Clozapine + bulk-forming laxatives — obstruction/perforation
- Clozapine can cause severe GI hypomotility
- Bulk fiber adds stool volume
- but does not fix poor propulsion
- Can worsen obstruction/impaction risk
- Prefer osmotic + stimulant laxative plan
- Avoid psyllium/bulk agents in CIGH
Interaction at a glance
- Can worsen obstruction/impaction risk
- Avoid psyllium/bulk agents in CIGH
Mechanism
- Bulk fiber adds stool volume
- but does not fix poor propulsion
Clinical consequence
- Can worsen obstruction/impaction risk
Management
- Clozapine can cause severe GI hypomotility
- Prefer osmotic + stimulant laxative plan
- Avoid psyllium/bulk agents in CIGH
Self-check
- In clozapine-induced GI hypomotility, what can bulk-forming laxatives worsen?
Obstruction or impaction risk. - What laxative plan is preferred in clozapine-induced GI hypomotility?
An osmotic plus stimulant laxative plan. - How should Clozapine + bulk-forming laxatives be managed?
Avoid psyllium/bulk agents in CIGH.
Drugs in this interaction (7)
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