drugs When using this product • avoid alcoholic beverages • do not drive a motor vehicle or operate… (Doxylamine label, Warnings)
- DronabinolcannabinoidMajor
Prescribe the lowest effective dosage; avoid or minimize concomitant use of CNS depressants and other substances associated with abuse, misuse, and addiction (e.g., opioid analgesics, stimulants); and advise patients on the proper disposal of unused drug. (Clobazam label, Warnings and precautions)
- DronedaroneantiarrhythmicMajor
• CYP3A inducers: Avoid concomitant use. (Dronedarone label, Drug interactions)
- Elexacaftor, tezacaftor, and ivacaftorMajor
Therefore, concomitant use with strong CYP3A inducers is not recommended [see Drug Interactions (7.1) and Clinical Pharmacology (12.3) ] . (Elexacaftor, tezacaftor, and ivacaftor label, Warnings and precautions)
- EluxadolineopioidMajor
WARNING: RISKS FROM CONCOMITANT USE WITH OPIOIDS ; ABUSE, MISUSE, AND ADDICTION; and DEPENDENCE AND WITHDRAWAL REACTIONS Concomitant use of benzodiazepines and opioids may result in profound sedation, respiratory depression, coma, and death. (Clobazam label, Boxed warning)
Prescribe the lowest effective dosage; avoid or minimize concomitant use of CNS depressants and other substances associated with abuse, misuse, and addiction (e.g., opioid analgesics, stimulants); and advise patients on the proper disposal of unused drug. (Clobazam label, Warnings and precautions)
- FelbamateanticonvulsantMajor
IT IS NOT KNOWN WHETHER CONCOMITANT USE OF OTHER ANTIEPILEPTIC DRUGS AND/OR OTHER DRUGS AFFECT THE INCIDENCE OF HEPATIC FAILURE. (Felbamate label, Boxed warning)
WARNING: RISKS FROM CONCOMITANT USE WITH OPIOIDS ; ABUSE, MISUSE, AND ADDICTION; and DEPENDENCE AND WITHDRAWAL REACTIONS Concomitant use of benzodiazepines and opioids may result in profound sedation, respiratory depression, coma, and death. (Clobazam label, Boxed warning)
- FlibanserinCNS depressantMajor
Preventing or Managing DI The concomitant use of ADDYI with CYP3A4 inducers is not recommended. (Flibanserin label, Drug interactions)
• Respiratory Depression: May occur with NEURONTIN when used with concomitant central nervous system (CNS) depressants, including opioids, or in the setting of underlying respiratory impairment. (Gabapentin label, Warnings and precautions)
Prescribe the lowest effective dosage; avoid or minimize concomitant use of CNS depressants and other substances associated with abuse, misuse, and addiction (e.g., opioid analgesics, stimulants); and advise patients on the proper disposal of unused drug. (Clobazam label, Warnings and precautions)
WARNING: RISKS FROM CONCOMITANT USE WITH OPIOIDS ; ABUSE, MISUSE, AND ADDICTION; and DEPENDENCE AND WITHDRAWAL REACTIONS Concomitant use of benzodiazepines and opioids may result in profound sedation, respiratory depression, coma, and death. (Clobazam label, Boxed warning)
WARNING: RISKS FROM CONCOMITANT USE WITH OPIOIDS ; ABUSE, MISUSE, AND ADDICTION; and DEPENDENCE AND WITHDRAWAL REACTIONS Concomitant use of benzodiazepines and opioids may result in profound sedation, respiratory depression, coma, and death. (Clobazam label, Boxed warning)
Rarely, cardiac arrests and death have been reported in association with the combined use of hydroxyzine hydrochloride intramuscularly and other CNS depressants. (Hydroxyzine label, Precautions)
- IloperidoneantipsychoticMajor
Prescribe the lowest effective dosage; avoid or minimize concomitant use of CNS depressants and other substances associated with abuse, misuse, and addiction (e.g., opioid analgesics, stimulants); and advise patients on the proper disposal of unused drug. (Clobazam label, Warnings and precautions)
- IsoniazidantibioticMajor
To avoid phenytoin intoxication, appropriate adjustment of the anticonvulsant should be made 5,6 . (Isoniazid label, Drug interactions)
Co-administration with eliglustat is contraindicated in poor or intermediate metabolizers of CYP2D6 and in subjects taking strong or moderate CYP2D6 inhibitors. (Itraconazole label, Boxed warning)
- IvabradineMajor
Avoid concomitant use of CYP3A4 inducers when using Corlanor. (Ivabradine label, Drug interactions)
- KetamineCNS depressantMajor
Prescribe the lowest effective dosage; avoid or minimize concomitant use of CNS depressants and other substances associated with abuse, misuse, and addiction (e.g., opioid analgesics, stimulants); and advise patients on the proper disposal of unused drug. (Clobazam label, Warnings and precautions)
This may potentiate and prolong hypnotic and sedative effects, especially with repeated dosing or chronic administration of these agents. (Ketoconazole label, Contraindications)
- Lemborexantsedative-hypnoticMajor
Prescribe the lowest effective dosage; avoid or minimize concomitant use of CNS depressants and other substances associated with abuse, misuse, and addiction (e.g., opioid analgesics, stimulants); and advise patients on the proper disposal of unused drug. (Clobazam label, Warnings and precautions)
Avoid concurrent use of alcohol or other central nervous system depressants with XYZAL. (Levocetirizine label, Warnings and precautions)
- LevorphanolopioidMajor
WARNING: RISKS FROM CONCOMITANT USE WITH OPIOIDS ; ABUSE, MISUSE, AND ADDICTION; and DEPENDENCE AND WITHDRAWAL REACTIONS Concomitant use of benzodiazepines and opioids may result in profound sedation, respiratory depression, coma, and death. (Clobazam label, Boxed warning)
If serotonin syndrome occurs, discontinue lisdexamfetamine dimesylate and the CYP2D6 inhibitor [see Warnings and Precautions (5.7) and Overdosage (10) ] . (Lisdexamfetamine label, Drug interactions)
Caution patients receiving LOREEV XR against operating machinery or driving a motor vehicle as well to avoid the concomitant use of alcohol and other CNS depressant drugs during treatment ( 5.4 , 7 ) (Lorazepam label, Warnings and precautions)
- LumateperoneantipsychoticMajor
Prescribe the lowest effective dosage; avoid or minimize concomitant use of CNS depressants and other substances associated with abuse, misuse, and addiction (e.g., opioid analgesics, stimulants); and advise patients on the proper disposal of unused drug. (Clobazam label, Warnings and precautions)
Prescribe the lowest effective dosage; avoid or minimize concomitant use of CNS depressants and other substances associated with abuse, misuse, and addiction (e.g., opioid analgesics, stimulants); and advise patients on the proper disposal of unused drug. (Clobazam label, Warnings and precautions)
- MacitentanMajor
Strong CYP3A4 inducers (rifampin) reduce exposure to macitentan: avoid co-administration with OPSUMIT ( 7.1 , 12.3 ). (Macitentan label, Drug interactions)
- MeperidineopioidMajor
WARNING: RISKS FROM CONCOMITANT USE WITH OPIOIDS ; ABUSE, MISUSE, AND ADDICTION; and DEPENDENCE AND WITHDRAWAL REACTIONS Concomitant use of benzodiazepines and opioids may result in profound sedation, respiratory depression, coma, and death. (Clobazam label, Boxed warning)
WARNING: RISKS FROM CONCOMITANT USE WITH OPIOIDS ; ABUSE, MISUSE, AND ADDICTION; and DEPENDENCE AND WITHDRAWAL REACTIONS Concomitant use of benzodiazepines and opioids may result in profound sedation, respiratory depression, coma, and death. (Clobazam label, Boxed warning)
Prescribe the lowest effective dosage; avoid or minimize concomitant use of CNS depressants and other substances associated with abuse, misuse, and addiction (e.g., opioid analgesics, stimulants); and advise patients on the proper disposal of unused drug. (Clobazam label, Warnings and precautions)
CYP2D6 Inhibitors Monitor patients closely when the combination use of CYP2D6 inhibitor and metoprolol cannot be avoided. (Metoprolol label, Drug interactions)
- MidazolambenzodiazepineMajor
WARNING: PERSONNEL AND EQUIPMENT FOR MONITORING AND RESUSCITATION, AND RISKS FROM CONCOMITANT USE WITH OPIOID ANALGESICS AND OTHER SEDATIVE-HYPNOTICS Personnel and Equipment for Monitoring and ResuscitationOnly personnel trained in the administration of procedural sedation, and not involved in the conduct of the diagnostic or therapeutic procedure, should administer… (Midazolam label, Boxed warning)
The concomitant use of benzodiazepines and alcohol with REMERON/REMERONSolTab should be avoided [see Drug Interactions (7) ] . (Mirtazapine label, Warnings and precautions)
WARNING: RISKS FROM CONCOMITANT USE WITH OPIOIDS ; ABUSE, MISUSE, AND ADDICTION; and DEPENDENCE AND WITHDRAWAL REACTIONS Concomitant use of benzodiazepines and opioids may result in profound sedation, respiratory depression, coma, and death. (Clobazam label, Boxed warning)
- NalbuphineopioidMajor
WARNING: RISKS FROM CONCOMITANT USE WITH OPIOIDS ; ABUSE, MISUSE, AND ADDICTION; and DEPENDENCE AND WITHDRAWAL REACTIONS Concomitant use of benzodiazepines and opioids may result in profound sedation, respiratory depression, coma, and death. (Clobazam label, Boxed warning)
- Naldemedineopioid antagonistMajor
John's Wort) Clinical Impact Significant decrease in plasma naldemedine concentrations, which may reduce efficacy [see Clinical Pharmacology (12.3) ] Intervention Avoid use of SYMPROIC with strong CYP3A inducers. (Naldemedine label, Drug interactions)
- Naltrexone and bupropionopioid antagonistMajor
…(e.g., buprenorphine) use, or acute opiate withdrawal [see Warnings and Precautions (5.4) and Drug Interactions (7.2) ] Patients undergoing an abrupt discontinuation of alcohol, benzodiazepines, barbiturates, and antiepileptic drugs [see Warnings and Precautions (5.3) and Drug Interactions (7.7) ] Concomitant administration of monoamine oxidase inhibitors (MAOI). (Naltrexone and bupropion label, Contraindications)
Avoid co-administration of nifedipine with phenytoin or any known CYP3A4 inducer or consider an alternative antihypertensive therapy. (Nifedipine label, Drug interactions)
Counsel patients to use a back-up method or alternative method of contraception when enzyme inducers are used with COCs ( 7.1 ) -- - ---------- ------ USE IN SPECIFIC POPULATIONS---- -- -- --------- ---- Lactation: Not recommended; Lo Loestrin Fe can decrease milk production ( 8.2 ) (Norethindrone and ethinyl estradiol label, Drug interactions)
Prescribe the lowest effective dosage; avoid or minimize concomitant use of CNS depressants and other substances associated with abuse, misuse, and addiction (e.g., opioid analgesics, stimulants); and advise patients on the proper disposal of unused drug. (Clobazam label, Warnings and precautions)
- OliceridineopioidMajor
WARNING: RISKS FROM CONCOMITANT USE WITH OPIOIDS ; ABUSE, MISUSE, AND ADDICTION; and DEPENDENCE AND WITHDRAWAL REACTIONS Concomitant use of benzodiazepines and opioids may result in profound sedation, respiratory depression, coma, and death. (Clobazam label, Boxed warning)
- OlopatadineantihistamineMajor
Avoid concurrent use of alcohol or other central nervous system depressants with olopatadine hydrochloride nasal spray ( 5.2 ). (Olopatadine label, Warnings and precautions)
WARNING: RISKS FROM CONCOMITANT USE WITH OPIOIDS ; ABUSE, MISUSE, AND ADDICTION; and DEPENDENCE AND WITHDRAWAL REACTIONS Concomitant use of benzodiazepines and opioids may result in profound sedation, respiratory depression, coma, and death. (Clobazam label, Boxed warning)
WARNING: RISKS FROM CONCOMITANT USE WITH OPIOIDS ; ABUSE, MISUSE, AND ADDICTION; and DEPENDENCE AND WITHDRAWAL REACTIONS Concomitant use of benzodiazepines and opioids may result in profound sedation, respiratory depression, coma, and death. (Clobazam label, Boxed warning)
- OxymorphoneopioidMajor
WARNING: RISKS FROM CONCOMITANT USE WITH OPIOIDS ; ABUSE, MISUSE, AND ADDICTION; and DEPENDENCE AND WITHDRAWAL REACTIONS Concomitant use of benzodiazepines and opioids may result in profound sedation, respiratory depression, coma, and death. (Clobazam label, Boxed warning)
- PalbociclibCYP3A4 inhibitorMajor
• CYP3A Inducers: Avoid concurrent use of IBRANCE with strong CYP3A inducers. (Palbociclib label, Drug interactions)
- PaliperidoneantipsychoticMajor
Prescribe the lowest effective dosage; avoid or minimize concomitant use of CNS depressants and other substances associated with abuse, misuse, and addiction (e.g., opioid analgesics, stimulants); and advise patients on the proper disposal of unused drug. (Clobazam label, Warnings and precautions)
- Pentazocine and naloxoneopioidMajor
WARNING: RISKS FROM CONCOMITANT USE WITH OPIOIDS ; ABUSE, MISUSE, AND ADDICTION; and DEPENDENCE AND WITHDRAWAL REACTIONS Concomitant use of benzodiazepines and opioids may result in profound sedation, respiratory depression, coma, and death. (Clobazam label, Boxed warning)
- PhenelzineMAO inhibitorMajor
Phenelzine sulfate should not be used in combination with dextromethorphan or with CNS depressants such as alcohol and certain narcotics. (Phenelzine label, Contraindications)
Prescribe the lowest effective dosage; avoid or minimize concomitant use of CNS depressants and other substances associated with abuse, misuse, and addiction (e.g., opioid analgesics, stimulants); and advise patients on the proper disposal of unused drug. (Clobazam label, Warnings and precautions)
- PimavanserinantipsychoticMajor
Prescribe the lowest effective dosage; avoid or minimize concomitant use of CNS depressants and other substances associated with abuse, misuse, and addiction (e.g., opioid analgesics, stimulants); and advise patients on the proper disposal of unused drug. (Clobazam label, Warnings and precautions)
• Respiratory Depression : May occur with LYRICA when used with concomitant CNS depressants or in the setting of underlying respiratory impairment. (Pregabalin label, Warnings and precautions)
Prescribe the lowest effective dosage; avoid or minimize concomitant use of CNS depressants and other substances associated with abuse, misuse, and addiction (e.g., opioid analgesics, stimulants); and advise patients on the proper disposal of unused drug. (Clobazam label, Warnings and precautions)
Prescribe the lowest effective dosage; avoid or minimize concomitant use of CNS depressants and other substances associated with abuse, misuse, and addiction (e.g., opioid analgesics, stimulants); and advise patients on the proper disposal of unused drug. (Clobazam label, Warnings and precautions)
- PropofolCNS depressantMajor
Prescribe the lowest effective dosage; avoid or minimize concomitant use of CNS depressants and other substances associated with abuse, misuse, and addiction (e.g., opioid analgesics, stimulants); and advise patients on the proper disposal of unused drug. (Clobazam label, Warnings and precautions)
Prescribe the lowest effective dosage; avoid or minimize concomitant use of CNS depressants and other substances associated with abuse, misuse, and addiction (e.g., opioid analgesics, stimulants); and advise patients on the proper disposal of unused drug. (Clobazam label, Warnings and precautions)
- Ramelteonsedative-hypnoticMajor
Prescribe the lowest effective dosage; avoid or minimize concomitant use of CNS depressants and other substances associated with abuse, misuse, and addiction (e.g., opioid analgesics, stimulants); and advise patients on the proper disposal of unused drug. (Clobazam label, Warnings and precautions)
ASPRUZYO Sprinkle is contraindicated in patients: Taking strong inhibitors of CYP3A [see Drug Interactions (7.1)] Taking inducers of CYP3A [see Drug Interactions (7.1)] With liver cirrhosis [see Use in Specific Populations (8.6)] Strong CYP3A inhibitors (e.g., ketoconazole, clarithromycin, nelfinavir) (4, 7.1) (Ranolazine label, Contraindications)
- RimegepantMajor
• Strong and Moderate CYP3A Inducers: Avoid concomitant administration. (Rimegepant label, Drug interactions)
Prescribe the lowest effective dosage; avoid or minimize concomitant use of CNS depressants and other substances associated with abuse, misuse, and addiction (e.g., opioid analgesics, stimulants); and advise patients on the proper disposal of unused drug. (Clobazam label, Warnings and precautions)
Avoid concomitant use of XARELTO with drugs that are known combined P-gp and strong CYP3A inducers [see Drug Interactions (7.3) ] . (Rivaroxaban label, Warnings and precautions)
- RoflumilastPDE4 inhibitorMajor
• Drug Interactions: Use with strong cytochrome P450 enzyme inducers (e.g., rifampicin, phenobarbital, carbamazepine, phenytoin) is not recommended. (Roflumilast label, Warnings and precautions)
- SirolimusimmunosuppressantMajor
Interaction with Strong Inhibitors and Inducers of CYP3A4 and/or P-gp Avoid concomitant use of sirolimus with strong inhibitors of CYP3A4 and/or P-gp (such as ketoconazole, voriconazole, itraconazole, erythromycin, telithromycin, or clarithromycin) or strong inducers of CYP3A4 and/or P-gp (such as rifampin or rifabutin) [ see Drug Interactions (7.2) ]. (Sirolimus label, Warnings and precautions)
- Sodium oxybateCNS depressantMajor
• Central Nervous System Depression Xyrem (sodium oxybate) is a CNS depressant. (Sodium oxybate label, Boxed warning)
- Sofosbuvir and velpatasvirantiviralMajor
Anticonvulsants: carbamazepine phenytoin phenobarbital ↓ sofosbuvir ↓ velpatasvir ↓ voxilaprevir Coadministration is not recommended. (Sofosbuvir and velpatasvir label, Drug interactions)
- Suvorexantsedative-hypnoticMajor
Prescribe the lowest effective dosage; avoid or minimize concomitant use of CNS depressants and other substances associated with abuse, misuse, and addiction (e.g., opioid analgesics, stimulants); and advise patients on the proper disposal of unused drug. (Clobazam label, Warnings and precautions)
Inducers of CYP3A4 Strong CYP3A4 inducers should not be used with tamoxifen. (Tamoxifen label, Drug interactions)
- TapentadolopioidMajor
WARNING: RISKS FROM CONCOMITANT USE WITH OPIOIDS ; ABUSE, MISUSE, AND ADDICTION; and DEPENDENCE AND WITHDRAWAL REACTIONS Concomitant use of benzodiazepines and opioids may result in profound sedation, respiratory depression, coma, and death. (Clobazam label, Boxed warning)
- Tasimelteonsedative-hypnoticMajor
Prescribe the lowest effective dosage; avoid or minimize concomitant use of CNS depressants and other substances associated with abuse, misuse, and addiction (e.g., opioid analgesics, stimulants); and advise patients on the proper disposal of unused drug. (Clobazam label, Warnings and precautions)
Prescribe the lowest effective dosage; avoid or minimize concomitant use of CNS depressants and other substances associated with abuse, misuse, and addiction (e.g., opioid analgesics, stimulants); and advise patients on the proper disposal of unused drug. (Clobazam label, Warnings and precautions)
• Avoid use with strong CYP3A inhibitors or CYP3A inducers. (Ticagrelor label, Drug interactions)
Prescribe the lowest effective dosage; avoid or minimize concomitant use of CNS depressants and other substances associated with abuse, misuse, and addiction (e.g., opioid analgesics, stimulants); and advise patients on the proper disposal of unused drug. (Clobazam label, Warnings and precautions)
WARNING: RISKS FROM CONCOMITANT USE WITH OPIOIDS ; ABUSE, MISUSE, AND ADDICTION; and DEPENDENCE AND WITHDRAWAL REACTIONS Concomitant use of benzodiazepines and opioids may result in profound sedation, respiratory depression, coma, and death. (Clobazam label, Boxed warning)
- TretinoinretinoidMajor
Avoid concomitant use with strong CYP3A inducers if possible. (Tretinoin label, Drug interactions)
- TriazolambenzodiazepineMajor
Prescribe the lowest effective dosage; avoid or minimize concomitant use of CNS depressants and other substances associated with abuse, misuse, and addiction (e.g., opioid analgesics, stimulants); and advise patients on the proper disposal of unused drug. (Clobazam label, Warnings and precautions)
- UbrogepantMajor
Strong CYP3A4 Inducers: Should be avoided as concomitant use will result in reduction of ubrogepant exposure. (Ubrogepant label, Drug interactions)
- UpadacitinibimmunosuppressantMajor
Strong CYP3A4 Inducers : Coadministration of RINVOQ/RINVOQ LQ with strong CYP3A4 inducers is not recommended. (Upadacitinib label, Drug interactions)
- ValbenazineVMAT2 inhibitorMajor
Use of strong CYP3A4 inducers with INGREZZA or INGREZZA SPRINKLE Concomitant use is not recommended. (Valbenazine label, Drug interactions)
- Valproic acidanticonvulsantMajor
Children under the age of two years are at a considerably increased risk of developing fatal hepatotoxicity, especially those on multiple anticonvulsants, those with congenital metabolic disorders, those with severe seizure disorders accompanied by mental retardation, and those with organic brain disease. (Valproic acid label, Boxed warning)
- Zaleplonsedative-hypnoticMajor
Prescribe the lowest effective dosage; avoid or minimize concomitant use of CNS depressants and other substances associated with abuse, misuse, and addiction (e.g., opioid analgesics, stimulants); and advise patients on the proper disposal of unused drug. (Clobazam label, Warnings and precautions)
Prescribe the lowest effective dosage; avoid or minimize concomitant use of CNS depressants and other substances associated with abuse, misuse, and addiction (e.g., opioid analgesics, stimulants); and advise patients on the proper disposal of unused drug. (Clobazam label, Warnings and precautions)
Prescribe the lowest effective dosage; avoid or minimize concomitant use of CNS depressants and other substances associated with abuse, misuse, and addiction (e.g., opioid analgesics, stimulants); and advise patients on the proper disposal of unused drug. (Clobazam label, Warnings and precautions)
Moderate interactions (129)
- Acetazolamidecarbonic anhydrase inhibitorModerate
By decreasing the gastrointestinal absorption of primidone, acetazolamide may decrease serum concentrations of primidone and its metabolites, with a consequent possible decrease in anticonvulsant effect. (Acetazolamide label, Drug interactions)
- AlbendazoleModerate
Risk of Neurologic Symptoms: Neurocysticercosis patients may experience cerebral hypertensive episodes, seizures or focal neurologic deficits after initiation of therapy; begin appropriate steroid and anticonvulsant therapy. (Albendazole label, Warnings and precautions)
Inform patients also that the central nervous system depressant effects of allopurinol tablets may be additive to those of alcohol and other CNS depressants. (Allopurinol label, Warnings and precautions)
- Amitriptylinetricyclic antidepressantModerate
Risk may be increased with concomitant use of other CNS depressants ( 5.4 , 5.5 ) (Clobazam label, Warnings and precautions)
- Amlodipinedihydropyridine calcium channel blockerModerate
Blood pressure should be closely monitored when amlodipine is co-administered with CYP3A inducers. (Amlodipine label, Drug interactions)
- Amlodipine and benazeprildihydropyridine calcium channel blockerModerate
Blood pressure should be monitored when amlodipine is coadministered with CYP3A4 inducers (e.g. rifampicin, St. (Amlodipine and benazepril label, Drug interactions)
- AprepitantCYP3A4 inhibitorModerate
Benzodiazepines Clinical Impact Increased exposure to midazolam or other benzodiazepines metabolized via CYP3A4 (alprazolam, triazolam) may increase the risk of adverse reactions [see Clinical Pharmacology (12.3) ] . (Aprepitant label, Drug interactions)
- ArmodafinilCNS stimulantModerate
Prescribe the lowest effective dosage; avoid or minimize concomitant use of CNS depressants and other substances associated with abuse, misuse, and addiction (e.g., opioid analgesics, stimulants); and advise patients on the proper disposal of unused drug. (Clobazam label, Warnings and precautions)
- Aspirin and dipyridamoleantiplatelet agentModerate
Anticonvulsants Salicylic acid can displace protein-bound phenytoin and valproic acid, leading to a decrease in the total concentration of phenytoin and an increase in serum valproic acid levels. (Aspirin and dipyridamole label, Drug interactions)
- Atomoxetinenorepinephrine reuptake inhibitorModerate
Strong CYP2D6 Inhibitors Prevention or Management With concomitant use of atomoxetine oral solution and a strong CYP2D6 inhibitor 1 , increase the titration interval [see Dosage and Administration (2.5) and Clinical Pharmacology (12.3) ] . (Atomoxetine label, Drug interactions)
- AzelastineantihistamineModerate
Risk may be increased with concomitant use of other CNS depressants ( 5.4 , 5.5 ) (Clobazam label, Warnings and precautions)
- Brimonidinealpha-adrenergic agonistModerate
Use with CNS depressants may result in an additive or potentiating effect. (Brimonidine label, Drug interactions)
- BrivaracetamanticonvulsantModerate
Risk may be increased with concomitant use of other CNS depressants ( 5.4 , 5.5 ) (Clobazam label, Warnings and precautions)
- BudesonidecorticosteroidModerate
Patients with major risk factors for decreased bone mineral content, such as prolonged immobilization, family history of osteoporosis, post menopausal status, tobacco use, advance age, poor nutrition, or chronic use of drugs that can reduce bone mass (e.g., anticonvulsants, oral corticosteroids) should be monitored and treated with established standards of care. (Budesonide label, Warnings and precautions)
- Budesonide and formoterolcorticosteroidModerate
Patients with major risk factors for decreased bone mineral content, such as prolonged immobilization, family history of osteoporosis, postmenopausal status, tobacco use, advanced age, poor nutrition, or chronic use of drugs that can reduce bone mass (e.g., anticonvulsants, oral corticosteroids) should be monitored and treated with established standards of care. (Budesonide and formoterol label, Warnings and precautions)
- Buspironeserotonergic drugModerate
Triazolam/flurazepam: Coadministration of buspirone with either triazolam or flurazepam did not appear to prolong or intensify the sedative effects of either benzodiazepine. (Buspirone label, Drug interactions)
- CanagliflozinSGLT2 inhibitorModerate
Table 7: Clinically Significant Drug Interactions with INVOKANA UGT Enzyme Inducers Clinical Impact: UGT enzyme inducers decrease canagliflozin exposure which may reduce the effectiveness of INVOKANA. (Canagliflozin label, Drug interactions)
- Carvedilolbeta blockerModerate
CYP2D6 Inhibitors and Poor Metabolizers Interactions of carvedilol with potent inhibitors of CYP2D6 isoenzyme (such as quinidine, fluoxetine, paroxetine, and propafenone) have not been studied, but these drugs would be expected to increase blood levels of the R(+) enantiomer of carvedilol [see Clinical Pharmacology (12.3) ]. (Carvedilol label, Drug interactions)
- CBD (cannabidiol)Tobacco and cannabisModerate
Cannabidiol: May increase risk of SYMPAZAN-related adverse reactions; consider dosage adjustment if this occurs ( 7.4 ) (Clobazam label, Drug interactions)
- CenobamateanticonvulsantModerate
Risk may be increased with concomitant use of other CNS depressants ( 5.4 , 5.5 ) (Clobazam label, Warnings and precautions)
- ChlordiazepoxidebenzodiazepineModerate
Risk may be increased with concomitant use of other CNS depressants ( 5.4 , 5.5 ) (Clobazam label, Warnings and precautions)
- CimetidineH2 blockerModerate
Strong or Moderate CYP2C19 Inhibitors: Dosage adjustment of SYMPAZAN ® may be necessary ( 7.4 ) (Clobazam label, Drug interactions)
- Clarithromycinmacrolide antibioticModerate
Benzodiazepines: Increased sedation and prolongation of sedation have been reported with concomitant administration of clarithromycin and triazolobenzodiazepines, such as triazolam and midazolam [see Drug Interactions ( 7 )] . (Clarithromycin label, Warnings and precautions)
- ClindamycinantibioticModerate
Inducers of CYP3A4 and CYP3A5 Inducers of CYP3A4 and/or CYP3A5 may reduce plasma concentrations of clindamycin. (Clindamycin label, Drug interactions)
- ClonazepambenzodiazepineModerate
Risk may be increased with concomitant use of other CNS depressants ( 5.4 , 5.5 ) (Clobazam label, Warnings and precautions)
- CyclosporineimmunosuppressantModerate
Drugs/Dietary Supplements That Decrease Cyclosporine Concentrations Antibiotics Anticonvulsants Other Drugs/Dietary Supplements nafcillin carbamazepine bosentan St. (Cyclosporine label, Drug interactions)
- DeutetrabenazineVMAT2 inhibitorModerate
Concomitant use of strong CYP2D6 inhibitors: Maximum recommended dose of AUSTEDO XR or AUSTEDO is 36 mg per day ( 2.3 , 7.1 ) (Deutetrabenazine label, Drug interactions)
- Dexlansoprazoleproton pump inhibitorModerate
Clinically Relevant Interactions Affecting DEXILANT When Coadministered with Other Drugs and Substances CYP2C19 or CYP3A4 Inducers Clinical Impact: Decreased exposure of dexlansoprazole when used concomitantly with strong inducers [see Clinical Pharmacology (12.3) ] . (Dexlansoprazole label, Drug interactions)
- Dexmedetomidinealpha-adrenergic agonistModerate
Risk may be increased with concomitant use of other CNS depressants ( 5.4 , 5.5 ) (Clobazam label, Warnings and precautions)
- DexmethylphenidateCNS stimulantModerate
Prescribe the lowest effective dosage; avoid or minimize concomitant use of CNS depressants and other substances associated with abuse, misuse, and addiction (e.g., opioid analgesics, stimulants); and advise patients on the proper disposal of unused drug. (Clobazam label, Warnings and precautions)
- DiazepambenzodiazepineModerate
Risk may be increased with concomitant use of other CNS depressants ( 5.4 , 5.5 ) (Clobazam label, Warnings and precautions)
- DiclofenacNSAIDModerate
Exercise caution when prescribing Diclofenac Potassium with concomitant drugs that are known to be potentially hepatotoxic (e.g., acetaminophen, antibiotics, antiepileptics). (Diclofenac label, Warnings and precautions)
- DicyclomineanticholinergicModerate
…anticholinergic drugs including dicyclomine hydrochloride: amantadine, antiarrhythmic agents of Class I (e.g., quinidine), antihistamines, antipsychotic agents (e.g., phenothiazines), benzodiazepines, MAO inhibitors, narcotic analgesics (e.g., meperidine), nitrates and nitrites, sympathomimetic agents, tricyclic antidepressants, and other drugs having anticholinergic… (Dicyclomine label, Drug interactions)
- DimenhydrinateantihistamineModerate
Risk may be increased with concomitant use of other CNS depressants ( 5.4 , 5.5 ) (Clobazam label, Warnings and precautions)
- DiphenhydramineantihistamineModerate
Risk may be increased with concomitant use of other CNS depressants ( 5.4 , 5.5 ) (Clobazam label, Warnings and precautions)
- DofetilideantiarrhythmicModerate
Concomitant medications were grouped as ACE inhibitors, oral anticoagulants, calcium channel blockers, beta blockers, cardiac glycosides, inducers of CYP3A4, substrates and inhibitors of CYP3A4, substrates and inhibitors of P-glycoprotein, nitrates, sulphonylureas, loop diuretics, potassium sparing diuretics, thiazide diuretics, substrates and inhibitors of tubular… (Dofetilide label, Drug interactions)
- Dorzolamide and timololcarbonic anhydrase inhibitorModerate
CYP2D6 inhibitors may potentiate systemic beta-blockade. (Dorzolamide and timolol label, Drug interactions)
- Doxepintricyclic antidepressantModerate
Risk may be increased with concomitant use of other CNS depressants ( 5.4 , 5.5 ) (Clobazam label, Warnings and precautions)
- Doxycyclinetetracycline antibioticModerate
Barbiturates and Anti-Epileptics Barbiturates, carbamazepine, and phenytoin decrease the half-life of doxycycline. (Doxycycline label, Drug interactions)
- DuloxetineSNRIModerate
Similar effects would be expected with other potent CYP2D6 inhibitors (e.g., fluoxetine, quinidine) [see Warnings and Precautions ( 5.12 )] . (Duloxetine label, Drug interactions)
- Dutasteride and tamsulosin5-alpha reductase inhibitorModerate
Use caution in combination with moderate CYP3A4 inhibitors (e.g., erythromycin) or strong (e.g., paroxetine) or moderate CYP2D6 inhibitors, a combination of both CYP3A4 and CYP2D6 inhibitors, or known poor metabolizers of CYP2D6. (Dutasteride and tamsulosin label, Warnings and precautions)
- Emtricitabine and tenofovirantiretroviralModerate
Other Agents Anticonvulsants: carbamazepine oxcarbazepine phenobarbital phenytoin ↓ TAF Consider alternative anticonvulsant. (Emtricitabine and tenofovir label, Drug interactions)
- Erythromycinmacrolide antibioticModerate
Triazolobenzodiazepines (such as triazolam and alprazolam) and related benzodiazepines Erythromycin has been reported to decrease the clearance of triazolam and midazolam, and thus, may increase the pharmacologic effect of these benzodiazepines. (Erythromycin label, Drug interactions)
- EslicarbazepineanticonvulsantModerate
Risk may be increased with concomitant use of other CNS depressants ( 5.4 , 5.5 ) (Clobazam label, Warnings and precautions)
- Esomeprazoleproton pump inhibitorModerate
Strong or Moderate CYP2C19 Inhibitors: Dosage adjustment of SYMPAZAN ® may be necessary ( 7.4 ) (Clobazam label, Drug interactions)
- EthosuximideanticonvulsantModerate
Risk may be increased with concomitant use of other CNS depressants ( 5.4 , 5.5 ) (Clobazam label, Warnings and precautions)
- EverolimusimmunosuppressantModerate
Interaction With Strong Inhibitors and Inducers of CYP3A4 Coadministration of Zortress with strong CYP3A4 inhibitors (e.g., ketoconazole, itraconazole, voriconazole, clarithromycin, telithromycin, ritonavir, boceprevir, telaprevir) or strong CYP3A4 inducers (e.g., rifampin, rifabutin) is not recommended without close monitoring of everolimus whole blood trough… (Everolimus label, Warnings and precautions)
- Felodipinedihydropyridine calcium channel blockerModerate
Anticonvulsants - In a pharmacokinetic study, maximum plasma concentrations of felodipine were considerably lower in epileptic patients on long-term anticonvulsant therapy (e.g., phenytoin, carbamazepine, or phenobarbital) than in healthy volunteers. (Felodipine label, Drug interactions)
- FesoterodineanticholinergicModerate
CYP3A4 Inducers No dosing adjustments are recommended in the presence of CYP3A4 inducers, such as rifampin and carbamazepine. (Fesoterodine label, Drug interactions)
- FlecainideantiarrhythmicModerate
Limited data in patients receiving known enzyme inducers ( phenytoin, phenobarbital, carbamazepine ) indicate only a 30% increase in the rate of flecainide elimination. (Flecainide label, Drug interactions)
- Fluconazoleazole antifungalModerate
Strong or Moderate CYP2C19 Inhibitors: Dosage adjustment of SYMPAZAN ® may be necessary ( 7.4 ) (Clobazam label, Drug interactions)
- FluoxetineSSRIModerate
Benzodiazepines: Diazepam – increased t½, alprazolam - further psychomotor performance decrement due to increased levels ( 7.7 ) (Fluoxetine label, Drug interactions)
- FluticasonecorticosteroidModerate
Patients with major risk factors for decreased bone mineral content, such as prolonged immobilization, family history of osteoporosis, postmenopausal status, tobacco use, advanced age, poor nutrition, or chronic use of drugs that can reduce bone mass (e.g., anticonvulsants, oral corticosteroids), should be monitored and treated with established standards of care. (Fluticasone label, Warnings and precautions)
- Fluticasone and salmeterolcorticosteroidModerate
Patients with major risk factors for decreased bone mineral content, such as prolonged immobilization, family history of osteoporosis, or chronic use of drugs that can reduce bone mass (e.g., anticonvulsants, oral corticosteroids) should be monitored and treated with established standards of care. (Fluticasone and salmeterol label, Warnings and precautions)
- FluvoxamineSSRIModerate
Strong or Moderate CYP2C19 Inhibitors: Dosage adjustment of SYMPAZAN ® may be necessary ( 7.4 ) (Clobazam label, Drug interactions)
- GlycopyrrolateanticholinergicModerate
Other Anticholinergic Drugs There is potential for an additive interaction between glycopyrrolate and concomitantly used anticholinergic drugs (e.g., tricyclic antidepressants, anti-epileptics, class I antiarrhythmics, anti-spasmodics, amantadine) resulting in increased anticholinergic adverse reactions. (Glycopyrrolate label, Drug interactions)
- Guanfacinealpha-adrenergic agonistModerate
Risk may be increased with concomitant use of other CNS depressants ( 5.4 , 5.5 ) (Clobazam label, Warnings and precautions)
- HydrocortisonecorticosteroidModerate
Concomitant administration of inducers of CYP3A4 may lead to decreases in serum concentrations of ALKINDI SPRINKLE and increase the risk of adverse reactions, including adrenal crisis. (Hydrocortisone label, Drug interactions)
- ImatinibCYP3A4 inhibitorModerate
CYP3A4 inducers may decrease Gleevec C max and area under curve (AUC). (Imatinib label, Drug interactions)
- IvacaftorCYP3A4 inhibitorModerate
Concomitant Use with CYP3A Inducers Use of KALYDECO with strong CYP3A inducers, such as rifampin, substantially decreases the exposure of ivacaftor, which may reduce the therapeutic effectiveness of KALYDECO. (Ivacaftor label, Warnings and precautions)
- LacosamideanticonvulsantModerate
Risk may be increased with concomitant use of other CNS depressants ( 5.4 , 5.5 ) (Clobazam label, Warnings and precautions)
- LamotrigineanticonvulsantModerate
Patients with History of Allergy or Rash to Other Antiepileptic Drugs The risk of rash may be increased in patients with a history of allergy or rash to other AEDs. (Lamotrigine label, Warnings and precautions)
- Lansoprazoleproton pump inhibitorModerate
Clinically Relevant Interactions Affecting PREVACID or PREVACID SoluTab When Coadministered with Other Drugs CYP2C19 OR CYP3A4 Inducers Clinical Impact: Decreased exposure of lansoprazole when used concomitantly with strong inducers [see Clinical Pharmacology (12.3) ] . (Lansoprazole label, Drug interactions)
- LevetiracetamanticonvulsantModerate
Risk may be increased with concomitant use of other CNS depressants ( 5.4 , 5.5 ) (Clobazam label, Warnings and precautions)
- Levonorgestrel and ethinyl estradioloral contraceptiveModerate
Enzyme inducers (e.g., CYP3A4) : May decrease the effectiveness of TYBLUME or increase breakthrough bleeding. (Levonorgestrel and ethinyl estradiol label, Drug interactions)
- Lidocaine and prilocainelocal anestheticModerate
…prilocaine, procaine, ropivacaine, tetracaine Antineoplastic agents cyclophosphamide, flutamide, hydroxyurea, isofamide, rasburicase Antibiotics dapsone, nitrofurantoin, para-aminosalicylic acid, sufonamides Antimalarials chloroquine, primaquine Anticonvulsants Phenobarbital, phenytoin, sodium valproate Other drugs acetaminophen, metoclopramide, quinine, sulfasalazine (Lidocaine and prilocaine label, Drug interactions)
- LinagliptinDPP-4 inhibitorModerate
Strong P-glycoprotein/CYP3A4 inducer: The efficacy of TRADJENTA may be reduced when administered in combination (e.g., with rifampin). (Linagliptin label, Drug interactions)
- Lofexidinealpha-adrenergic agonistModerate
Risk may be increased with concomitant use of other CNS depressants ( 5.4 , 5.5 ) (Clobazam label, Warnings and precautions)
- MeclizineantihistamineModerate
Risk may be increased with concomitant use of other CNS depressants ( 5.4 , 5.5 ) (Clobazam label, Warnings and precautions)
- MedroxyprogesteroneprogestinModerate
MPA Injectable Suspension, USP can pose an additional risk in patients with risk factors for osteoporosis (e.g., metabolic bone disease, chronic alcohol and/or tobacco use, anorexia nervosa, strong family history of osteoporosis or chronic use of drugs that can reduce bone mass such as anticonvulsants or corticosteroids). (Medroxyprogesterone label, Warnings and precautions)
- MethylphenidateCNS stimulantModerate
Prescribe the lowest effective dosage; avoid or minimize concomitant use of CNS depressants and other substances associated with abuse, misuse, and addiction (e.g., opioid analgesics, stimulants); and advise patients on the proper disposal of unused drug. (Clobazam label, Warnings and precautions)
- MethylprednisolonecorticosteroidModerate
Hepatic Enzyme Inducers (e.g., barbiturates, phenytoin, carbamazepine, rifampin) : Drugs which induce cytochrome P450 3A4 enzyme activity may enhance the metabolism of corticosteroids and require that the dosage of the corticosteroid be increased. (Methylprednisolone label, Drug interactions)
- Metoclopramidedopamine antagonistModerate
Risk may be increased with concomitant use of other CNS depressants ( 5.4 , 5.5 ) (Clobazam label, Warnings and precautions)
- ModafinilCNS stimulantModerate
Prescribe the lowest effective dosage; avoid or minimize concomitant use of CNS depressants and other substances associated with abuse, misuse, and addiction (e.g., opioid analgesics, stimulants); and advise patients on the proper disposal of unused drug. (Clobazam label, Warnings and precautions)
- MometasonecorticosteroidModerate
Patients with major risk factors for decreased bone mineral content, such as prolonged immobilization, family history of osteoporosis, or chronic use of drugs that can reduce bone mass (e.g., anticonvulsants and corticosteroids) should be monitored and treated with established standards of care. (Mometasone label, Warnings and precautions)
- Naloxoneopioid antagonistModerate
WARNINGS AND PRECAUTIONS Risk of Recurrent Respiratory and CNS Depression : Due to the duration of action of naloxone relative to the opioid, respiratory and CNS depression may recur after the first dose of naloxone. (Naloxone label, Warnings and precautions)
- Nebivololbeta blockerModerate
Use with CYP2D6 Inhibitors Nebivolol exposure increases with inhibition of CYP2D6 [see Drug Interactions ( 7 ) ] . (Nebivolol label, Warnings and precautions)
- NintedanibModerate
Coadministration with oral doses of a P-gp and CYP3A4 inducer, rifampicin, decreased exposure to nintedanib by 50%. (Nintedanib label, Drug interactions)
- NorethindroneprogestinModerate
Contraceptive effectiveness may be reduced when hormonal contraceptives are co-administered with antibiotics, anticonvulsants, and other drugs that increase the metabolism of contraceptive steroids. (Norethindrone label, Drug interactions)
- Norgestimate and ethinyl estradioloral contraceptiveModerate
…immunodeficiency virus (HIV)/Hepatitis C virus (HCV) protease inhibitors, non-nucleoside reverse transcriptase inhibitors , and HIV/AIDS medications containing strong inhibitors or inducers of CYP3A Significant changes (increase or decrease) in the plasma concentrations of estrogen and/or progestin have been noted in some cases of co-administration with HIV protease… (Norgestimate and ethinyl estradiol label, Drug interactions)
- Nortriptylinetricyclic antidepressantModerate
Risk may be increased with concomitant use of other CNS depressants ( 5.4 , 5.5 ) (Clobazam label, Warnings and precautions)
- Omeprazoleproton pump inhibitorModerate
Strong or Moderate CYP2C19 Inhibitors: Dosage adjustment of SYMPAZAN ® may be necessary ( 7.4 ) (Clobazam label, Drug interactions)
- OndansetronQT-prolonging drugModerate
Phenytoin, Carbamazepine, and Rifampin In patients treated with potent inducers of CYP3A4 (i.e., phenytoin, carbamazepine, and rifampin), the clearance of ondansetron was significantly increased and ondansetron blood concentrations were decreased. (Ondansetron label, Drug interactions)
- OrlistatModerate
Drug Interactions and Decreased Vitamin Absorption ORLISTAT may interact with concomitant drugs including cyclosporine, levothyroxine, warfarin, amiodarone, antiepileptic drugs, and antiretroviral drugs [see Drug Interactions (7) ]. (Orlistat label, Warnings and precautions)
- OxcarbazepineanticonvulsantModerate
Risk may be increased with concomitant use of other CNS depressants ( 5.4 , 5.5 ) (Clobazam label, Warnings and precautions)
- ParoxetineSSRIModerate
Cimetidine Increased plasma concentration of paroxetine Use caution if BRISDELLE is used concomitantly with other drugs that inhibit CYP2D6 (e.g., quinidine). (Paroxetine label, Drug interactions)
- PerampanelanticonvulsantModerate
Risk may be increased with concomitant use of other CNS depressants ( 5.4 , 5.5 ) (Clobazam label, Warnings and precautions)
- PhentermineCNS stimulantModerate
Prescribe the lowest effective dosage; avoid or minimize concomitant use of CNS depressants and other substances associated with abuse, misuse, and addiction (e.g., opioid analgesics, stimulants); and advise patients on the proper disposal of unused drug. (Clobazam label, Warnings and precautions)
- Phentermine and topiramateCNS stimulantModerate
Risk may be increased with concomitant use of other CNS depressants ( 5.4 , 5.5 ) (Clobazam label, Warnings and precautions)
- PhenylephrinedecongestantModerate
Antagonistic Effects (decrease in BIORPHEN blood pressure effect) can occur with α-adrenergic antagonists, phosphodiesterase Type 5 inhibitors, mixed α- and β-receptor antagonists, calcium channel blockers, benzodiazepines and ACE inhibitors, centrally acting sympatholytic agents. (Phenylephrine label, Drug interactions)
- PhenytoinanticonvulsantModerate
Risk may be increased with concomitant use of other CNS depressants ( 5.4 , 5.5 ) (Clobazam label, Warnings and precautions)
- PitolisantQT-prolonging drugModerate
Strong CYP2D6 Inhibitors: Increased exposure of WAKIX; reduce the maximum recommended dose of WAKIX by half ( 2.6 , 7.1 ) (Pitolisant label, Drug interactions)
- Posaconazoleazole antifungalModerate
Concomitant Use with Midazolam : Noxafil can prolong hypnotic/sedative effects. (Posaconazole label, Warnings and precautions)
- Pramipexoledopamine agonistModerate
Risk may be increased with concomitant use of other CNS depressants ( 5.4 , 5.5 ) (Clobazam label, Warnings and precautions)
- PrednisolonecorticosteroidModerate
CYP 3A4 inducers (e.g. barbiturates, phenytoin, carbamazepine, and rifampin): Drugs such as barbiturates, phenytoin, ephedrine, and rifampin, which induce hepatic microsomal drug metabolizing enzyme activity may enhance metabolism of prednisolone and require that the dosage of Orapred be increased. (Prednisolone label, Drug interactions)
- PrednisonecorticosteroidModerate
CYP 3A4 inducers and inhibitors: May, respectively, increase or decrease clearance of corticosteroids, necessitating dose adjustment. (Prednisone label, Drug interactions)
- PromethazineantihistamineModerate
Risk may be increased with concomitant use of other CNS depressants ( 5.4 , 5.5 ) (Clobazam label, Warnings and precautions)
- Propranololbeta blockerModerate
Impact of Other Drugs on Propranolol CYP2D6, CYP1A2 and CYP2C19 Inhibitors: CYP2D6 inhibitors (e.g. bupropion, fluoxetine, paroxetine, quinidine), CYP1A2 inhibitors (e.g., ciprofloxacin, enoxamine, fluvoxamine) and CYP2C19 inhibitors (e.g., fluconazole, fluvoxamine, ticlopidine) increase exposure to propranolol when co-administered with INNOPRAN XL. (Propranolol label, Drug interactions)
- RepaglinidemeglitinideModerate
CYP2C8 and CYP3A4 Inducers Intervention: Repaglinide tablets dose increases and increased frequency of glucose monitoring may be required when co‑administered. (Repaglinide label, Drug interactions)
- RifampinantibioticModerate
…Hormonal Contraceptives Prevention or Management: Advise patients to change to non-hormonal methods of birth control during rifampin therapy Estrogens Decrease exposure Progestins Anticonvulsants Phenytoin Administered with rifampin 450 mg daily Decrease exposure Antiarrhythmics Disopyramide Decrease exposure Mexiletine Decrease exposure Quinidine Decrease exposure… (Rifampin label, Drug interactions)
- Ropiniroledopamine agonistModerate
Risk may be increased with concomitant use of other CNS depressants ( 5.4 , 5.5 ) (Clobazam label, Warnings and precautions)
- RufinamideanticonvulsantModerate
Risk may be increased with concomitant use of other CNS depressants ( 5.4 , 5.5 ) (Clobazam label, Warnings and precautions)
- ScopolamineanticholinergicModerate
Risk may be increased with concomitant use of other CNS depressants ( 5.4 , 5.5 ) (Clobazam label, Warnings and precautions)
- SelegilineMAO inhibitorModerate
Drugs that induce CYP3A4 (e.g., phenytoin, carbamazepine, nafcillin, phenobarbital, and rifampin) should be used with caution. (Selegiline label, Drug interactions)
- SolriamfetolCNS stimulantModerate
Prescribe the lowest effective dosage; avoid or minimize concomitant use of CNS depressants and other substances associated with abuse, misuse, and addiction (e.g., opioid analgesics, stimulants); and advise patients on the proper disposal of unused drug. (Clobazam label, Warnings and precautions)
- TacrolimusimmunosuppressantModerate
Risk of Rejection with Strong CYP3A Inducers and Risk of Serious Adverse Reactions with Strong CYP3A Inhibitors The concomitant use of strong CYP3A inducers may increase the metabolism of tacrolimus, leading to lower whole blood trough concentrations and greater risk of rejection. (Tacrolimus label, Warnings and precautions)
- TadalafilPDE5 inhibitorModerate
CYP3A4 inhibitors (e.g. ketoconazole, ritonavir) increase CIALIS exposure ( 2.7 , 5.10 , 7.2 ) requiring dose adjustment: CIALIS for use as needed: no more than 10 mg every 72 hours CIALIS for once daily use: dose not to exceed 2.5 mg CYP3A4 inducers (e.g. rifampin) decrease CIALIS exposure ( 7.2 ). (Tadalafil label, Drug interactions)
- Tamsulosinalpha blockerModerate
Use with caution in combination with moderate inhibitors of CYP3A4, with strong or moderate inhibitors of CYP2D6, in patients known to be CYP2D6 poor metabolizers, or in combination with other cytochrome P450 inhibitors. (Tamsulosin label, Warnings and precautions)
- TerbinafineantifungalModerate
Terbinafine clearance is increased 100% by rifampin, a CYP450 enzyme inducer, and decreased 33% by cimetidine, a CYP450 enzyme inhibitor. (Terbinafine label, Drug interactions)
- TetrabenazineVMAT2 inhibitorModerate
Risk may be increased with concomitant use of other CNS depressants ( 5.4 , 5.5 ) (Clobazam label, Warnings and precautions)
- TheophyllinemethylxanthineModerate
25% increase Diazepam Benzodiazepines increase CNS concentrations of adenosine, a potent CNS depressant, while theophylline blocks adenosine receptors. (Theophylline label, Drug interactions)
- TiagabineanticonvulsantModerate
Risk may be increased with concomitant use of other CNS depressants ( 5.4 , 5.5 ) (Clobazam label, Warnings and precautions)
- Timololbeta blockerModerate
CYP2D6 Inhibitors Potentiated systemic beta-blockade (e.g., decreased heart rate) has been reported during combined treatment with CYP2D6 inhibitors (e.g., quinidine) and timolol. (Timolol label, Drug interactions)
- TinidazoleantibioticModerate
Phenytoin, fosphenytoin: Adjustment of anticonvulsant and/or tinidazole dose(s) may be needed ( 7.1, 7.2 ) (Tinidazole label, Drug interactions)
- TofacitinibimmunosuppressantModerate
…exposure to tofacitinib Intervention Dosage modification of XELJANZ/XELJANZ XR is recommended [see Dosage and Administration (2) , Clinical Pharmacology, Figure 3 (12.3) ] Strong CYP3A4 Inducers (e.g., rifampin) Clinical Impact Decreased exposure to tofacitinib and may result in loss of or reduced clinical response Intervention Concomitant use with XELJANZ/XELJANZ… (Tofacitinib label, Drug interactions)
- TopiramateanticonvulsantModerate
Risk may be increased with concomitant use of other CNS depressants ( 5.4 , 5.5 ) (Clobazam label, Warnings and precautions)
- TranylcypromineMAO inhibitorModerate
Excessive reduction of blood glucose (additive effect) f CNS depressant agents (including opioids, alcohol, sedatives, hypnotics) Use with caution d Increased CNS depression Dietary supplements containing sympathomimetics Contraindicated a Antidepressants including but not limited to: Other MAOIs (e.g., linezolid, intravenous methylene blue, selective MAOIs)… (Tranylcypromine label, Drug interactions)
- TrazodoneantidepressantModerate
Risk may be increased with concomitant use of other CNS depressants ( 5.4 , 5.5 ) (Clobazam label, Warnings and precautions)
- Treprostinilprostaglandin analogModerate
Co-administration of a CYP2C8 enzyme inducer (e.g., rifampin) may decrease exposure to treprostinil. (Treprostinil label, Warnings and precautions)
- TriamcinolonecorticosteroidModerate
Hepatic enzyme inducers (e.g., barbiturates, phenytoin, carbamazepine, rifampin): Drugs which induce hepatic microsomal drug metabolizing enzyme activity may enhance the metabolism of corticosteroids and require that the dosage of the corticosteroid be increased. (Triamcinolone label, Drug interactions)
- TrihexyphenidylanticholinergicModerate
Concurrent use of alcohol or other CNS depressants with trihexyphenidyl HCl may cause increased sedative effects. (Trihexyphenidyl label, Drug interactions)
- VenlafaxineSNRIModerate
Therefore, the potential exists for a drug interaction between drugs that inhibit CYP2D6-mediated metabolism of venlafaxine, reducing the metabolism of venlafaxine to ODV, resulting in increased plasma concentrations of venlafaxine and decreased concentrations of the active metabolite. (Venlafaxine label, Drug interactions)
- Verapamilcalcium channel blockerModerate
CYP3A4 inducers decrease verapamil levels ( 7.1 ) (Verapamil label, Drug interactions)
- VigabatrinanticonvulsantModerate
Risk may be increased with concomitant use of other CNS depressants ( 5.4 , 5.5 ) (Clobazam label, Warnings and precautions)
- VilazodoneSSRIModerate
CYP3A4 Inducers: Consider increasing VIIBRYD dosage by 2-fold, up to 80 mg once-daily over 1 to 2 weeks when used concomitantly with strong CYP3A4 inducers for greater than 14 days ( 2.4 , 7 ). (Vilazodone label, Drug interactions)
- Viloxazinenorepinephrine reuptake inhibitorModerate
CYP2D6 Substrates Clinical Impact Viloxazine is a weak inhibitor of CYP2D6, and increases the exposure of CYP2D6 substrates when coadministered [see Clinical Pharmacology (12.3) ] . (Viloxazine label, Drug interactions)
- Voriconazoleazole antifungalModerate
Strong or Moderate CYP2C19 Inhibitors: Dosage adjustment of SYMPAZAN ® may be necessary ( 7.4 ) (Clobazam label, Drug interactions)
- VortioxetineantidepressantModerate
• Strong inhibitors of CYP2D6: Reduce TRINTELLIX dose by half when coadministered ( 2.5 , 7.1 ). (Vortioxetine label, Drug interactions)
- ZonisamideanticonvulsantModerate
Risk may be increased with concomitant use of other CNS depressants ( 5.4 , 5.5 ) (Clobazam label, Warnings and precautions)
Minor mentions (19)
- CelecoxibNSAIDMinor
CYP2D6 substrates Clinical Impact: In vitro studies indicate that celecoxib, although not a substrate, is an inhibitor of CYP2D6. (Celecoxib label, Drug interactions)
- CephalexincephalosporinMinor
Anticonvulsant therapy can be given if clinically indicated. (Cephalexin label, Warnings and precautions)
- Cevimelinecholinergic agonistMinor
Drugs which inhibit CYP2D6 and CYP3A3/4 also inhibit the metabolism of cevimeline. (Cevimeline label, Drug interactions)
- Conjugated estrogensestrogenMinor
Effect of SYMPAZAN ® on Other Drugs Hormonal Contraceptives SYMPAZAN ® is a weak CYP3A4 inducer. (Clobazam label, Drug interactions)
- Drospirenone and ethinyl estradioloral contraceptiveMinor
Effect of SYMPAZAN ® on Other Drugs Hormonal Contraceptives SYMPAZAN ® is a weak CYP3A4 inducer. (Clobazam label, Drug interactions)
- Epoetin alfaMinor
The “gasping syndrome” is characterized by central nervous system (CNS) depression, metabolic acidosis, and gasping respirations. (Epoetin alfa label, Warnings and precautions)
- EscitalopramSSRIMinor
Seizures Although anticonvulsant effects of racemic citalopram have been observed in animal studies, Escitalopram Capsules have not been systematically evaluated in patients with a seizure disorder. (Escitalopram label, Warnings and precautions)
- EstradiolestrogenMinor
Effect of SYMPAZAN ® on Other Drugs Hormonal Contraceptives SYMPAZAN ® is a weak CYP3A4 inducer. (Clobazam label, Drug interactions)
- Finasteride5-alpha reductase inhibitorMinor
…angiotensin-converting enzyme (ACE) inhibitors, analgesics, anti-convulsants, beta-adrenergic blocking agents, diuretics, calcium channel blockers, cardiac nitrates, HMG-CoA reductase inhibitors, nonsteroidal anti-inflammatory drugs (NSAIDs), benzodiazepines, H 2 antagonists and quinolone anti-infectives without evidence of clinically significant adverse interactions. (Finasteride label, Drug interactions)
- GranisetronQT-prolonging drugMinor
There have been no definitive drug-drug interaction studies to examine pharmacokinetic or pharmacodynamic interaction with other drugs; however, in humans, granisetron hydrochloride injection has been safely administered with drugs representing benzodiazepines, neuroleptics and anti-ulcer medications commonly prescribed with antiemetic treatments. (Granisetron label, Drug interactions)
- HydroxychloroquineQT-prolonging drugMinor
Antiepileptics The activity of antiepileptic drugs might be impaired if co-administered with PLAQUENIL. (Hydroxychloroquine label, Drug interactions)
- KetorolacNSAIDMinor
Antiepileptic Drugs Sporadic cases of seizures have been reported during concomitant use of ketorolac tromethamine and antiepileptic drugs (phenytoin, carbamazepine). (Ketorolac label, Drug interactions)
- LevonorgestrelprogestinMinor
Effect of SYMPAZAN ® on Other Drugs Hormonal Contraceptives SYMPAZAN ® is a weak CYP3A4 inducer. (Clobazam label, Drug interactions)
- MegestrolprogestinMinor
Effect of SYMPAZAN ® on Other Drugs Hormonal Contraceptives SYMPAZAN ® is a weak CYP3A4 inducer. (Clobazam label, Drug interactions)
- Prazosinalpha blockerMinor
…to date with the following: (1) cardiac glycosides– digitalis and digoxin; (2) hypoglycemics–insulin, chlorpropamide, phenformin, tolazamide, and tolbutamide; (3) tranquilizers and sedatives–chlordiazepoxide, diazepam, and phenobarbital; (4) antigout–allopurinol, colchicine, and probenecid; (5) antiarrhythmics–procainamide, propranolol (see WARNINGS however),… (Prazosin label, Drug interactions)
- ProgesteroneprogestinMinor
Effect of SYMPAZAN ® on Other Drugs Hormonal Contraceptives SYMPAZAN ® is a weak CYP3A4 inducer. (Clobazam label, Drug interactions)
- RifaximinantibioticMinor
CYP3A4 Substrates An in vitro study has suggested that rifaximin induces CYP3A4 [see Clinical Pharmacology ( 12.3 )] . (Rifaximin label, Drug interactions)
- RiociguatvasodilatorMinor
Strong CYP3A inducers: Strong inducers of CYP3A (for example, rifampin, phenytoin, carbamazepine, phenobarbital or St. (Riociguat label, Drug interactions)
- SertralineSSRIMinor
False-Positive Effects on Screening Tests for Benzodiazepines False-positive urine immunoassay screening tests for benzodiazepines have been reported in patients taking another sertraline hydrochloride product. (Sertraline label, Warnings and precautions)
No significant interaction reported (1)
- Montelukastleukotriene receptor antagonistNo interaction
…adjustment is needed when SINGULAIR is co-administered with theophylline, prednisone, prednisolone, oral contraceptives, fexofenadine, digoxin, warfarin, gemfibrozil, itraconazole, thyroid hormones, sedative hypnotics, non-steroidal anti-inflammatory agents, benzodiazepines, decongestants, and Cytochrome P450 (CYP) enzyme inducers [see Clinical Pharmacology (12.3) ]. (Montelukast label, Drug interactions)
Check Clobazam against everything you take. Add your full list; every pair is checked at once.
Open in the checkerNot medical advice. Severity reflects the label's wording, not your circumstances. A "major" flag can be routine under supervision and a "minor" one can matter at high doses. Ask a pharmacist.