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Clozapine / ClozarilProper use of this medicine: * This medication is not addictive, and does not cause a 'high' feeling. * Take this medicine exactly as directed. Do not take more of it and do not take it more often than prescribed. Do not miss any doses. * If you do miss a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses. * Do not drink alcohol while taking this medication. * Cigarette smoking may interfere with the body's ability to use Clozapine. * If there is a possibility you may become pregnant or breast-feed while on this medication, first consult with your psychiatrist. * This medication should not be discontinued without first consulting with your psychiatrist. Serious symptoms may result from sudden discontinuation. * Store this medication in a cool, safe area away from the reach of children. Blood tests: * Clozapine can cause a low WBC in 1 - 2% of patients, which can cause serious problems. This usually occurs between 6-18 weeks after starting Clozapine. White Blood Cells help to fight infections. Your doctor will order weekly White Blood Counts (WBC) to monitor for this possibility. Contact your primary care physician if you develop a fever or other signs of infection while on Clozapine. Possible Side Effects include: * Increased saliva production: Most patients will get this side effect. Some tolerance develops after 8-12 weeks. Chewing sugarless gum may help. * Feeling tired, dizziness: Usually improves or goes away in 3-4 weeks. * Low blood pressure with standing: Usually improves with time. Discuss increasing the dose slower with your prescriber. * Heart beating faster: Usually does not cause serious problems. Tolerance may develop. * High Blood Pressure: (4%) * Fever: Call your doctor if this symptom develops. A blood count should be done any time a fever is present. (5%). * Constipation: Drink plenty of fluids. Increase fiber (fresh fruits [especially pineapple], oat and wheat bran, vegetables, etc.) in diet. Exercise regularly. * Weight gain: May occur with continued long-term use. Regular exercise (e.g. walking) may keep the weight down. * Nausea: Uncommon, but may occur after weeks or months of treatment. Call psychiatry if this develops. * Headache: Uncommon. Responds to over-the-counter analgesics (e.g. Acetaminophen/Tylenol, Aspirin, etc.). * Urinary problems/difficulty with sexual activity (uncommon). * Seizure: These have occurred in 1-2% of patients taking less than 300 mg/day, 3-4% taking 300-600 mg/day, and 5% over 600 mg/day. Contact your prescriber immediately if a seizure occurs. * Restlessness, tremors, stiffness, muscle spasms are uncommon, but can be treated. If the following combination of symptoms occurs, call the psychiatry department immediately: * Muscle tightness, significant fever, high or low blood pressure. The following medications should not be taken with Clozapine without first consulting with your psychiatrist: * Anti-anxiety medications (e.g. Lorazepam/Ativan, Diazepam/Valium, Alprazolam/Xanax, Clonazepam/Klonopin, etc.) * Cimetidine/Tagamet, Risperidone/Risperdal, Erythromycin, Fluoxetin/Prozac * Clozapine may lower oral contraceptive effectiveness. * Phenytoin/Dilantin, Carbamazepine/Tegretol, Propanolo/Inderol * Ritonavir/Norvir * Cigarette smoking may lower clozapine levels and effectiveness. * Nefazodone/Serzone |
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