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Fazaclo and Yosprala

Determining the interaction of Fazaclo and Yosprala and the possibility of their joint administration.

Check result:
Fazaclo <> Yosprala
Relevance: 02.11.2022 Reviewer: Shkutko P.M., M.D., in

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Consumer:

Using cloZAPine together with omeprazole may decrease the effects of cloZAPine. Contact your doctor if your condition worsens. If your doctor does prescribe these medications together, you may need a dose adjustment or special test to safely use both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Professional:

MONITOR: Coadministration with omeprazole may decrease the plasma concentrations of clozapine. The proposed mechanism is omeprazole induction of clozapine metabolism via CYP450 1A2. Two case reports describe patients stabilized on clozapine who experienced a 42% and 45% decrease in their plasma clozapine levels following the addition of omeprazole. No changes in their clinical presentation were noted, however. In a retrospective study of the medical files of 13 psychiatric patients receiving both clozapine and omeprazole, a switch to pantoprazole was associated with a significant rise of the serum clozapine levels in all nonsmokers relative to smokers, although the daily dosage of clozapine was unchanged. Presumably, the increase was due to the discontinuation of CYP450 1A2 induction by omeprazole in nonsmokers, whereas the isoenzyme remained induced in patients who smoked, as cigarette smoke is a known inducer of CYP450 1A2. Theoretically, this interaction could also occur with esomeprazole, the S-enantiomer of omeprazole.

MANAGEMENT: Pharmacologic response and serum clozapine levels should be monitored more closely whenever omeprazole or esomeprazole is added to or withdrawn from therapy, and the clozapine dosage adjusted as necessary. Alternatively, use of another proton pump inhibitor such as pantoprazole may be considered.

References
  • Frick A, Kopitz J, Bergemann N "Omeprazole reduces clozapine plasma concentrations. A case report." Pharmacopsychiatry 36 (2003): 121-3
  • Mookhoek EJ, Loonen AJ "Retrospective evaluation of the effect of omeprazole on clozapine metabolism." Pharm World Sci 26 (2004): 180-2
Fazaclo

Generic Name: clozapine

Brand name: Clozaril, Fazaclo, Versacloz, Clopine, CloZAPine Synthon, Denzapine, Zaponex

Synonyms: FazaClo

Yosprala

Generic Name: aspirin / omeprazole

Brand name: Yosprala

Synonyms: n.a.

In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.

Interaction with food and lifestyle
Disease interaction