N05AH02 - Clozapine

Probably not porphyrinogenic

Rationale

Substrate of CYP 1A2, 2C19, 2C8, 2C9, 2D6, 3A4 (major enzyme at higher concentrations), 2C19, 2E1. Inhibitor of CYP3A4 (low potency), 2D6, 2C19, 2C9. References consider it safe for use.

Chemical description

High-dose neuroleptic (benzodiazepine derivative) used in therapy-resistant schizophrenia. Extensively metabolized via CYPs.

Personal communication

Thunell, clinical experience from prolonged treatment (n=1): No porphyric side effects. Report on uneventful use: One report of uneventful use of clozapine for 2-3 years in female AIP patient with known mutation. Porphyrin excretion low/normal during use. From Dr Salamanca, Madrid.

IPNet drug reports

Uneventful use reported in 1 patient with acute porphyria.

Similar drugs

Explore alternative drugs in similar therapeutic classes N05A / N05AH or go back.

References

#	Citation details	PubMed ID
1.	Psychotropic drugs in acute intermittent porphyria. Holroyd S, Seward RL. Clin Pharmacol Ther. 1999 Sep; 66(3):323-5.	10511069
Porphyria Drug Lists
2.	French List Centre Français des Porphyries
3.	EPI List European Porphyria Initiative No longer maintained
4.	South African List Porphyria South Africa No longer maintained