Klonopin interactions: Alcohol, medications, and other factors

Klonopin (clonazepam) is a brand-name prescription drug used to treat panic disorder and certain seizure disorders. As with other medications, Klonopin can interact with alcohol and certain other drugs. An interaction occurs when one substance causes another substance to have a different effect than expected.

For details about Klonopin’s interactions, keep reading. For additional information about Klonopin, including details about its uses, see this article.

In some cases, a factor or condition could prevent your doctor from prescribing Klonopin due to the risk of harm. This is known as a contraindication. The contraindications of Klonopin include:

Having severe liver disease

Doctors typically will not prescribe Klonopin if you have severe liver disease, such as liver failure.

If you have severe liver disease, your body may not be able to break down Klonopin as it should. This could raise the level of Klonopin in your body, which could increase your risk of side effects from the drug. (For details about possible side effects of Klonopin, see this article.)

Before taking Klonopin, be sure to tell your doctor if you have severe liver disease. They can recommend a different treatment for your condition.

Having acute closed-angle glaucoma

Doctors typically will not prescribe Klonopin during an episode of acute (sudden) closed-angle glaucoma.

Acute closed-angle glaucoma is a medical emergency. It occurs when the pressure inside of your eye suddenly increases. Klonopin may raise the pressure inside your eye, which lead to new or worsened closed-angle glaucoma.

While taking Klonopin, watch for sudden eye pain, severe headache, or vision changes. These could be symptoms of acute closed-angle glaucoma. If you have these symptoms, stop taking Klonopin and call 911 or your local emergency number right away.

Having had an allergic reaction to Klonopin or any of its ingredients

If you’ve had an allergic reaction to Klonopin, any of its ingredients, or other benzodiazepines,* your doctor will likely not prescribe Klonopin. Taking the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better choices.

Note: Before you start treatment with Klonopin, it’s important to tell your doctor if any of these contraindications apply to you. They can determine whether to prescribe Klonopin.

* Klonopin is a type of drug called a benzodiazepine.

Doctors will typically recommend that you avoid drinking alcohol while taking Klonopin.

Both alcohol and Klonopin depress (slow down) your central nervous system.* As a result, both alcohol and Klonopin can lead to side effects such as loss of coordination and drowsiness. Your risk of these side effects is higher if you drink alcohol while taking Klonopin. (To learn more about possible side effects of Klonopin, see this article.)

If you drink alcohol, talk with your doctor. They can suggest safe ways to stop drinking while taking Klonopin. Or your doctor may prescribe a different treatment for your condition.

* This system helps control movement, breathing, and other bodily functions.

Before you start treatment with Klonopin, tell your doctor and pharmacist which prescription, over-the-counter, and other medications you take. By sharing this information with them, you may help prevent possible interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Here’s a chart of drugs that can interact with Klonopin. Due to the risk of interactions, doctors may not prescribe Klonopin with these medications. Keep in mind that this chart does not include all drugs that may interact with Klonopin. Some of these interactions are described in detail just below in “Drug interactions in depth.”

* To learn about possible side effects of Klonopin, see this article.
† Klonopin has a boxed warning about the risk of serious injury or death if taken with opioids. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). To learn more, see “Drug interactions in depth” below.

Here’s a closer look at certain drug interactions of Klonopin.

Opioids

Opioids are drugs that are used to ease pain.

Interaction result. Taking Klonopin with an opioid can increase the risk of extreme drowsiness and respiratory depression. (With respiratory depression, your breathing is weakened or slowed.) In some cases, these effects may lead to coma or be fatal. In fact, Klonopin has a boxed warning about the risk of the side effects. A boxed warning is the most serious warning from the Food and Drug Administration (FDA).

Interaction explained. Both Klonopin and opioids can cause drowsiness and respiratory depression when taken on their own. Taking Klonopin in combination with an opioid can further increase the risk of these effects.

Examples of opioids. Below are examples of opioids that may interact with Klonopin:

• morphine (Mitigo, MS Contin, others)
• hydrocodone (Hysingla ER)
• oxycodone (Xtampza ER, Oxaydo, Oxycontin)
• hydromorphone (Dilaudid)
• tramadol (ConZip, Qdolo, Ultram)

Steps you or your doctor may take. Before starting Klonopin treatment, tell your doctor about all medications you’re taking.

If you’re taking an opioid, your doctor will talk with you about the risks of taking Klonopin. The use of an opioid and Klonopin should generally be avoided. However, if they tell you it’s safe to take Klonopin, your doctor may prescribe a lower dosage of the drug than usual. The lower dosage may help reduce your risk of extreme drowsiness and respiratory depression. (For details about Klonopin’s dosage, see this article.)

If your doctor prescribes Klonopin while you’re taking an opioid, watch for extreme drowsiness and symptoms of respiratory depression. Examples include shortness of breath and shallow breathing. If you have these symptoms, tell your doctor right away. They can advise you on whether it’s safe for you to keep taking the opioid with Klonopin.

However, if your symptoms seem severe or life threatening, call 911 or your local emergency number immediately.

Keep in mind that your doctor may also prescribe naloxone (Narcan, Kloxxado). This drug can help treat an overdose, which may be caused by respiratory depression from the opioid and Klonopin. Narcan is also available without a prescription at your local pharmacy. To learn more about any of these medications, talk with your doctor or pharmacist.

Stimulant drugs

Stimulants are drugs used to treat conditions such as binge eating disorder, narcolepsy, and attention-deficit hyperactivity disorder (ADHD).

Interaction result. Taking Klonopin with a stimulant can make Klonopin less effective for treating your condition.

Interaction explained. Klonopin depresses (slows down) your central nervous system,* while stimulants activate the system. As a result, taking a stimulant with the drug could cancel out the effects of Klonopin.

In addition, certain stimulants can increase your risk of seizures. Klonopin is used to treat certain seizure disorders. If you’re taking Klonopin to treat seizures, a stimulant could make Klonopin less effective for treating your condition.

Examples of stimulant drugs. Below are examples of stimulant drugs that may interact with Klonopin:

• lisdexamfetamine (Vyvanse)
• amphetamine/dextroamphetamine (Adderall, Adderall XR)
• methylphenidate (Concerta, Daytrana, others)
• dexmethylphenidate (Focalin)
• dextroamphetamine (Dexedrine, Xelstrym)

Steps you or your doctor may take. Before starting treatment with Klonopin, tell your doctor if you’re taking a stimulant. They can advise you on whether it’s safe to take these medications together.

If your doctor prescribes a stimulant while you’re taking Klonopin, watch for symptoms of the condition you’re taking Klonopin to treat. This could indicate that Klonopin is not effective for treating your condition. Your doctor can instruct you on what to do if this happens.

* This system helps control movement, breathing, and other bodily functions.

Certain antidepressant drugs

Antidepressants are drugs used to treat depression. Klonopin may interact with certain antidepressants, including tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs).

Interaction result. Taking Klonopin with certain antidepressants can increase the risk of side effects with Klonopin. Examples include drowsiness and lack of coordination. (To learn more about possible side effects of Klonopin, see this article.)

Interaction explained. Klonopin slows down your central nervous system,* which can lead to effects such as drowsiness and lack of coordination. Taking a TCA or MAOI can also lead to these effects. Therefore, when Klonopin is taken with certain antidepressants, your risk of these side effects can increase further.

Examples of antidepressant drugs. Here are some TCAs that may interact with Klonopin: imipramine (Tofranil) and amitriptyline.

Examples of MAOIs that may interact with Klonopin include selegeline (Emsam) and isocarboxazid (Marplan).

In addition to the drugs above, mirtazapine (Remeron, Remeron Soltab) is another antidepressant that may interact with Klonopin.

Steps you or your doctor may take. Before taking Klonopin, be sure your doctor knows if you’re taking an antidepressant. They can advise you on whether it’s safe to take these medications together.

If your doctor prescribes any of the antidepressants above with Klonopin, watch for worsened drowsiness or lack of coordination. If you have these symptoms, talk with your doctor. They may switch you to an antidepressant that has not been reported to interact with Klonopin, such as sertraline (Zoloft). Or they may prescribe a drug other than Klonopin.

* This system helps control movement, breathing, and other bodily functions.

Klonopin may have other interactions, such as with supplements, foods, vaccines, or even lab tests. You’ll find details below.

Klonopin and supplements

It’s possible for drugs to interact with supplements such as vitamins and herbs.

Klonopin and herbs

There have been no specific reports of herbs interacting with Klonopin. However, it’s still important to check with your doctor or pharmacist before taking any of these products during Klonopin treatment.

Klonopin and vitamins

No vitamins have been reported to interact with Klonopin. Keep in mind that you should still talk with your doctor or pharmacist before taking any vitamins with Klonopin.

Klonopin and food

Food interactions with Klonopin have not been reported. If you’d like to learn more about eating certain foods during treatment with Klonopin, talk with your doctor.

Klonopin and vaccines

There haven’t been any specific reports of vaccines interacting with Klonopin. If you have questions about getting vaccines during Klonopin treatment, talk with your doctor or pharmacist.

Klonopin and lab tests

No lab tests have been reported to interact with Klonopin. Your doctor or pharmacist can give you more information about having certain lab tests while taking Klonopin.

KLONOPIN AND CANNABIS OR CBD

Cannabis (marijuana) and cannabis products, such as cannabidiol (CBD), have not been specifically reported to interact with Klonopin. However, as with any drug or supplement, talk with your doctor before taking cannabis in combination with Klonopin. The impact of cannabis may affect how well you stick to your Klonopin treatment plan.

Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.

Certain medical conditions and other factors may increase the risk of interactions with Klonopin. Before you take Klonopin, be sure to talk with your doctor about your health history. Klonopin may not be the right treatment option for you if you have certain medical conditions or other factors affecting your health.

Health conditions or factors that might interact with Klonopin include:

• Acute closed-angle glaucoma. Doctors typically will not prescribe Klonopin during an episode of acute (sudden) closed-angle glaucoma. For details, see “When to avoid Klonopin” above.
• Liver problems. Doctors typically will not prescribe Klonopin if you have severe liver disease, such as liver failure. For details, see “When to avoid Klonopin” above.
• Allergic reaction. If you’ve had an allergic reaction to Klonopin or any of its ingredients, your doctor will likely not prescribe Klonopin. For details, see “When to avoid Klonopin” above.
• Kidney problems. Before starting treatment with Klonopin, let your doctor know about any kidney problems you have. If your kidneys are not working properly, your body may not get rid of Klonopin as it should. This could cause the drug to build up in your system, increasing your risk of side effects.* If you have kidney problems, your doctor may prescribe a lower dosage of Klonopin than usual.
• Seizures. Before starting Klonopin treatment, tell your doctor if you have a seizure disorder. Klonopin may worsen certain types of seizures. Your doctor can advise you on whether Klonopin is the right treatment option for you.
• Breathing problems. Before taking Klonopin, tell your doctor if you have any breathing problems. This includes conditions such as sleep apnea and chronic obstructive pulmonary disease (COPD). Klonopin can cause respiratory depression. You may have an increased risk of this side effect if you have breathing problems. Your doctor can advise on whether it’s safe to take Klonopin.
• Porphyria. Before you begin Klonopin treatment, tell your doctor if you have a blood disorder called porphyria. Klonopin may worsen this condition. If you have porphyria, talk with your doctor about whether it’s safe for you to take the drug.
• Pregnancy. It may not be safe to take Klonopin while pregnant. If you’re pregnant or planning a pregnancy, talk with your doctor before you take the medication. For details about Klonopin’s use during pregnancy, see this article.
• Breastfeeding. Klonopin can pass into breast milk, which may cause side effects in a breastfed child. If you’re considering breastfeeding while taking Klonopin, talk with your doctor. To learn more about Klonopin’s use while breastfeeding, see this article.

* To learn about possible side effects of Klonopin, see this article.

Here are some frequently asked questions about Klonopin and possible interactions.

Does grapefruit interact with Klonopin?

Grapefruit and grapefruit juice are not known to interact with Klonopin.

Eating grapefruit or drinking grapefruit juice while taking some medications could raise the level of those medications in your body. The higher levels could increase your risk of side effects. However, this is not known to happen with grapefruit and Klonopin.

If you have additional questions, talk with your doctor or pharmacist.

Can I take Klonopin with an over-the-counter pain reliever, such as ibuprofen or acetaminophen?

It should be safe to take Klonopin with an over-the-counter (OTC) pain reliever. This includes ibuprofen (Advil) and acetaminophen (Tylenol). There’s no known interaction between these medications.

If you’re interested in using an OTC pain reliever with Klonopin, talk with your doctor or pharmacist. They can recommend a treatment option for you.

Is there an interaction between Klonopin and Viagra?

There’s not a known interaction between Klonopin and sildenafil (Viagra).

Klonopin may cause erectile dysfunction (ED) as a side effect.* Viagra is prescribed to treat ED. If you have ED due to Klonopin, your doctor may prescribe Viagra.

If you have other questions about Klonopin and Viagra, talk with your doctor or pharmacist.

* To learn about possible side effects of Klonopin, see this article.

Can I take Klonopin with Claritin?

Yes, you can take Klonopin with loratadine (Claritin). There’s no known interaction between these medications.

Claritin is an antihistamine. The drug is used to treat conditions such as seasonal allergies.

If you’re interested in treating seasonal allergies while taking Klonopin, talk with your doctor or pharmacist. They can advise you on ways to ease your symptoms.

Is it safe to take Klonopin with amoxicillin?

No interactions have been reported with Klonopin and amoxicillin (Amoxil, Larotid).

Amoxicillin is an antibiotic. It’s used to treat infections caused by bacteria.

If you’d like to learn more about Klonopin and amoxicillin, talk with your doctor or pharmacist.

You can take certain steps to help prevent interactions with Klonopin. Your doctor and pharmacist are key resources, so reach out to them before starting treatment. For example, you should plan the following:

• Let them know if you drink alcohol.
• Tell them about any other medications you take, as well as any supplements, herbs, and vitamins.
• Create a medication list, which your doctor and pharmacist can help you fill out.

It’s also important to read the label of Klonopin and other paperwork that comes with the drug. The label may have colored stickers that mention an interaction. And the paperwork, sometimes called the prescribing information, may contain details about interactions. If this information is difficult to understand, ask your doctor or pharmacist to help explain it.

You can also help prevent interactions with Klonopin by taking it exactly as your doctor prescribes.

Besides learning about interactions, you may want to find out more about Klonopin. These resources might help:

• Overview of Klonopin. For a general overview of Klonopin, you can see this article.
• Drug comparison. Find information about how Klonopin compares with Xanax.
• Facts about your condition. To learn more about seizures, see our epilepsy and seizures hub. For details about panic disorder, our mental health hub and these related articles might be helpful.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.