Clozapine
Bipolar Disorder, Schizophrenia ... show more
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Drug Status
Government Approvals
US(FDA), UK(BNF)
WHO Essential Medicine
YES
Known Teratogen
NO
Pharmaceutical Class
Atypical Antipsychotic
Controlled Drug Substance
NO
Clozapine
Summary
Clozapine is primarily used to treat serious mental health conditions like schizophrenia and schizoaffective disorder. It's particularly effective for those who haven't responded well to other antipsychotic medications. It also helps to reduce the risk of suicidal thoughts and actions in people with these conditions.
Clozapine works by blocking certain receptors in the brain, including dopamine and serotonin receptors. This helps to reduce symptoms like hallucinations, delusions, and disorganized thinking. It also increases certain types of brain waves, which can improve mood and overall functioning.
The usual starting dose for adults is 12.5 mg once or twice daily. This can be gradually increased to a target of 300 mg to 450 mg per day. The maximum dose is 900 mg per day. Clozapine is taken orally.
Common side effects include drowsiness, dizziness, headaches, and shaking. Some people may also experience increased saliva, sweating, or dry mouth, difficulty seeing clearly, constipation, nausea, or fever. It can also cause weight gain and cognitive difficulties.
Clozapine should not be used by individuals with severe allergic reactions, bone marrow problems, heart conditions, liver or kidney disease, seizure disorders, or intestinal obstruction. It's also not recommended during pregnancy or breastfeeding unless advised by a doctor. Regular monitoring is essential during treatment.
Indications and Purpose
How does Clozapine work?
Clozapine is a unique antipsychotic medicine that is particularly effective in treating schizophrenia. It works by blocking certain receptors in the brain, including dopamine and serotonin receptors. Unlike other antipsychotics, clozapine does not significantly raise prolactin levels. It also has effects on brain activity, as it increases certain types of brain waves. Clozapine is broken down in the body and mainly eliminated through the urine and feces.
Is Clozapine effective?
Yes, clozapine is highly effective for individuals with treatment-resistant schizophrenia or other severe psychiatric conditions, especially when other antipsychotic medications have not been effective. It is known for significantly reducing symptoms such as hallucinations, delusions, and agitation. Clozapine is also beneficial for improving mood and preventing relapse in schizophrenia, but it may be associated with side effects, so close monitoring by a healthcare provider is essential.
What is Clozapine?
Clozapine is a medication used to treat serious mental health conditions like schizophrenia and schizoaffective disorder. It helps reduce the risk of suicidal thoughts and actions in people with these conditions who have a high chance of experiencing them again. Clozapine can also be used to treat seizures, but the higher the dose, the greater the risk of seizures. It's important to note that Clozapine can cause drowsiness, dizziness, and problems with balance and coordination. These side effects can increase the risk of falls.
Directions for Use
For how long do I take Clozapine?
Clozapine is typically used as a long-term treatment for conditions like treatment-resistant schizophrenia or to reduce the risk of recurrent suicidal behavior. Its duration of use depends on the individual's response and clinical needs. Many patients require ongoing treatment for years to manage symptoms effectively. The decision to continue or stop treatment should always be guided by a healthcare provider.
How do I dispose of Clozapine?
If you can, bring unused medicines to a drug take-back program or collection site at a pharmacy or hospital. They will dispose of this medicine properly so they don't harm people or the environment. If you can't find a take-back program, you can throw most medicines in the trash at home. But first, take them out of their original containers, mix them with something undesirable like used coffee grounds, seal the mixture in a plastic bag and throw it away.
How do I take Clozapine?
You can take Clozapine with or without food. It does not matter if you eat when you take this medicine.
How long does it take for Clozapine to start working?
Clozapine may take 1 to 2 weeks to start showing noticeable effects, such as improvement in symptoms like agitation, anxiety, or aggression. However, full therapeutic effects may take 6 to 12 weeks or longer. Since it’s used to treat conditions like schizophrenia and is usually prescribed when other antipsychotics are ineffective, it’s important to be patient and continue regular follow-ups with your healthcare provider during treatment.
How should I store Clozapine?
Store clozapine at room temperature (68°F to 77°F), in a tightly sealed container, and out of reach of children. Avoid storing in the bathroom due to moisture.
What is the usual dose of Clozapine?
The usual starting dose for adults is 12.5 mg once or twice daily. The dose can be increased gradually to a target of 300 mg to 450 mg per day, divided into multiple doses. The maximum dose is 900 mg per day. Clozapine is not approved for use in children, so there is no recommended dose for this age group.
Warnings and Precautions
Can Clozapine be taken safely while breastfeeding?
Clozapine, a medication, passes into breast milk. It can cause serious harm to a nursing baby, so it's important to weigh the risks and benefits carefully. If you're taking clozapine, you should stop breastfeeding or stop taking the medication. It's crucial for you to discuss this decision with your doctor, who can help you make the best choice for both you and your baby.
Can Clozapine be taken safely while pregnant?
Clozapine is generally not recommended during pregnancy unless absolutely necessary, as it may pose risks to the fetus, including low birth weight, respiratory issues, or withdrawal symptoms after birth. If clozapine is required for managing severe psychiatric conditions, your doctor will carefully weigh the potential risks and benefits. Always consult your healthcare provider to discuss alternatives or to manage risks if you are pregnant or planning to become pregnant while on clozapine.
Can I take Clozapine with other prescription drugs?
Clozapine can interact with several prescription drugs, which may affect its effectiveness or increase the risk of side effects. Some medications, like antidepressants, anticonvulsants, blood pressure medications, and medications that affect the liver, can alter clozapine levels in your body. Always inform your doctor about all other prescription medications you are taking to ensure they are safe to use together and avoid harmful interactions. Regular monitoring is essential while on clozapine.
Does Clozapine have adverse effects?
Adverse effects, which are unwanted or harmful reactions to a medicine, can occur when taking any medication. For this medicine, common adverse effects might include nausea, headache, dizziness, fatigue, and dry mouth. These effects can vary in how often they occur, but they are generally not severe. However, there are serious adverse effects that, although rare, need immediate medical attention. These might include severe allergic reactions, which can cause difficulty breathing or swelling, or signs of liver damage, such as yellowing of the skin or eyes. It's important to report any new or worsening symptoms to a healthcare provider. Never stop taking a medicine without first consulting with a healthcare professional, as they can provide guidance on how to manage side effects safely.
Does Clozapine have any safety warnings?
To determine if a medicine has safety warnings, you should first check the prescription information provided with the medicine. This information often includes a section on warnings and precautions. For example, if a medicine has a warning about causing drowsiness, the rationale is that it affects the central nervous system, which is the part of the body that controls most functions of the mind and body. The possible consequence is that it may impair your ability to drive or operate machinery safely. Symptoms to monitor include feeling unusually sleepy or having difficulty concentrating. If you experience these symptoms, it's important to avoid activities that require full alertness and consult your healthcare provider.
Is Clozapine addictive?
To determine if a medicine is addictive, we first need to know if it has habit-forming potential. If it does, this means the body can become dependent on it, which means needing more of the medicine to feel the same effects. This can happen because the brain gets used to the medicine and changes how it works. Signs of dependence include needing to take the medicine more often, feeling anxious or irritable without it, or using it even when it causes problems. To avoid addiction, follow the doctor's instructions carefully, don't take more than prescribed, and talk to a healthcare provider if you feel you need more of the medicine. If the medicine has no known potential for dependence or addiction, it's important to state this clearly, so users can feel reassured about its safety.
Is Clozapine safe for the elderly?
Older people need to start with a lower dose of clozapine, a medicine for mental health issues, because their bodies might not process it as well as younger people's. This is because older adults often have weaker livers, kidneys, or hearts, and may be taking other medications. They're also more likely to experience side effects like low blood pressure when standing up, a fast heart rate, and problems with urination or bowel movements. There's also a higher chance of a specific movement disorder (tardive dyskinesia) in older adults, particularly women. Doctors often adjust the dose based on how well the liver and kidneys are working. We don't know for sure if the medicine works differently in people over 65 compared to younger people.
Is it safe to drink alcohol while taking Clozapine?
Drinking alcohol while taking Clozapine can increase the risk of side effects such as drowsiness, dizziness, and difficulty concentrating. It may also impair judgment and coordination. Therefore, it is generally advised to avoid alcohol while taking Clozapine to ensure safety and effectiveness.
Is it safe to exercise while taking Clozapine?
Clozapine may cause side effects like dizziness, sedation, or orthostatic hypotension, which can affect your ability to exercise safely. If you experience these symptoms, it is important to exercise caution and consult your healthcare provider for advice on safe physical activity while taking Clozapine.
Is it safe to stop Clozapine?
To determine if it's safe to stop a medicine, first identify its purpose. If it's for managing a chronic condition like hypertension or diabetes, stopping it might lead to worsening symptoms or complications. For medicines providing symptomatic relief, stopping might cause symptoms to return. If it's for a temporary condition like an infection, stopping early might not fully resolve the issue. Some medicines can cause withdrawal symptoms or rebound effects, where symptoms return worse than before. Abruptly stopping certain medicines can be life-threatening, especially those affecting the heart or brain. Always consult a doctor before stopping any medicine to ensure it's safe and to discuss a proper plan for discontinuation if needed.
What are the most common side effects of Clozapine?
A side effect is an unwanted symptom caused by medical treatment. For this medicine, common side effects might include nausea, which is feeling sick to your stomach, dizziness, which is feeling lightheaded, headache, which is pain in your head, fatigue, which is feeling very tired, and dry mouth, which is when your mouth feels unusually dry. These side effects can vary in how often they occur. It's important to remember that when you start a new medicine, you might notice new symptoms. These could be unrelated to the medicine, temporary, or due to another health issue. Always talk to your healthcare provider before stopping any medicine, as they can help you manage side effects safely.
Who should avoid taking Clozapine?
Clozapine should be avoided by individuals with severe allergic reactions, bone marrow problems, heart conditions, liver/kidney disease, seizure disorders, or intestinal obstruction. It is also generally not recommended during pregnancy or breastfeeding unless advised by a doctor. Regular monitoring is important during treatment.
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