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Klonopin and Alcohol/Food Interactions

There are 2 alcohol/food/lifestyle interactions with Klonopin (clonazepam).

Moderate

Clonazepam Alcohol (Ethanol)

Moderate Drug Interaction

GENERALLY AVOID: Acute ethanol ingestion may potentiate the CNS effects of many benzodiazepines. Tolerance may develop with chronic ethanol use. The mechanism may be decreased clearance of the benzodiazepines because of CYP450 hepatic enzyme inhibition. Also, it has been suggested that the cognitive deficits induced by benzodiazepines may be increased in patients who chronically consume large amounts of alcohol.

MANAGEMENT: Patients should be advised to avoid alcohol during benzodiazepine therapy.

References (7)
  1. MacLeod SM, Giles HG, Patzalek G, Thiessen JJ, Sellers EM (1977) "Diazepam actions and plasma concentrations following ethanol ingestion." Eur J Clin Pharmacol, 11, p. 345-9
  2. Whiting B, Lawrence JR, Skellern GG, Meier J (1979) "Effect of acute alcohol intoxication on the metabolism and plasma kinetics of chlordiazepoxide." Br J Clin Pharmacol, 7, p. 95-100
  3. Divoll M, Greenblatt DJ, Lacasse Y, Shader RI (1981) "Benzodiazepine overdosage: plasma concentrations and clinical outcome." Psychopharmacology (Berl), 73, p. 381-3
  4. Juhl RP, Van Thiel DH, Dittert LW, Smith RB (1984) "Alprazolam pharmacokinetics in alcoholic liver disease." J Clin Pharmacol, 24, p. 113-9
  5. Ochs HR, Greenblatt DJ, Arendt RM, Hubbel W, Shader RI (1984) "Pharmacokinetic noninteraction of triazolam and ethanol." J Clin Psychopharmacol, 4, p. 106-7
  6. Staak M, Raff G, Nusser W (1979) "Pharmacopsychological investigations concerning the combined effects of dipotassium clorazepate and ethanol." Int J Clin Pharmacol Biopharm, 17, p. 205-12
  7. Nichols JM, Martin F, Kirkby KC (1993) "A comparison of the effect of lorazepam on memory in heavy and low social drinkers." Psychopharmacology (Berl), 112, p. 475-82

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Moderate

Clonazepam Obesity

Moderate Potential Hazard, Moderate plausibility

benzodiazepines - obesity

The plasma half-lives of benzodiazepines may be prolonged in obese patients, presumably due to increased distribution into fat. Marked increases in distribution (> 100%) have been reported for diazepam and midazolam, and moderate increases (25% to 100%) for alprazolam, lorazepam, and oxazepam. Therapy with benzodiazepines should be administered cautiously in obese patients, with careful monitoring of CNS status. Longer dosing intervals may be appropriate. When dosing by weight, loading doses should be based on actual body weight, while maintenance dose should be based on ideal body weight to avoid toxicity.

References (14)
  1. (2002) "Product Information. Xanax (alprazolam)." Pharmacia and Upjohn
  2. (2002) "Product Information. Valium (diazepam)." Roche Laboratories
  3. (2002) "Product Information. Ativan (lorazepam)." Wyeth-Ayerst Laboratories
  4. (2001) "Product Information. Serax (oxazepam)." Wyeth-Ayerst Laboratories
  5. (2001) "Product Information. Restoril (temazepam)." Sandoz Pharmaceuticals Corporation
  6. (2001) "Product Information. Halcion (triazolam)." Pharmacia and Upjohn
  7. (2001) "Product Information. Dalmane (flurazepam)." Roche Laboratories
  8. (2001) "Product Information. Tranxene (clorazepate)." Abbott Pharmaceutical
  9. (2001) "Product Information. Klonopin (clonazepam)." Roche Laboratories
  10. (2022) "Product Information. Prosom (estazolam)." Abbott Pharmaceutical
  11. (2001) "Product Information. Librium (chlordiazepoxide)." Roche Laboratories
  12. (2001) "Product Information. Doral (quazepam)." Wallace Laboratories
  13. (2001) "Product Information. Versed (midazolam)." Roche Laboratories
  14. American Medical Association, Division of Drugs and Toxicology (1994) "Drug evaluations annual 1994." Chicago, IL: American Medical Association;

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Klonopin drug interactions

There are 531 drug interactions with Klonopin (clonazepam).

Klonopin disease interactions

There are 10 disease interactions with Klonopin (clonazepam) which include:

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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