Clomethiazole interaction

Clomethiazole has sedative, muscle relaxant, and anticonvulsant properties. It is used outside the U. S. for hypnosis in elderly and institutionalized patients, for preanesthetic sedation, and especially in the management of withdrawal from ethanol. Given alone, its effects on respiration are slight, and the therapeutic index is high. However, deaths from adverse interactions with ethanol are relatively frequent. 

Only small and clinically unimportant pharmacokinetic interactions occur between most benzodiazepines and beta blockers, but there is some evidence that patients taking diazepam may possibly be more accident-prone while taking metoprolol. An isolated report describes marked bradycardia when an elderly woman taking propranolol started to take clomethiazole. 

Information about interactions between the benzodiazepines and beta blockers is very limited indeed. The current evidence does not seem to justify any additional caution, but bear this interaction in mind in the case of an unexpected response to treatment. The interaction between propranolol and clomethiazole appears to be an isolated case and therefore probably of limited clinical significance. 

The serum levels of many of the benzodiazepines and related drugs are raised by cimetidine, but normally this appears to be of little or no clinical importance and only the occasional patient may experience an increase in the effects (sedation). The interactions with midazolam, zaleplon, and Zolpidem may be more significant, but this is not established. Famotidine, nizatidine and ranitidine do not normally appear to interact with most benzodiazepines. Increased sedation appears to occur with clomethiazole and cimetidine. 

Ranitidine does not interact significantly with clomethiazole. Mechanism... 

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