ANTIPSYCHOTICS AND MACROLIDES - POTENTIAL INTERACTIONS

A study in healthy subjects found no evidence of an interaction between clozapine and erythromycin, but three case reports describe clozapine toxicity (seizures in one patient, drowsiness, incoordination and incontinence in another, and neutropenia in the third) when the patients also took erythromycin. Quetiapine levels are increased by erythromycin.
The clinical importance of these interactions is uncertain, but bear them in mind in case of an unexpected response to treatment. The manufacturers suggest that lower quetiapine doses should be considered if macrolides are given. Note that not all macrolides would be expected to interact, see macrolides.
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