CLOZAPINE

Brand & Generic Names

Clozaril

Leponex

Basic Information

• Habit forming? No
• Prescription needed? Yes. Prescribed only through a special program.
• Available as generic? No
• Drug class: Antipsychotic

Uses

Treats severe schizophrenia in patients not helped by other medicines.

Dosage & Usage Information

How to take:
Tablet--Swallow with liquid. If you can't swallow whole, crumble tablet and take with liquid or food.

When to take:
Once or twice daily as directed.

If you forget a dose:
Take as soon as you remember up to 2 hours late. If more than 2 hours, wait for next scheduled dose (don't double this dose).

What drug does:
Interferes with binding of dopamine. May produce significant improvement, but may at times also make schizophrenia worse.

Time lapse before drug works:
1 to 6 hours.

Don't take with:
Any other prescription drug, non-prescription drug or alcohol without first checking with your doctor.

Overdose

SYMPTOMS:
Heartbeat fast, slow, irregular; hallucinations; restlessness; excitement; drowsiness; breathing difficulty.

WHAT TO DO:

• Dial 911 (emergency) or O (operator) for an ambulance or medical help. Then give first aid immediately.
• See EMERGENCY Information.

Possible Adverse Reactions or Side Effects

Life-threatening:

Seizures (rare). Seek emergency treatment immediately.

Common:

• Fast or irregular heartbeat, dizziness or fainting, fever.
• Constipation, lightheadedness, increased salivation, heartburn, nausea, weight gain.

Infrequent:

Abdominal discomfort, increased sweating, anxiety, confusion, mild restlessness, blurred vision, unusual bleeding.

Rare:

Chills, fever, sore throat, mouth ulcers; difficult urination; rigid muscles; muscle tremors; mental depression; insomnia; lip-smacking, cheek puffing, uncontrolled tongue movements.

Warnings & Precautions

Don't take if:

• You are significantly mentally depressed.
• You have bone marrow depression from other drugs.
• You have glaucoma.

Before you start, consult your doctor:

• If you have an enlarged prostate gland.
• If you have ever had seizures from any cause.
• If you have liver, heart or gastrointestinal disease.

Over age 60:
Possible greater risk of weakness or dizziness upon standing after sitting or lying down. Greater risk of excitement, confusion. Great risk of difficulty in urination.

Pregnancy:
Safety not established. Consult doctor.

Breast-feeding:
May cause sedation, restlessness or irritability in the nursing infant. Avoid.

Infants & children:
Safety not established. Consult doctor.

Prolonged use:
Effects unknown.

Skin & sunlight:
No problems expected.

Driving, piloting or hazardous work:
Don't drive or pilot aircraft until you learn how medicine affects you. Don't work around dangerous machinery. Don't climb ladders or work in high places. Danger increases if you drink alcohol or take medicine affecting alertness and reflexes.

Discontinuing:
Don't discontinue without consulting doctor. Dose may require gradual reduction if you have taken drug for a long time. Doses of other drugs may also require adjustment.

Others:

• This medicine is available only through a special management program for monitoring and distributing this drug.
• You will need laboratory studies each week for white blood cell and differential counts.

Possible Interaction with Other Drugs

GENERIC NAME	COMBINED EFFECT
------------------------	-----------------------
Bone marrow depressants*	Toxic bone marrow depression.
Central nervous system	Toxic effects on the central
(CNS) depressants*	nervous system.
Lithium	Increased risk of seizures.

Possible Interaction with Other Substances

INTERACTS WITH	COMBINED EFFECT
---------------	---------------
Alcohol:	Avoid. Increases toxic effect on
	the central nervous system.
Caffeine drinks.	Excess (more than 3 cups of coffee
	or equivalent) increases risk of
	heartbeat irregularities.
Cocaine:	Increased risk of heartbeat
	irregularities.
Foods:	No special problems expected.
Marijuana:	Increased risk of heartbeat
	irregularities.
Tobacco:	Decreased serum concentration of
	clozapine. Avoid.