Ciprofloxacin and Clozapine: A Potentially Fatal but Underappreciated Interaction

<table class="table-group" id="tab2"><tr><td><table class="table"><tr><td class="thead-hr" colspan="4"><hr/></td></tr><tr class="thead"><td class="align_left">Comedications</td><td class="align_center" colspan="3">⁢Scenarios</td></tr><tr><td class="thead-hr" colspan="4"><hr/></td></tr><tr><td class="align_left"> </td><td class="align_center">Initiating CLOZARIL while taking a comedication</td><td class="align_center">Adding a comedication while taking CLOZARIL</td><td class="align_center">Discontinuing a comedication while continuing CLOZARIL</td></tr><tr><td class="align_left">Strong CYP1A2 inhibitors</td><td class="align_center" colspan="2">⁢Use one third of the CLOZARIL dose</td><td class="align_center">Increase CLOZARIL dose based on clinical response</td></tr><tr class="table-tr"><td colspan="4"><hr class="tbody-hr"/></td></tr></table></td></tr></table>

US July 2013 CLOZARIL package insert table on dose adjustment in patients taking concomitant strong CYP 1A2 inhibitors.

Case Reports in Psychiatry

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Table 2

Table 2: Ciprofloxacin and Clozapine: A Potentially Fatal but Underappreciated Interaction 