Clozapine (By mouth)

Introduction

Clozapine (KLOE-za-peen)

Treats schizophrenia. Also used to prevent risk of suicidal behavior from occurring again in patients with schizophrenia or schizoaffective disorder.

Brand Name(s)

There may be other brand names for this medicine.

Clozaril, FazaClo

When This Medicine Should Not Be Used

You should not use this medicine if you have had an allergic reaction to clozapine. You should not use this medicine if you have certain blood problems, a bone marrow disorder, uncontrolled seizures (epilepsy), bowel blockage, certain nervous system problems, or certain heart problems. Do not breastfeed while you are using this medicine.

How to Use This Medicine

Tablet, Dissolving Tablet

  • Your doctor will tell you how much of this medicine to use and how often. Your dose may need to be changed several times in order to find out what works best for you. Do not use more medicine or use it more often than your doctor tells you to.
  • You may take this medicine with or without food.
  • Drink extra fluids so you will pass more urine while you are using this medicine. This will keep your kidneys working well and help prevent kidney problems.
  • If you are using the disintegrating tablet, make sure your hands are dry before you handle the tablet. Do not open the blister pack that contains the tablet until you are ready to take it. Remove the tablet from the blister pack by peeling back the foil, then taking the tablet out. Do not push the tablet through the foil. Place the tablet in your mouth. It should melt quickly. After the tablet has melted, swallow or take a drink of water. The disintegrating tablets may also be chewed.

If a dose is missed:

  • If you miss a dose or forget to use your medicine, use it as soon as you can. If it is almost time for your next dose, wait until then to use the medicine and skip the missed dose. Do not use extra medicine to make up for a missed dose.
  • If for any reason you stop taking clozapine for longer than 2 days, do not start back on the same dose. Ask your doctor what dose you should take.

How to Store and Dispose of This Medicine

  • Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.
  • Ask your pharmacist, doctor, or health caregiver about the best way to dispose of any leftover medicine after you have finished your treatment. You will also need to throw away old medicine after the expiration date has passed.
  • Keep all medicine away from children and never share your medicine with anyone.

Drugs and Foods to Avoid

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

  • There are many other drugs that can interact with clozapine. Make sure your doctor knows about all other medicines you are using.
  • Make sure your doctor knows if you are using carbamazepine (Tegretol®), cimetidine (Tagamet®), ciprofloxacin (Cipro®), erythromycin (Ery-tab®), fluvoxamine (Luvox®), paroxetine (Paxil®), phenytoin (Dilantin®), quinidine, or rifampin (Rifadin®, Rimactane®). Tell your doctor if you are using atropine, dicyclomine (Bentyl®), glycopyrrolate (Robinul®), hyoscyamine (Cystospaz®), propantheline (Pro-Banthine®), or scopolamine (Transderm Scop®).
  • Make sure your doctor knows if you are also using medicine to lower blood pressure (such as atenolol, hydrochlorothiazide [HCTZ], lisinopril, metoprolol, quinapril, Accupril®, Cozaar®, Diovan®, Lotrel®, Norvasc®, Toprol®, or Zestril®) or medicine for heart rhythm problems (such as flecainide, encainide, propafenone, Rythmol®, or Tambocor®).
  • Tell your doctor if you are also using other medicine to treat mental illness (such as chlorpromazine, haloperidol, risperidone, thioridazine, Haldol®, Mellaril®, Risperdal®, or Thorazine®), medicine to treat anxiety (such as alprazolam, clonazepam, Ativan®, Valium®, or Xanax®), medicine for nausea or vomiting (such as prochlorperazine, promethazine, Compazine®, or Phenergan®), or medicine to treat depression (such as citalopram, fluoxetine, sertraline, venlafaxine, Celexa®, Effexor®, Prozac®, or Zoloft®). Tell your doctor if you are smoking tobacco or drinking caffeine-containing products.
  • Tell your doctor if you are using any medicines that make you sleepy. These include sleeping pills, cold and allergy medicine, narcotic pain relievers, and sedatives.
  • Do not drink alcohol while you are using this medicine.

Warnings While Using This Medicine

  • Make sure your doctor knows if you are pregnant or if you ever had neuroleptic malignant syndrome (NMS). Tell your doctor if you have kidney disease, liver disease (including hepatitis), blood vessel problems, heart disease, heart failure, heart rhythm problems, low blood pressure, lung disease, an enlarged prostate, or a problem with your bowels (such as constipation). Tell your doctor if you have glaucoma, if you have ever had a head injury, or if you have a history of seizures or stroke.
  • Tell your doctor if you have diabetes, because this medicine may raise your blood sugar.
  • Tell your doctor if you have phenylketonuria. The orally disintegrating tablet contains phenylalanine, which can make this condition worse.
  • This medicine lowers the number of some types of blood cells in your body. Because of this, you may bleed or get infections more easily. To help with these problems, avoid being near people who are sick or have infections. Wash your hands often. Stay away from rough sports or other situations where you could be bruised, cut, or injured. Brush and floss your teeth gently. Be careful when using sharp objects, including razors and fingernail clippers.
  • This medicine can cause drowsiness or seizures. Avoid driving, swimming, climbing, using machines, or doing anything else that could be dangerous if you are not alert. You may also feel lightheaded when getting up suddenly from a lying or sitting position, so stand up slowly.
  • Stop using this medicine and contact your doctor as soon as possible if you have chest pain or discomfort, a fast heartbeat, trouble breathing, or fever and chills. These can be symptoms of a very serious problem with your heart.
  • Your doctor will need to check your blood at regular visits while you are using this medicine. Be sure to keep all appointments. If you do not have your scheduled blood test, you may not be given your next week's supply of this medicine.
  • This medicine is not approved to treat behavior disorders in older people who have dementia. Using this medicine to treat this problem could increase the risk of death. This risk has not been shown for the approved uses of this medicine.
  • Stop using this medicine and contact your doctor as soon as possible if you have chest pain or discomfort, a fast heartbeat, trouble breathing, or fever and chills. These can be symptoms of a very serious problem with your heart.
  • Check with your doctor right away if you are having convulsions (seizures); difficulty with breathing; fast heartbeat; high fever; high or low blood pressure; increased sweating; loss of bladder control; severe muscle stiffness; unusually pale skin; or tiredness. These could be symptoms of a serious condition called neuroleptic malignant syndrome (NMS).
  • Tardive dyskinesia (a movement disorder) may occur and may not go away after you stop using the medicine. Stop using this medicine and check with your doctor right away if you have any of the following symptoms while taking this medicine: lip smacking or puckering, puffing of the cheeks, rapid or worm-like movements of the tongue, uncontrolled chewing movements, or uncontrolled movements of the arms and legs.
  • Stop using this medicine and check with your doctor right away if you have pain or tenderness in the upper stomach; pale stools; dark urine; loss of appetite; nausea; unusual tiredness or weakness; or yellow eyes or skin. These could be symptoms of a serious liver problem.
  • Make sure any doctor or dentist who treats you knows that you are using this medicine. You may need to stop using this medicine several days before having surgery or medical tests.
  • Do not stop using this medicine suddenly without asking your doctor. You may need to slowly decrease your dose before stopping it completely.

Possible Side Effects While Using This Medicine

Call your doctor right away if you notice any of these side effects:

  • Keep all medicine away from children and never share your medicine with anyone.
  • Blistering, red, or peeling skin rash.
  • Constant muscle movement that you cannot control, often in your face, lips, tongue, jaw, arms, or legs.
  • Dark-colored urine or pale stools.
  • Fever with chills, cough, sore throat, and body aches.
  • Fever with sweating, confusion, uneven heartbeat, or muscle stiffness.
  • Lightheadedness, dizziness, or fainting.
  • Nausea, vomiting, loss of appetite, or pain in your upper stomach.
  • Pain in your lower leg (calf).
  • Seizures or tremors.
  • Swelling in your hands, ankles, or feet.
  • Weak and rapid heartbeat, tiredness, chest pain, fever, or trouble breathing.
  • Yellowing of your skin or the whites of your eyes.

If you notice these less serious side effects, talk with your doctor:

  • Blurred vision or vision problems.
  • Constipation, upset stomach.
  • Dry mouth, increased sweating.
  • Excess saliva or drooling.
  • Feeling of constant movement of self or surroundings.
  • Headache.
  • Sleepiness or unusual drowsiness.
  • Trouble sleeping.
  • Weight gain.

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088

Review Date: 2011-02-04 Reviewed By: Keywords: ,
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