Clonazepam interactions

Clonazepam Clonazepam interacts with carbamazepine, benzodiazepine, alcohol, and phenytoin. 

Clonazepam. Clonazepam interacts with phenytoin with the resultant decrease in plasma levels of the benzodiazepine. 

Saavedra IN, Aguilera LI, FaureE, GaldamesDG. Case report. Phenytoin/clonazepam interaction, Ther Drug Monit (19S5) 7, 481-4. 

Carbamazepine also can induce the enzymes that metabolize other anticonvulsant drugs, including phenytoin, primidone, phenobarbital, valproic acid, clonazepam, and ethosuximide, and metabolism of other drugs the patient may be taking. Similarly, other drugs may induce metabolism of carbamazepine the end result is the same as for autoinduction, and the dose of carbamazepine must be readjusted. A common drug-drug interaction is between carbamazepine and the macrolide antibiotics erythromycin and trolean-domycin. After a few days of antibiotic therapy, symptoms of carbamazepine toxicity develop this is readily reversible if either the antibiotic or carbamazepine is discontinued. 

Greenblatt, D.J., Miller, L.G., and Shader, R.I. (1987) Clonazepam pharmacokinetics, brain uptake, and receptor interactions. / Clin Psychiatry 48 Suppl 4-11. 

Clonazepam As for diazepam >80% bioavailability extensively metabolized but no active metabolites fiy2 20-50 h Absence seizures, myoclonic seizures, infantile spasms Toxicity Similar to diazepam Interactions Minimal... 

Lai AA, Levy RH, Cutler RE. Time-course of interaction between carbamazepine and clonazepam in normal man. Clin Pharmacol Ther 1978 24(3) 316-323. 

Bonate PL, Kroboth PD, Smith RB, Suarez E, Oo C. Clonazepam and sertraline absence of drug interaction in a multiple-dose study. J Clin Psychopharmacol 2000 20(1) 19-27. 

A flushing reaction has been associated with an interaction of phenelzine with clonazepam (SEDA-17, 17). 

The addition of risperidone 10 mg/day over 2 months to valproate and clonazepam in a 40-year-old woman provoked marked edema in the legs and moderate edema in the arms (276). The authors considered that this was a possible interaction, since edema has not been reported with either of these drugs separately. 

Burrows DL, Hagardorn AN, Harlan GC, Wallen ED, Ferslew KE. A fatal drug interaction between oxycodone and clonazepam. J Forensic Sci 2003 48(3) 683-6. 

The mutual interaction of clonazepam and carbamazepine has been investigated in 183 children and adults with epilepsy during routine clinical care (13). Carbamazepine increased the clearance of clonazepam by 22% and clonazepam reduced the clearance of carbamazepine by 21%. 

The effects of concomitant carbamazepine, phenytoin, sodium valproate, and zonisamide on the steady-state serum concentrations of clonazepam have been investigated in 51 epileptic in-patients under 20 years of age (14). Serum concentrations of clonazepam correlated positively with the dose of clonazepam and negatively with the doses of carbamazepine and valproic acid, but not with phenytoin or zonisamide. These results confirm that as the oral doses of carbamazepine and sodium valproate increase, the serum concentration of clonazepam falls, but there is no interaction with either phenytoin or zonisamide. In the case of carbamazepine the mechanism of action is thought to be enzyme induction, increasing the metabolism of clonazepam. It is not known what the mechanism is with sodium valproate. In patients with epilepsy, the co-administration of either sodium valproate or carbamazepine will reduce the serum concentration of clonazepam and increase the risk of a seizure. When... 

A fatal drug interaction was caused by the ingestion of oxycodone and clonazepam. 

Yukawa E, Nonaka T, Yukawa M, Ohdo S, Higuchi S, Kuroda T, Goto Y. Pharmacoepidemiologic investigation of a clonazepam-carbamazepine interaction by mixed effect modeling using routine clinical pharmacokinetic data in Japanese patients. J Clin Psychopharmacol 2001 21(6) 588-93. 

Clinically important, potentially hazardous interactions with amiodarone, amitriptyline, amoxapine, benzodiazepines, bepridil, clomipramine, clonazepam, clorazepate, delavirdine, desipramine, diazepam, dihydroergotamine, doxepin, ergotamine, fentanyl, flurazepam, imipramine, ixabepilone, lidocaine, lorazepam, methysergide, midazolam, nortriptyline, oxazepam, phenytoin, protriptyline, quazepam, quinidine, rifampin, ritonavir, sildenafil, St John s wort, temazepam, tricyclic antidepressants, trimipramine, vitamin E... 

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