Drug General Information (ID: DDIK90WRIZ)
Drug Name			Clozapine		Drug Info		Digitoxin		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antipsychotic Agents				Antiarrhythmic Agents
Structure

Mechanism of Clozapine-Digitoxin Interaction (Severity Level: Moderate)
Competitive binding of plasma proteins Click to Show/Hide Mechanism Graph
Drug Name		Clozapine				Digitoxin
Mechanism		Competition for plasma protein binding sites				Competition for plasma protein binding sites
Key Mechanism Factor 1
		Factor Name		Plasma protein binding
		Factor Description		Plasma protein binding refers to the degree of binding of a drug to proteins in the blood, and the lower the degree of binding, the more efficiently the drug can cross cell membranes or diffuse. Plasma protein binding alters the distribution and therapeutic characteristics of the drugs.
Mechanism Description		Increased plasma concentration of Digitoxin and Clozapine due to competitive binding of plasma proteins

Recommended Action
Management		If clozapine and digitoxin must be used together, caution is recommended, as is close monitoring for evidence of altered digitoxin effect. Digoxin is less protein-bound and may be considered as an alternative.

References
1	Product Information. Clozaril (clozapine). Novartis Pharmaceuticals, East Hanover, NJ.