Clozapine: functions, dosage, side effects, how to use it

What medicine clozapine?

What is Clozapine for?

Clozapine is a drug for treating mental disorders, anxiety disorders, as well as certain mood disorders (schizophrenia, schizoaffective, etc.). Clozapine is a class of psychiatric drugs (antipsychotics) that work to balance certain natural substances in the brain (neurotransmitters).

Clozapine reduces hallucinations and helps prevent suicidal thoughts in people trying to harm themselves. These drugs help you think more clearly and positively about yourself, reduce nervousness, and help sufferers go about their daily activities.

The clozapine dosage and side effects of clozapine are described further below.

How is Clozapine used?

Take this medication after or before meals, or as directed by your doctor. If you are taking tablets that dissolve in the mouth, use caution when opening each tablet from the package, and putting it in your mouth immediately. Let the tablet dissolve on your tongue and then swallow it. You don't need to dilute the tablet with water. Discard tablets that have previously been exposed to air due to opening / damaged packaging. Don't save it for the next dose.

It is very important to start taking this drug at a low dose. After that, increase your dose slowly to reduce side effects such as dizziness, drowsiness and seizures. Follow the doctor's instructions exactly. Your dose is based on your medical condition and response to treatment. Since clozapine can cause a decrease in white blood cells, you will need to get regular blood tests done as directed. Make sure to stick to all schedules for these laboratory tests.

If you miss your dose for more than a day or two, consult your doctor for a new schedule to re-adjust your dosage. Take this medicine regularly to get the best benefits. To help you remember, take the medicine at the same time each day.

Don't stop taking clozapine without consulting your doctor. Some conditions may get worse when the consumption of this drug suddenly stops. Also, you may experience symptoms such as heavy sweating, headache, nausea, vomiting, and diarrhea. To prevent these symptoms while you are stopping treatment with this medicine, your doctor may reduce the dose gradually. Consult your doctor or pharmacist for more details. Immediately report any new symptoms or worsening condition.

It may take several weeks before the full benefits of this drug are felt. Always confirm your doctor if your condition persists or gets worse.

How is Clozapine stored?

Clozapine is a drug that is best stored at room temperature, away from direct light and damp places. Don't keep it in the bathroom. Don't freeze it. Other brands of this drug may have different storage rules. Observe the storage instructions on the product package or ask your pharmacist. Keep all medicines away from children and pets.

Do not flush medicines down the toilet or down the drain unless instructed to do so. Discard this product when it has expired or when it is no longer needed. Consult your pharmacist or local waste disposal company about how to safely dispose of your product.

Clozapine dosage

The information provided is not a substitute for medical advice. ALWAYS consult your doctor or pharmacist before starting treatment.

What is the dosage of Clozapine for adults?

For mental disorders in adults, the dose of clozapine is 12.5 mg per day as a single dose or twice per day. The doctor may adjust the dosage as needed. However, doctors usually will not give doses above 900 mg per day.

What is the dosage of Clozapine for children?

Safety and effectiveness have not been determined for pediatric patients (under 18 years of age).

In what dosage is Clozapine available?

The dosage requirements for clozapine are:

• 25 mg tablets 100 mg
• Injection 50mg / 2Ml

Clozapine side effects

What side effects can be experienced due to Clozapine?

Clozapine side effects are:

• Constipation
• Dry mouth
• Blurred vision
• Sweat a lot
• Sleepy
• Dizzy
• Kliyengan
• Sleep disturbance (insomnia)

Call the emergency room if you experience signs of an allergic reaction such as hives, difficulty breathing, swelling of the face, lips, tongue, or throat. In addition, you are also advised to stop taking clozapine and contact your doctor immediately if there are serious side effects which include:

• Headache with chest pain and severe dizziness, heart palpitations
• Seizures (dark vision or convulsions)
• Feeling weak, lethargic, and not energized until you have trouble breathing
• Feeling short of breath (even at night or with light exertion), swelling in the hands or feet
• Feelings like they might pass out
• Slow heart rate, weak pulse, slowed breathing (breathing may stop)
• Very stiff (rigid) muscles
• Twitching or uncontrollable movements of your eyes, lips, tongue, face, arms, or legs or
• Decreased appetite
• Have jaundice (yellowing of the skin or eyes)

Not everyone experiences the following side effects. There may be some side effects not listed above. If you have concerns about certain side effects, consult your doctor or pharmacist.

Clozapine Drug Warnings and Cautions

What should be known before using Clozapine?

In deciding to take medication, the risks of taking the drug must be considered for a good outcome. This is a decision you and your doctor will make. Some things you should consider before taking clozapine are:

• Allergy. Tell your doctor if you have ever had any unusual or allergic reactions to this medicine or any other medicines. Also tell your doctor if you have any other allergies such as: dyes, preservatives, or animals.
• Children.There are no known side effects of clozapine in children. So, the safety and efficacy of this drug have not been determined.
• Elderly. Elderly patients are more likely to develop constipation, difficulty passing stools, uncontrolled movements, liver and kidney problems, or age-related heart problems. This drug should not be used for psychological problems in the elderly who have dementia.

Is Clozapine safe for pregnant and breastfeeding women?

There are not sufficient studies in women to determine the risk when taking this medicine during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the benefits and risks before taking this medicine. This medicine is pregnancy risk category B.

• A = Not at risk
• B = not at risk according to several studies
• C = May be risky
• D = There is positive evidence of risk
• X = Contraindicated
• N = Unknown

Clozapine Drug Interactions

What medicines may interact with Clozapine?

Although several drugs should not be used at the same time, in other cases two different drugs can be used together even if there is an interaction. In this case, the doctor may be able to change the dose, or other risk prevention may be needed. Tell your doctor if you are taking other drugs, whether prescribed or not.

Taking this drug with any of the following medicines is not recommended. Your doctor may decide not to give you this drug or change some of the other drugs you take.

• Amifampridine
• Cisapride
• Dronedarone
• Droperidol
• Fluconazole
• Ketoconazole
• Mesoridazine
• Metoclopramide
• Nelfinavir
• Pimozide
• Piperaquine
• Posaconazole
• Saquinavir
• Sparfloxacin
• Terfenadine
• Thioridazine
• Ziprasidone

Taking this drug with any of the following medicines is usually not recommended, but may be needed in some cases. If the two drugs are prescribed together, your doctor may change the dose or how often you take one or both drugs.

• Abiraterone Acetate
• Alfuzosin
• Amiodarone
• Amoxapine
• Amprenavir
• Anagrelide
• Apomorphine
• Aprepitant
• Aripiprazole
• Armodafinil
• Arsenic Trioxide
• Asenapine
• Astemizole
• Atazanavir
• Azithromycin
• Balofloxacin
• Bedaquiline
• Bepridil
• Besifloxacin
• Boceprevir
• Bored
• Bupropion
• Buserelin
• Buspirone
• Caffeine
• Carbamazepine
• Ceritinib
• Chloroquine
• Chlorpromazine
• Cimetidine
• Cinacalcet
• Cinoxacin
• Ciprofloxacin
• Citalopram
• Clarithromycin
• Clobazam
• Cobicistat
• Conivaptan
• Crizotinib
• Cyclobenzaprine
• Dabrafenib
• Darunavir
• Dasatinib
• Deferasirox
• Delamanid
• Deslorelin
• Dexamethasone
• Diltiazem
• Disopyramide
• Disulfiram
• Dofetilide
• Dolasetron
• Domperidone
• Doxorubicin
• Doxorubicin Hydrochloride Liposome
• Efavirenz
• Enoxacin
• Enzalutamide
• Erythromycin
• Escitalopram
• Eslicarbazepine Acetate
• Ethinyl Estradiol
• Etravirine
• Famotidine
• Fentanyl
• Fingolimod
• Flecainide
• Flumequine
• Fluoxetine
• Fluvoxamine
• Fosamprenavir
• Fosphenytoin
• Gatifloxacin
• Gemifloxacin
• Gonadorelin
• Goserelin
• Granisetron
• Halofantrine
• Histrelin
• Hydromorphone
• Hydroquinidine
• Ibutilide
• Idelalisib
• Iloperidone
• Imatinib
• Indinavir
• Itraconazole
• Ivabradine
• Lapatinib
• Leuprolide
• Levofloxacin
• Lithium
• Lomefloxacin
• Lomitapide
• Lopinavir
• Lumefantrine
• Mate
• Mefloquine
• Methadone
• Methoxsalen
• Metronidazole
• Mexiletine
• Mibefradil
• Miconazole
• Mifepristone
• Milnacipran
• Mitotane
• Mizolastine
• Modafinil
• Montelukast
• Moricizine
• Morphine
• Morphine Sulfate Liposome
• Moxifloxacin
• Nadifloxacin
• Nafarelin
• Nafcillin
• Nalidixic Acid
• Nefazodone
• Nevirapine
• Nilotinib
• Norfloxacin
• Octreotide
• Ofloxacin
• Omeprazole
• Oxcarbazepine
• Oxolinic Acid
• Oxycodone
• Oxymorphone
• Paliperidone
• Pasireotide
• Pazopanib
• Pazufloxacin
• Pefloxacin
• Peginterferon Alfa-2b
• Pentamidine
• Perflutren Lipid Microsphere
• Perphenazine
• Phenobarbital
• Phenylpropanolamine
• Phenytoin
• Pipemidic Acid
• Pixantrone
• Prednisone
• Procainamide
• Prochlorperazine
• Promethazine
• Propranolol
• Protriptyline
• Prulifloxacin
• Quetiapine
• Quinidine
• Quinine
• Ranolazine
• Regorafenib
• Rifabutin
• Rifampin
• Rifapentine
• Rosoxacin
• Rufinamide
• Rufloxacin
• Salmeterol
• Sertindole
• Sertraline
• Sevoflurane
• Siltuximab
• Sodium Phosphate
• Sodium Phosphate, Dibasic
• Sodium Phosphate, Monobasic
• Solifenacin
• Sorafenib
• Sotalol
• St. John's Wort
• Sunitinib
• Suvorexant
• Tacrolimus
• Tapentadol
• Tegafur
• Telaprevir
• Telavancin
• Telithromycin
• Terbinafine
• Teriflunomide
• Tetrabenazine
• Thiabendazole
• Ticagrelor
• Ticlopidine
• Tipranavir
• Topiramate
• Toremifene
• Trazodone
• Trifluoperazine
• Trimipramine
• Triptorelin
• Umeclidinium
• Vandetanib
• Vardenafil
• Vemurafenib
• Verapamil
• Vinflunine
• Voriconazole
• Zileuton
• Zotepine

Can food or alcohol interact with Clozapine?

Certain drugs should not be used with meals or when eating certain foods because drug interactions can occur. Consuming alcohol or tobacco with certain drugs can also cause interactions to occur. Discuss your use of drugs with food, alcohol, or tobacco with your health care provider.

Taking this medication with one of the following is usually not recommended, but it may not be avoided in some cases. When used together, your doctor may change the dose or how often you take these drugs, or give specific instructions about use of food, alcohol, or tobacco.

• Grapefruit juice
• Tobacco

Taking this medicine with any of the following may cause an increased risk of certain side effects but may not be avoided in some cases. When used together, your doctor may change your dose or how often you take these drugs, or give specific instructions about use of food, alcohol, or tobacco.

• Caffeine

What health conditions may interact with Clozapine?

The presence of other medical problems may affect the use of this drug. Some of the health conditions that can interact with the drug clozapine are:

• Alcohol abuse
• Blood clotting problems (eg, deep vein thrombosis, pulmonary embolism)
• Blood vessel problems (poor circulation)
• History of head injury
• Had / recently had a heart attack
• Heart disease
• Heart failure
• Heart rhythm problems (eg, arrhythmias, long QT syndrome, slow heart rate),
• Hypokalemia (low potassium in the blood)
• Hypomagnesemia (low magnesium in the blood)
• Hypotension (low blood pressure) or
• Stroke
• Bone marrow disorders
• Bowel obstruction (for example, paralytic ileus)
• Seizures (epilepsy)
• Digestive problems (for example, constipation)
• Diabetes
• Dyslipidemia (high fat in the blood)
• Enlarged prostate
• Glaucoma
• Hyperglycemia (high blood sugar)
• Neuroleptic malignant syndrome
• Kidney illness
• Liver disease
• Phenylketonuria

Clozapine overdose

What should I do in an emergency or overdose?

In case of an emergency or overdose, contact the local emergency services provider (112) or immediately to the nearest hospital emergency department. Overdose symptoms may include:

• Dizzy
• Fainting
• Hard to breathe
• Loss of consciousness

What should I do if I miss a dose?

If you forget a dose of this medicine, take it as soon as possible. However, when it is nearing the time of the next dose, skip the missed dose and return to the usual dosing schedule. Don't double the dose.