clozapine

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Clozaril, Fazaclo, |clozapine

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clozapine

Generic Name: clozapine (CLAW za peen)
Brand Names: Clozaril, Fazaclo

What is clozapine?

Clozapine is an antipsychotic medication. It works by changing the actions of chemicals in the brain.

Clozapine is used to treat severe schizophrenia symptoms in people who have not responded to other medications.

Clozapine may also be used for purposes other than those listed here.

What is the most important information I should know about clozapine?

Do not take clozapine without first talking to your doctor if you have seizures, epilepsy, diabetes, paralytic ileus, liver disease, lung disease, kidney disease, heart disease, high blood pressure, glaucoma, enlarged prostate, urination problems, or if you have ever had a heart attack, bone marrow or blood cell disorders, or decreased white blood cells caused by taking clozapine in the past.

What should I discuss with my healthcare provider before taking clozapine?

Clozapine is not for use in older adults with dementia.

Do not take clozapine without first talking to your doctor if you have:
  • seizures or epilepsy;

  • paralytic ileus;

  • a history of decreased white blood cells when taking clozapine;

  • heart disease, high blood pressure, a previous heart attack, irregular heartbeats;

  • liver disease;
  • kidney disease;
  • lung disease;

  • diabetes;

  • a history of bone marrow or blood cell disorders;

  • narrow angle glaucoma; or

  • an enlarged prostate or urination problems.

If you have any of these conditions, you may not be able to use clozapine or you may need a dosage adjustment or special tests during treatment.

Clozapine may cause seizures or fainting. Be careful if you drive or do anything that requires you to be awake and alert.

Clozapine may raise your blood sugar. Symptoms include extreme thirst, increased urination, excessive hunger, or weakness. If you are diabetic and you use medication to control your blood sugar, your dosage may need to be adjusted while you are using clozapine.

You may need to stop using clozapine temporarily if you will be having surgery. Tell the surgeon that you are using this medication.

Clozapine orally-disintegrating tablets contain phenylalanine. Tell your doctor if you have phenylketonuria (PKU).

FDA pregnancy category B: This medication is not expected to be harmful to an unborn baby. Do not use clozapine without telling your doctor if you are pregnant or plan to become pregnant during treatment. Clozapine can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How should I take clozapine?

Take clozapine exactly as it was prescribed for you. Do not take it in larger doses or for longer than recommended by your doctor.

Take the regular oral tablet with a full glass of water. Drink plenty of water to keep from getting constipated. Your doctor may also recommend a laxative.

The FazaClo orally-disintegrating tablet can be taken without water. When you are ready for your dose, remove the tablet from the blister pack by gently peeling the foil back and dropping the tablet into your hand. Do not push the tablet through the foil. Quickly place the tablet in your mouth. It will dissolve rapidly on your tongue and can be swallowed with saliva. No water is needed.

If your doctor has prescribed one-half of an orally-disintegrating tablet, you will need to break the tablet in half. After taking the tablet half, throw the other half away. Do not store it for later use.

Clozapine can be taken with or without food.

While you are taking clozapine, your blood will need to be tested every week for the first 6 months of treatment. It is important that you not miss any scheduled visits to your doctor or you may not be able to continue using clozapine. You may still need to have weekly blood tests for at least 4 weeks after you stop using clozapine.

If you have not taken your clozapine for more than 2 days in a row, call your doctor before you start taking it again. You may need to start with a lower dose than you were taking before. Do not stop taking clozapine without first talking to your doctor.

Store clozapine at room temperature away from moisture and heat. Keep each FazaClo tablet in the unopened blister pack until you are ready to take the medicine.

What happens if I miss a dose?

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you have used too much of this medicine. Symptoms of a clozapine overdose include confusion, fainting, fast heart rate, drowsiness, drooling, difficulty breathing, seizures, coma, and death.

What should I avoid while taking clozapine?

Avoid driving, operating machinery, or performing other hazardous activities during treatment with clozapine. Clozapine may cause seizures, dizziness, or fainting. Avoid drinking alcohol while taking clozapine.

Clozapine side effects

Stop using clozapine and get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using clozapine and get emergency medical help if you feel tired or short of breath, or if you have rapid breathing, chest pain, uneven heartbeats, unusual swelling or water retention. These could be signs of swelling in your heart muscle or a blood clot in your lung. Both side effects are life-threatening. Contact your doctor at once if you feel unusually weak or tired, feel as if you have the flu, or have fever, sore throat, or sores or white patches in your mouth or throat. These could be signs that your white blood cells are low, a serious side effect that could lead to a life-threatening infection.

Call your doctor at once if you have any of these serious side effects:

  • seizure (black-out or convulsions);

  • fainting, light-headedness;

  • shallow breathing, weak pulse;

  • high fever with muscle stiffness, confusion, sweating, fast or uneven heartbeats;

  • twitching or uncontrolled muscle movements; or

  • nausea, stomach pain, low fever, lost appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Other less serious side effects are more likely to occur, such as:

  • constipation;

  • nausea, vomiting, upset stomach;

  • drowsiness;

  • salivation (drooling);

  • increased sweating; or

  • sleep problems or nightmares.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect clozapine?

Before taking clozapine, tell your doctor if you are using any of the following drugs:

  • seizure medicine such as phenytoin (Dilantin) or carbamazepine (Tegretol);

  • rifampin (Rifadin, Rimactane);

  • cimetidine (Tagamet);

  • erythromycin (E-Mycin, E.E.S, Ery-Tab);

  • atropine (Donnatal, and others), belladonna, clidinium (Quarzan), dicyclomine (Bentyl), scopolamine (Transderm-Scop);

  • drugs that weaken your immune system (such as cancer medicine or steroids); or

  • drugs that make you sleepy (such as alcohol, cold medicine, pain medication, muscle relaxants, and medicine for depression or anxiety).

If you are using any of these drugs, you may not be able to take clozapine, or you may need dosage adjustments or special tests during treatment.

There may be other drugs not listed that can affect clozapine. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

  • Your pharmacist has more information about clozapine written for health professionals that you may read.

What does my medication look like?

Clozapine is available with a prescription under the brand name Clozaril. Other brand or generic formulations may also be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you.

  • Clozaril 25 mg--round, yellow tablets

  • Clozaril 100 mg--round, yellow tablets

  • FazaClo 25 mg-round, yellow tablets

  • FazaClo 100 mg--round, yellow tablets

  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ("Multum") is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum"s drug information does not endorse drugs, diagnose patients or recommend therapy. Multum"s drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.
Copyright 1996-2006 Cerner Multum, Inc. Version: 6.01. Revision Date: 2/27/06 4:01:57 PM.



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