Drug General Information (ID: DDIZ7EKY30)
Drug Name			Clozapine		Drug Info		Diclofenamide		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antipsychotic Agents				Ophthalmic Glaucoma Agents
Structure

Mechanism of Clozapine-Diclofenamide Interaction (Severity Level: Moderate)
Additive myelosuppressive effects Click to Show/Hide Mechanism Graph
Drug Name		Clozapine				Diclofenamide
Mechanism		Myelosuppressive effects				Increase the risk of neutropenia combined with clozapine
Key Mechanism Factor 1
		Factor Name		Myelosuppressive effects
		Factor Description		Myelosuppression, also known as bone marrow suppression, is a decrease in bone marrow activity that leads to a decrease in the production of blood cells. Some blood cell disorders include: erythrocytopenia (anemia), leukopenia (neutropenia), and thrombocytopenia (thrombocytopenia).
Mechanism Description		Additive myelosuppressive effects by the combination of Clozapine and Diclofenamide

Recommended Action
Management		Close monitoring is advisable during concomitant use. White blood cell (WBC) counts and absolute neutrophil counts (ANC) should be measured regularly according to official recommendations, and clozapine should be discontinued if cell counts fall below critical limits. Patients should be counseled to notify their doctor immediately if they experience influenza-like symptoms, fever, or a sore throat.

References
1	Product Information. Diamox (acetazolamide). Lederle Laboratories, Wayne, NJ.
2	Product Information. Fycompa (perampanel). Eisai Inc, Teaneck, NJ.
3	Burke WJ, Ranno AE "Neutropenia with clozapine and methazolamide." J Clin Psychopharmacol 14 (1994): 357-8