Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Clozaril (Clozapine).
Blood Clots: Clozaril (Clozapine) may increase the chance of blood clot formation, causing reduction of blood flow to organs or the extremities.
If you have a history of clotting you may be at increased risk of experiencing blood clot-related problems such as heart attack, stroke, or clots in the deep veins of your leg. Discuss with your doctor how Clozaril (Clozapine) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Clozaril (Clozapine), and whether any special monitoring is needed.
If you experience symptoms such as sharp pain and swelling in the leg, difficulty breathing, chest pain, blurred vision, or difficulty speaking, contact your doctor immediately.
Blood disorders: Because of the significant risk of serious blood disorders, including life-threatening decrease in white blood cell counts, Clozaril (Clozapine) should only be used by people for whom other medications do not work or for whom other medications cause intolerable side effects.
Blood work must be performed weekly for the first 26 weeks of treatment, then every 2 weeks for the next 26 weeks, in order to monitor the effect of the medication on the number of white blood cells. After this time, blood tests should be done at least every 4 weeks and continue for 4 weeks after the medication is stopped. If you notice lethargy (a tired and groggy feeling), weakness, fever, sore throat, flu-like complaints, or any other signs of infection, contact a doctor immediately.
For safety reasons, lab test results are recorded in patient registries. A patient registry is a database of health-related information collected from people with a particular medical condition for the purposes of safety and research. Different drug companies that make Clozaril (Clozapine) have different registries. If you switch from one brand of Clozaril (Clozapine) to another, your name will be entered into a different registry, and it will make it difficult to monitor your history of Clozaril (Clozapine) use and your safety. To ensure that this does not happen, new information will be added to the Patient Registration Form. This will help improve the way your health information is collected and shared between registries.
Diabetes: Clozaril (Clozapine) may cause an increase in blood sugar levels and glucose tolerance may change. People with diabetes may find it necessary to monitor their blood sugar more frequently while using Clozaril (Clozapine).
If you have diabetes or are at risk for developing diabetes, discuss with your doctor how Clozaril (Clozapine) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Clozaril (Clozapine), and whether any special monitoring is needed.
Drowsiness/reduced alertness: Clozaril (Clozapine) may affect the mental or physical abilities needed to drive or operate machinery, particularly during the first few days of taking Clozaril (Clozapine). Avoid driving, operating machinery, or performing other hazardous tasks until you have determined how Clozaril (Clozapine) affects you.
Enlarged prostate: Clozaril (Clozapine) may worsen symptoms of an enlarged prostate, such as reduced urine flow. If you have a prostate condition, discuss with your doctor how Clozaril (Clozapine) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Clozaril (Clozapine), and whether any special monitoring is needed.
Glaucoma: People with glaucoma (increased pressure in the eyes) may find that Clozaril (Clozapine) makes the symptoms of glaucoma worse. If you have glaucoma, discuss with your doctor how Clozaril (Clozapine) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Clozaril (Clozapine), and whether any special monitoring is needed.
Heart and lung problems: Clozaril (Clozapine) may increase the risk of heart and lung problems. If you have heart disease, you should not use Clozaril (Clozapine). Get medical attention immediately if you notice chest pain; shortness of breath; fast, irregular, or pounding heartbeat; extreme fatigue; flu-like symptoms; unexplained fever; more noticeable neck veins when standing or sitting; or fainting.
Heart rhythm: Clozaril (Clozapine) can cause changes to the normal rhythm of the heart, including an irregular heartbeat called QT prolongation. QT prolongation is a serious, life-threatening condition that can cause fainting, seizures, and sudden death. If you are at risk for heart rhythm problems (e.g., if you have heart failure, Angina, or low potassium or magnesium levels), discuss with your doctor how Clozaril (Clozapine) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Clozaril (Clozapine), and whether any special monitoring is needed.
Interruption of treatment: If you stop taking Clozaril (Clozapine) for 2 days or more, do not restart your medication at the same dosage; contact your doctor for dosage instructions.
Kidney function: Kidney disease or reduced kidney function may cause Clozaril (Clozapine) to build up in the body, causing side effects. If you have reduced kidney function or kidney disease, discuss with your doctor how Clozaril (Clozapine) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Clozaril (Clozapine), and whether any special monitoring is needed.
Liver function: Clozaril (Clozapine) is broken down by the liver. Liver disease or reduced liver function may cause Clozaril (Clozapine) to build up in the body, causing side effects. If you have liver problems, discuss with your doctor how Clozaril (Clozapine) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Clozaril (Clozapine), and whether any special monitoring is needed. Your doctor may want to test your liver function regularly with blood tests while you are taking Clozaril (Clozapine).
Clozaril (Clozapine) may also cause a decrease in liver function. If you experience symptoms of liver problems such as fatigue, feeling unwell, loss of appetite, nausea, yellowing of the skin or whites of the eyes, dark urine, pale stools, abdominal pain or swelling, and itchy skin, contact your doctor immediately.
Low Blood Pressure: Extreme lowering of blood pressure when moving from a lying or sitting to a standing position, with or without loss of consciousness, can occur with Clozaril (Clozapine), especially at the beginning of therapy when doses are being increased. To reduce the possibility of this being problematic, rise slowly when rising from a sitting or lying position.
Movement disorder: People taking Clozaril (Clozapine) may develop tardive dyskinesia, a disorder of uncontrolled muscle movements, mainly in the face, tongue, mouth, or jaw. The risk increases with longer treatment and is higher in seniors, especially senior women. Tardive dyskinesia is more likely to be irreversible with long-term treatment (over 12 weeks). If you develop signs and symptoms of tardive dyskinesia, including sticking the tongue out, smacking the lips, pursing or puckering of lips, or other involuntary movements, contact your doctor as soon as possible.
Neuroleptic malignant syndrome: A rare but serious effect called neuroleptic malignant syndrome has been reported with antipsychotic medications such as Clozaril (Clozapine). You should monitor for the following symptoms: altered mental status, heart palpitations, high fever, irregular pulse or blood pressure, muscle rigidity (muscle stiffness), and sweating. If you notice these symptoms, contact your doctor immediately.
Seizures: Clozaril (Clozapine) may cause seizures. The dosing prescribed by the doctor should be carefully followed and activities requiring alertness (e.g., driving, operating machinery, swimming, climbing) should be avoided.
Pregnancy: Clozaril (Clozapine) should be used only if the benefits clearly outweigh the risks. If you become pregnant or intend to become pregnant while taking Clozaril (Clozapine), contact your doctor immediately.
Breast-feeding: Clozaril (Clozapine) may pass into breast milk. If you are a breast-feeding mother and are taking Clozaril (Clozapine), it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.
Children: The safety and efficacy of Clozaril (Clozapine) for use by children and adolescents below age 18 have not been established.
Seniors: People over the age of 60 years may have an increased risk of developing side effects from Clozaril (Clozapine). Studies with antipsychotic medications have shown that seniors with Dementia taking antipsychotic medications have an increased rate of death. Seniors with dementia should not take Clozaril (Clozapine).