Clozapine Side Effects

Severe Side effects

• If you experience weakness; extreme tiredness, fever, sore throat, chills, or other sings of flu or infection, or sores in your mouth, immediately inform your doctor.
• Clozapine may cause a severe reduction in blood white cell count, a condition known as agranulocytosis, in about 1 in 100 patients who are on this medication for at least a year.
• Patients received higher doses of clozapine are more susceptible to seizures that have occurred in 1 out of every 20 to 20 patients.
• Symptoms of dizziness can be a sign of orthostatic hypotension, a marked decrease in blood, which may occur in 1 of 5 patients. It occurs when going from a lying or sitting position to a standing position. This reaction is most common during the first few weeks of therapy while the dose is being increased to find optimal dosage, when drug is stopped briefly, or when patients are also taking benzodiazepines such as diazepam (Valium) or other anti-psychotic drugs.
• Clozapine may cause myocarditis, swelling of the heart muscle that may be dangerous. Inform your doctor immediately if you have extreme tiredness, difficulty breathing or fast breathing, fever chest pain; or fast, irregular, or pounding heartbeat.

Common Side effects

• Drowsiness and tremors.
• Increased salivation
• Headache and fever symptoms.
• Low blood pressure and increased heart rate.
• In approximately 14% of patients clozapine slows intestine which leads to constipation.

Warnings & Recalls for Clozapine

Black Box Warnings

A Black box warning has been put into effect for serious adverse effects such as: agranulocytosis, seizures, myocarditis, other adverse cardiovascular and respiratory effects, and increased mortality in elderly patients with dementia-related psychosis. Clozapine may cause a serious blood condition.

Warnings

May cause heart failure, sudden death, or pneumonia in older adults that have dementia-related conditions. Do not take this medicine if you are allergic to it or have untreated or uncontrolled epilepsy, a bone marrow disorder, paralytic ileus or intestinal blockage, a history of infections cause by taking this medication, or are using any drugs that can weaken your immune system, such as cancer medicine or steroids. Alcohol can increase the drowsiness felt when taking this medication. Tobacco can decrease the effectiveness of this medication.

Drug interactions

Risperidone (Risperal) can cause the amount of clozapine to increase in the blood stream. Which can lead to an increased risk of side effects from clozapine.

Do not take clozapine if you have:

• lung disease;
• glaucoma;
• diabetes;
• epilepsy or other seizure disorder;
• heart disease, heart rhythm disorder, high blood pressure;
• if you smoke;
• an enlarged prostate or urination problems;
• a history of bone marrow or blood cell disorders;
• history or heart attack or stroke;
• a personal or family history of Long QT syndrome; or
• liver or kidney disease

Family planning

The FDA categorized clozapine as a category B pregnancy. Be sure to tell your doctor if you are pregant or plan to become pregnant during treatment. Being on anti-psychotic during the last 3 months of pregnancy can cause issues for newborns such as withdrawal symptoms, fussiness, breathing problems, tremors, feeding problems, and limp or stiff muscles. However, you may have withdrawal symptoms or other problems if you suddenly stop taking the medication during pregnancy. If you become pregnant while on clozapine, don't stop taking your medication without your doctor's advice. Do not breast feed while on this medication as Clozapine can pass through the breastmilk, and may harm a nursing baby.

Clozapine Treatment and Use

What is Clozapine

Clozapine is an antipychotic medication that works by changing the actions of the chemicals in the brain. It’s used to treat severe schizophrenia and to reduce the risk of suicidal behavior in people with schizophrenia or similar disorders. It is in a class of medications called atypical anti-psychotics, usually given when all other venues have been looked into without success. This medication only controls schizophrenia but does not cure it.

How does Clozapine work?

Clozapine exerts potent anticholinergic, adrenolytic, antihistaminic and antiserotoninergic activity. The absorption of the medication that is orally administered is 90 to 95%. It works by blocking receptors in the brain for several neurotransmitters, chemicals that nerves use to communicate with each other, including dopamine type 4 receptors, histamine receptors, serotonin type 2 receptors and norepinephrine receptors.

Dosage information

Take exactly as directed by your doctor, no less or more or for longer than recommended. Make sure to follow the directions on your prescription label. It can be taken with or without food.

Take the regular oral tablet (Clozaril) with a full glass of water. Clozapine is given once, twice, or three times daily, with the dosage increasing slowly until optimal dose is found.

The orally disintegrating tablet shouldn’t be pushed through the foil, but instead the foil should be peeled back. The pill should immediately be placed on your tongue which will quickly dissolve. Take the medication around the same time(s) each every day.

Continue taking the medication even when you feel well. Do not stop taking Clozapine without talking to your doctor, who will gradually decrease the dose.

Other Names for Clozapine

Brand name

Clozaril

FazaClo

Clopine

CloZAPine Synthon

Denzapine

Zaponex

Lawsuits & Legal Information for Clozapine