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Klonopin Interactions: What to Avoid

Documented interactions for Klonopin (clonazepam). Each entry cites the prescribing information or FDA safety communication it is based on.

4 major3 moderate

Interaction summary

SeverityInteracts withClassConcern
MajorAlcohol (ethanol)CNS depressantClonazepam with alcohol: additive CNS and respiratory depression
MajorAlcohol (ethanol)CNS depressantBenzodiazepine with alcohol: additive CNS and respiratory depression
MajorOther opioids (morphine, fentanyl, methadone, oxycodone, hydromorphone, tramadol)OpioidOpioid with benzodiazepine: risk of profound sedation, respiratory depression, coma, and death
MajorStrong CYP3A4 inhibitors (ketoconazole, itraconazole, clarithromycin, ritonavir, grapefruit juice)CYP3A4 inhibitorStrong CYP3A4 inhibitors raise benzodiazepine exposure
ModerateOther CNS depressants (opioids, benzodiazepines, sleep aids, sedating antihistamines, gabapentinoids, muscle relaxants)CNS depressantBenzodiazepine with other CNS depressants: additive sedation
ModerateSedating H1 antihistamines (diphenhydramine, hydroxyzine, chlorpheniramine, doxylamine, promethazine)Sedating antihistamineAdditive sedation with sedating antihistamines
ModerateSedating H1 antihistamines (diphenhydramine, hydroxyzine, chlorpheniramine, doxylamine, promethazine)Sedating antihistamineBenzodiazepine with sedating antihistamines: additive sedation

Detailed interactions

Major

Clonazepam with alcohol: additive CNS and respiratory depression

With: Alcohol (ethanol) CNS depressant

Why it happens

Both agents depress the central nervous system and slow breathing.

What can happen

Excessive sedation, respiratory depression, and death are possible.

What to do

Avoid alcohol while taking clonazepam and for several days after the last dose.

Basis: Clonazepam (Klonopin) prescribing information, Warnings. source

Major

Benzodiazepine with alcohol: additive CNS and respiratory depression

With: Alcohol (ethanol) CNS depressant

Why it happens

Both agents depress the central nervous system and breathing.

What can happen

Excessive sedation, respiratory depression, and death.

What to do

Avoid alcohol during benzodiazepine therapy.

Basis: Benzodiazepine prescribing information, Warnings. source

Major

Opioid with benzodiazepine: risk of profound sedation, respiratory depression, coma, and death

With: Other opioids (morphine, fentanyl, methadone, oxycodone, hydromorphone, tramadol) Opioid

Why it happens

Additive depression of the central nervous system and respiratory drive.

What can happen

FDA requires a boxed warning on benzodiazepines describing this combination. Deep sedation, respiratory arrest, coma, and death have been reported.

What to do

Avoid where possible. If required, use the lowest effective doses for the shortest duration with close monitoring.

Basis: FDA Drug Safety Communication (2016); benzodiazepine boxed warning. source

Major

Strong CYP3A4 inhibitors raise benzodiazepine exposure

With: Strong CYP3A4 inhibitors (ketoconazole, itraconazole, clarithromycin, ritonavir, grapefruit juice) CYP3A4 inhibitor

Why it happens

CYP3A4 inhibition slows clearance of benzodiazepines metabolized by this pathway.

What can happen

Increased sedation; labeling recommends dose reduction for some agents.

What to do

Expect the prescriber to reduce the benzodiazepine dose.

Basis: Benzodiazepine prescribing information, Drug Interactions. source

Moderate

Benzodiazepine with other CNS depressants: additive sedation

With: Other CNS depressants (opioids, benzodiazepines, sleep aids, sedating antihistamines, gabapentinoids, muscle relaxants) CNS depressant

Why it happens

Additive central nervous system depression.

What can happen

Excessive sedation, confusion, and impaired coordination.

What to do

Review all sedating medications with the prescriber.

Basis: Benzodiazepine prescribing information, Drug Interactions. source

Moderate

Additive sedation with sedating antihistamines

With: Sedating H1 antihistamines (diphenhydramine, hydroxyzine, chlorpheniramine, doxylamine, promethazine) Sedating antihistamine

Why it happens

Sedating H1 antihistamines add to benzodiazepine sedation.

What can happen

Marked drowsiness, confusion, and impaired coordination.

What to do

Avoid sedating antihistamines such as diphenhydramine while on clonazepam; check with a pharmacist before combining.

Basis: Clonazepam prescribing information, Drug Interactions. source

Moderate

Benzodiazepine with sedating antihistamines: additive sedation

With: Sedating H1 antihistamines (diphenhydramine, hydroxyzine, chlorpheniramine, doxylamine, promethazine) Sedating antihistamine

Why it happens

Additive sedative effects.

What can happen

Marked drowsiness and impaired coordination.

What to do

Avoid combining without prescriber approval.

Basis: Benzodiazepine prescribing information, Drug Interactions. source

Common questions

What should I know about Klonopin interactions?

We have documented 7 interaction classes for Klonopin in our dataset. Usually avoided, or used only with explicit prescriber oversight and close monitoring. The most serious items on this page are marked contraindicated or major.

Can I take Klonopin with alcohol?

Alcohol interacts with most of the medications on this site because it adds to sedation and slows breathing. For the specific documented risk, see the relevant entry above. The general rule from labeling is to avoid alcohol.

Does an empty result mean Klonopin is safe with other drugs?

No. An empty result only means our curated dataset has no matching rule. A pharmacist can run a full interaction screen against every medication and supplement you take.

Related

Editorial Review Board

Clinical review by licensed pharmacists (PharmD)

Every page on this site is reviewed against current FDA prescribing information, DailyMed labelling, DEA scheduling regulations and MedlinePlus monographs before publication. Reviewers have no commercial relationship with any manufacturer or pharmacy.

Last substantive review: October 01, 2026

Important

This site provides educational information only and does not sell, prescribe or dispense medications. Always consult a licensed healthcare provider. This page is not medical advice.