Clozaril

Clozaril

     * Generic Name: clozapine
     * Brand Name: Clozaril


     * What is clozapine?
     * What are the possible side effects of clozapine?
     * What is the most important information I should know about
       clozapine?
     * What should I discuss with my healthcare provider before taking
       clozapine?
     * How should I take clozapine?
     * What happens if I miss a dose?
     * What happens if I overdose?
     * What should I avoid while taking clozapine?
     * What other drugs will affect clozapine?
     * Where can I get more information?

What is clozapine?

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

   Clozapine is used to treat severe schizophrenia, or to reduce the
   risk of suicidal behavior in people with schizophrenia or similar
   disorders.

   Clozapine is available only from a certified pharmacy under a special
   program.

   Clozapine may also be used for purposes not listed in this medication
   guide.

What are the possible side effects of clozapine?

   Get emergency medical help if you have signs of an allergic reaction:
   hives, skin pain, rash that spreads and causes blistering or peeling;
   difficult breathing; swelling of your face, lips, tongue, or throat.

   Serious and sometimes fatal infections may occur during treatment with
   clozapine. Call your doctor right away if you have signs of infection
   such as: weakness, fever, swollen gums, sore throat, painful
   mouth sores, pain when swallowing, skin sores, cold or flu
   symptoms, cough, trouble breathing.

   High doses or long-term use of clozapine can cause a serious movement
   disorder that may not be reversible. Symptoms of this disorder include
   uncontrollable muscle movements of your lips, tongue, eyes, face, arms,
   or legs. The longer you take clozapine, the more likely you are to
   develop a serious movement disorder. The risk of this side effect is
   higher in women and older adults.

   Also call your doctor at once if you have:
     * headache with chest pain and severe dizziness, pounding heartbeats
       or fluttering in your chest;
     * a light-headed feeling, like you might pass out;
     * sudden cough, rapid breathing, coughing up blood;
     * tight feeling in your neck or jaw, twitching or uncontrollable
       muscle movements;
     * a seizure (blackout-out or convulsions);
     * kidney problems--little or no urination, swelling in your feet or
       ankles, feeling tired or short of breath;
     * liver problems--nausea, upper stomach pain, loss of appetite,
       tiredness, confusion, unusual bleeding, dark urine,
       clay-colored stools, jaundice (yellowing of the skin or eyes);
     * severe nervous system reaction--very stiff (rigid) muscles, high
       fever, sweating, confusion, fast or uneven heartbeats, tremors,
       feeling like you might pass out;
     * high blood sugar--increased thirst, increased urination,
       hunger, dry mouth, fruity breath odor, drowsiness, dry skin,
       blurred vision, weight loss; or
     * signs of inflammation in your body--easy bruising or bleeding,
       severe tingling or numbness, muscle weakness, upper stomach pain,
       jaundice (yellowing of the skin or eyes), chest pain, new or
       worsening cough, trouble breathing.

   Common side effects may include:
     * weight gain;
     * tremor, dizziness, spinning sensation;
     * headache, drowsiness;
     * nausea, constipation;
     * dry mouth, or increased salivation;
     * blurred vision; or
     * fast heart rate, increased sweating.

   This is not a complete list of side effects and others may occur. Call
   your doctor for medical advice about side effects. You may report side
   effects to FDA at 1-800-FDA-1088.

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

   Call your doctor right away if you have: chest pain, trouble breathing,
   fluttering in your chest, signs of infection (weakness, fever, sore
   throat, cold or flu symptoms), or if you feel like you might pass out.

   Clozapine can cause severe dizziness, slow heartbeats, fainting, or
   seizures. Do not take more of this medicine than recommended.

   Clozapine is not approved for use in psychotic conditions related to
   dementia. Clozapine may increase the risk of death in older adults
   with dementia-related conditions.

   Clozapine is available only from a certified pharmacy under a special
   program.

   Clozaril Patient Information including How Should I Take
   Schizophrenia: Types, Causes, Symptoms, and Treatment

   Schizophrenia Slideshow Pictures
   RxList

   Take the Schizophrenia Quiz

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

   You should not take clozapine if you are allergic to it.

   Clozapine is not approved for use in psychotic conditions related to
   dementia. Clozapine may increase the risk of death in older adults with
   dementia-related conditions.

   To make sure clozapine is safe for you, tell your doctor if you have:
     * heart disease, high blood pressure, or history of heart
       attack or stroke (including "mini-stroke");
     * a personal or family history of long QT syndrome;
     * an electrolyte imbalance (such as low levels of potassium
       or magnesium in your blood);
     * a history of seizures, head injury, or brain tumor;
     * diabetes, or risk factors such as being overweight or
       having a family history of diabetes;
     * high cholesterol or triglycerides;
     * a bowel obstruction called paralytic ileus;
     * liver or kidney disease;
     * an enlarged prostate or urination problems;
     * glaucoma;
     * if you are malnourished or dehydrated; or
     * if you smoke.

   Tell your doctor if you are pregnant or plan to become pregnant during
   treatment. Taking antipsychotic medication during the last 3 months of
   pregnancy may cause problems in the newborn, such as withdrawal
   symptoms, breathing problems, feeding problems, fussiness, tremors, and
   limp or stiff muscles. However, you may have withdrawal symptoms or
   other problems if you stop taking your medicine during pregnancy. If
   you become pregnant while taking clozapine, do not stop taking it
   without your doctor's advice.

   Clozapine can pass into breast milk and may harm a nursing baby. You
   should not breast-feed while you are taking clozapine.

How should I take clozapine?

   Follow all directions on your prescription label. Your doctor may
   occasionally change your dose. Do not use this medicine in larger or
   smaller amounts or for longer than recommended.

   Clozapine can be taken with or without food.

   The orally-disintegrating tablet (FazaClo) can be taken without
   water. Keep the tablet in its blister pack until you are ready to take
   it. Open the package and peel back the foil. Do not push a tablet
   through the foil or you may damage the tablet. Use dry hands to remove
   the tablet and place it in your mouth. Do not swallow the tablet whole.
   Allow it to dissolve in your mouth without chewing. If desired, you may
   drink liquid to help swallow the dissolved tablet.

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

   Clozapine can lower blood cells that help your body fight infections,
   especially in women and older adults, and in people who are
   malnourished or have serious medical problems. This can make it easier
   for you to develop a serious or life-threatening infection. Your blood
   will need to be tested often. Your future treatments may be delayed
   based on the results of these tests.

   If you need surgery, tell the surgeon ahead of time that you are
   using clozapine. You may need to stop using the medicine for a short
   time.

   You should not stop using clozapine suddenly or you could have
   unpleasant withdrawal symptoms. Follow your doctor's instructions about
   tapering your dose.

   Clozapine can have long lasting effects on your body. You may need
   frequent medical tests for a short time after you stop using this
   medicine.

   Store at room temperature away from moisture and heat.

   Clozaril Patient Information including If I Miss a Dose
   Schizophrenia: Types, Causes, Symptoms, and Treatment

   Schizophrenia Slideshow Pictures
   RxList

   Take the Schizophrenia Quiz

What happens if I miss a dose?

   Take the missed dose as soon as you remember. Skip the missed dose if
   it is almost time for your next scheduled dose. Do not take extra
   medicine to make up the missed dose. If you miss taking clozapine for
   more than 2 days in a row, call your doctor before you start taking it
   again.

What happens if I overdose?

   Seek emergency medical attention or call the Poison Help line at
   1-800-222-1222.

What should I avoid while taking clozapine?

   Clozapine can cause severe dizziness, slow heartbeats, fainting, or
   seizures. Do not take more of this medicine than recommended. Be
   careful if you drive or do anything that requires you to be alert.
   Avoid getting up too fast from a sitting or lying position, or you may
   feel dizzy. Dizziness or severe drowsiness can cause falls, fractures,
   or other injuries.

   Avoid drinking alcohol. Dangerous side effects could occur.

What other drugs will affect clozapine?

   Clozapine can cause a serious heart problem, especially if you use
   certain medicines at the same time. Tell your doctor about all
   medicines you use, and those you start or stop using during your
   treatment with clozapine.

   Taking clozapine with other drugs that make you sleepy or slow your
   breathing can cause dangerous or life-threatening side effects. Ask
   your doctor before taking a sleeping pill, narcotic pain medicine,
   prescription cough medicine, a muscle relaxer, or medicine for anxiety,
   depression, or seizures.

   Many drugs can interact with clozapine. Not all possible interactions
   are listed here. Tell your doctor about all your current medicines and
   any you start or stop using, especially:
     * dolasetron, methadone, probucol, tacrolimus;
     * an antibiotic--ciprofloxacin, enoxacin, erythromycin,
       pentamidine, rifampin;
     * an antidepressant--citalopram, escitalopram,
       fluoxetine, fluvoxamine, paroxetine, sertraline;
     * anti-malaria medication--mefloquine, halofantrine;
     * heart rhythm medicine--amiodarone, encainide, flecainide,
       procainamide, propafenone, quinidine, sotalol;
     * medicine to treat a psychiatric disorder--chlorpromazine,
       droperidol, haloperidol, iloperidone, pimozide,
       thioridazine, ziprasidone; or
     * seizure medication--carbamazepine, phenytoin.

   This list is not complete and many other drugs can interact with
   clozapine. This includes prescription and over-the-counter medicines,
   vitamins, and herbal products. Give a list of all your medicines to any
   healthcare provider who treats you.

Where can I get more information?

   Your pharmacist can provide more information about clozapine.
     __________________________________________________________________

   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.