Clozapine and Dextromethorphan and quinidine interaction

Clozapine and Dextromethorphan and quinidine: both prescribing labels describe an interaction that usually calls for monitoring, a dose change, or spacing the doses.

Moderate

Usually manageable with monitoring or a dose change. Tell your pharmacist you take both.

What the FDA labels say

From the Clozapine (Clozaril) label · effective 2025-06-06

Moderate

…thioridazine, mesoridazine, droperidol, pimozide), specific antibiotics (e.g., erythromycin, gatifloxacin, moxifloxacin, sparfloxacin), Class 1A antiarrhythmic medications (e.g., quinidine, procainamide) or Class III antiarrhythmics (e.g., amiodarone, sotalol), and others (e.g., pentamidine, levomethadyl acetate, methadone, halofantrine, mefloquine, dolasetron…

Warnings and precautionsnames Dextromethorphan and quinidineView label on DailyMed
Moderate

CYP2D6 and CYP3A4 Inhibitors Concomitant treatment with CLOZARIL and CYP2D6 or CYP3A4 inhibitors (e.g., cimetidine, escitalopram, erythromycin, paroxetine, bupropion, fluoxetine, quinidine, duloxetine, terbinafine, or sertraline) can increase clozapine levels and lead to adverse reactions [see Clinical Pharmacology ( 12.3 )] .

Drug interactionsnames Dextromethorphan and quinidineView label on DailyMed

From the Dextromethorphan and quinidine (Nuedexta) label · effective 2026-01-22

Moderate

Anticholinergic effects of quinidine: Monitor for worsening in myasthenia gravis and other sensitive conditions.

Warnings and precautionsby drug classView label on DailyMed
Moderate

Anticholinergic Effects of Q uinidine Monitor for worsening clinical condition in myasthenia gravis and other conditions that may be adversely affected by anticholinergic effects.

Warnings and precautionsby drug classView label on DailyMed

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Not medical advice. Interaction Checker quotes FDA label text and NIH fact sheets. Whether an interaction matters for you depends on doses, timing, kidney and liver function, and other conditions. Confirm with a pharmacist or prescriber.