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.

Summary of Interactions with Vitamins, Herbs, and Foods
(for details about the summarized interactions, read the full article)

Beneficial May be Beneficial: Supportive interaction—Taking these supplements may support or otherwise help your medication work better.

Vinpocetine*
Avoid Avoid: Reduced drug absorption/bioavailability—Avoid these supplements when taking this medication since the supplement may decrease the absorption and/or activity of the medication in the body.

Tobacco
Avoid Avoid: Adverse interaction—Avoid these supplements when taking this medication because taking them together may cause undesirable or dangerous results.

Alcohol
Check Check: Other—Before taking any of these supplements or eating any of these foods with your medication, read this article in full for details.

L-tryptophan*
Depletion or interference

None known
Side effect reduction/prevention

None known

An asterisk (*) next to an item in the summary indicates that the interaction is supported only by weak, fragmentary, and/or contradictory scientific evidence.

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.

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.