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Clorazepate Dipotassium

Also indexed as: Gen-Xene®, Tranxene®

Clorazepate is used to treat the symptoms of anxiety, including restlessness, insomnia, and worry; it is also used for convulsions and symptoms associated with acute alcohol withdrawal. It is in a class of drugs known as benzodiazepines.

Interactions with Dietary Supplements

L-tryptophan
Test tube studies show that L-tryptophan and clorazepate dipotassium interact in the blood in such a way that the actions of the drug may be enhanced when high amounts of L-tryptophan are ingested.1 Controlled research is needed to determine the significance of this interaction and to investigate possible interactions between clorazepate and 5-hydroxytryptophan, a supplement related to L-tryptophan.

Vinpocetine
In a preliminary trial, an extract of periwinkle called vinpocetine was shown to produce minor improvements in short-term memory among people taking flunitrazepam, a benzodiazepine.2 Further study is needed to determine if vinpocetine would be a helpful adjunct to use of benzodiazepines, or clorazepate specifically.

Interactions with Foods and Other Compounds

Alcohol
Drinking alcohol while taking clorazepate may enhance drowsiness and slow reaction time,3 and, according to animal studies, prolong sleep time.4 Consequently, people taking clorazepate dipotassium should avoid alcoholic beverages.

Smoking
Cigarette smoking decreases the amount of time clorazepate is in the body, lowers blood levels of the drug, and reduces the beneficial effects;5 therefore, people should avoid smoking while taking the drug. People who quit smoking while taking clorazepate might experience unwanted side effects due to increased blood levels of the drug; gradual reduction in nicotine is preferred.

Summary of Interactions for Clorazepate Dipotassium

Depletion or interference None known
Adverse interaction Alcohol
Side effect reduction/prevention None known
Supportive interaction Vinpocetine*
Reduced drug absorption/bioavailability Tobacco
Other (see text) L-tryptophan*

For the convenience of the reader, the information in the summary is categorized as follows: “Depletion or interference” indicates the drug may deplete or interfere with the absorption or function of the supplement or herb. “Adverse interaction” indicates that the supplement or herb used together with the drug may result in undesirable effects. “Side effect reduction/prevention” indicates the supplement or herb may reduce the likelihood and/or severity of a potential side effect caused by the drug. “Supportive interaction” indicates the supplement or herb may support or aid the function of the drug. “Reduced drug absorption/bioavailability” indicates that the supplement or herb may decrease the absorption and/or activity of the drug in the body. An asterisk (*) next to an item in the summary indicates that the interaction is supported only by weak, fragmentary, and/or contradictory scientific evidence.

References:

1. Coassolo P, Briand C, Bourdeaux M, Sari JC. Microcalorimetric method to determine competitive binding. Action of a psychotropic drug (dipotassium clorazepate) on L-tryptophan human serum albumin complex. Biochem Biophys Acta 1978;538:512–20.

2. Bhatti JZ, Hindmarch I. Vinpocetine effects on cognitive impairments produced by flunitrazepam. Int Clin Psychopharmacol 1987;2:325–31.

3. Threlkeld DS, ed. Central Nervous System Drugs, Psychotherapeutic Drugs, Antianxiety Agents. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, 1993, 1255–69.

4. Sifton, DW, ed. Physicians Desk Reference. Montvale, NJ; Medical Economics Company, Inc., 2000, 475–6.

5. Norman TR, Fulton A, Burrows GD, Maguire KP. Pharmacokinetics of N-desmethyldiazepam after a single oral dose of clorazepate: the effect of smoking. Eur J Clin Pharmacol 1981;21:229–33.