Rivotril Drug Interactions

Rivotril can be administered concurrently with one or more antiepileptic agents. But adding an extra drug to the patient's regimen should involve a careful evaluation of the response to the treatment, because unwanted effects, such as sedation and apathy, are more likely to occur. In such cases, the dosage of each drug must be adjusted to achieve the optimum desired effect.
Pharmacokinetic Drug-Drug Interactions (DDI): The antiepileptic drugs phenytoin, phenobarbital, carbamazepine, and valproate may increase the clearance of clonazepam thereby decreasing the plasma concentrations of the latter during combined treatment.
Clonazepam itself does not induce the enzymes responsible for its own metabolism.
The selective serotonin reuptake inhibitors sertraline and fluoxetine do not affect the pharmacokinetics of clonazepam when administered concomitantly.
Pharmacodynamic Drug-Drug Interactions (DDI): The combination of clonazepam with valproic acid may occasionally cause petit mal status epilepticus.
Enhanced effects on sedation, respiration and hemodynamics may occur when Rivotril is co-administered with any centrally-acting depressants, including alcohol.
Alcohol should be avoided in patients receiving Rivotril (see General under Precautions).
See Overdosage for warning of other central nervous system depressants, including alcohol.
In combination therapy with centrally-acting medications, the dosage of each drug must be adjusted to achieve the optimum effect.