Clozapine

Common use

Clozapine is an antipsychotic medicine. It works by changing the actions of chemicals in the brain. Clozapine is used to treat schizophrenia in adults after other treatments have failed. Clozapine is also used to reduce the risk of suicidal behavior in adults with schizophrenia or similar disorders.

Dosage and direction

Take clozapine exactly as prescribed by your doctor. You may take clozapine with or without food. You should not stop using clozapine suddenly. Follow your doctor's instructions about tapering your dose. Usual Adult Dose for Schizophrenia: Initial dose: 12.5 mg orally once or twice a day; Titration and Maintenance dose: May increase total daily dose in increments of 25 mg to 50 mg per day to a target dose of 300 mg to 450 mg per day (administered in divided doses) by the end of week 2. Subsequent dose increases can be in increments of up to 100 mg once or twice weekly. Maximum dose: 900 mg per day.

Precautions

To make sure this medicine is safe for you, tell your doctor if you have ever had: heart problems, high blood pressure, a heart attack or stroke (including "mini-stroke"); long QT syndrome (in you or a family member); an electrolyte imbalance (such as low levels of potassium or magnesium in your blood); a seizure, head injury, or brain tumor; diabetes, or risk factors such as being overweight or having a family history of diabetes; high cholesterol or triglycerides; constipation or problems with your bowel movements; liver or kidney disease; an enlarged prostate or urination problems; glaucoma; malnourishment or dehydration; or if you smoke.
Do not drink alcohol. Dangerous side effects or death could occur.
Avoid coffee, tea, cola, energy drinks or other sources of caffeine.
Avoid driving or hazardous activity until you know how clozapine will affect you. Dizziness or drowsiness can cause falls, accidents, or severe injuries.
Avoid getting up too fast from a sitting or lying position, or you may feel dizzy.

Contraindications

You should not take clozapine if you are allergic to it.
If you get pregnant, tell your doctor right away. Do not stop taking clozapine without your doctor's advice.
You should not breastfeed while using this medicine.
Clozapine is not approved for use by anyone younger than 18 years old.

Possible side effect

Common clozapine side effects may include: weight gain; dizziness, tremor; fast heart rate; headache, drowsiness; nausea, constipation; dry mouth, or increased salivation; vision problems; or fever, increased sweating.

Drug interaction

Clozapine can cause a serious heart problem. Your risk may be higher if you also use certain other medicines for infections, asthma, heart problems, high blood pressure, depression, mental illness, cancer, malaria, or HIV.
Using clozapine with other drugs that make you drowsy or slow your breathing can cause dangerous side effects or death. Ask your doctor before using opioid medication, a sleeping pill, a muscle relaxer, cold or allergy medicine, or medicine for anxiety or seizures.

Missed dose

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time. If you miss taking clozapine for more than 2 days in a row, call your doctor before you start taking it again.

Overdose

Seek emergency medical attention. Overdose symptoms may include drowsiness, confusion, fast heartbeats, feeling light-headed, weak or shallow breathing, drooling, choking, or seizure.

Storage

Store at room temperature away from moisture and heat. Keep away from children.