$Unique_ID{BRK03102}
$Pretitle{}
$Title{clozapine}
$Subject{Clozaril Sandoz Antipsychotic clozapine schizophrenia monitor blood}
$Volume{}
$Log{}

Copyright (C) 1993 Publications International, Ltd.


clozapine
------------------------------------------------------------------------------

BRAND NAME (Manufacturer)

     Clozaril (Sandoz)

TYPE OF DRUG

     Antipsychotic

INGREDIENT

     clozapine

DOSAGE FORM

     Tablets (25 mg and 100 mg)

STORAGE

     Clozapine tablets should be stored at room temperature in the unit-dose
packages provided by the manufacturer.

USES

     Clozapine is prescribed for the treatment of schizophrenia in patients
who have not been helped by or could not tolerate other medications.  It is
available only through pharmacies that agree to participate with your doctor
in a program to monitor your blood.  The program, which your doctor will
arrange, provides a week's supply of the drug at the time that blood is drawn
for testing.

TREATMENT

     To avoid stomach irritation, you can take this medication with a meal or
a glass of water or milk (unless your doctor directs you to do otherwise).
     If you miss a dose of this medication, take the missed dose as soon as
possible, then return to your regular dosing schedule.  If it is almost time
for the next dose, however, skip the one you missed and return to your regular
schedule.  Do not double the next dose (unless your doctor directs you to do
otherwise).
     The full effects of this medication for the control of emotional or
mental symptoms may not become apparent for two weeks after you start to take
it.

SIDE EFFECTS

     Minor.

     Abdominal discomfort, constipation, dizziness, drowsiness, dry mouth,
headache, heartburn, increased saliva production, light-headedness, nausea,
vomiting, or weight gain.  As your body adjusts to the medication, these side
effects should disappear.
     If you are constipated, increase the amount of fiber in your diet (fresh
fruits and vegetables, salads, bran, and whole-grain breads), exercise, and
drink more water (unless your doctor directs you to do otherwise).
     Chew sugarless gum or suck on ice chips or a piece of hard candy to
reduce mouth dryness.
     To avoid dizziness or light-headedness when you stand, contract and relax
the muscles of your legs for a few moments before rising.  Do this by pushing
one foot against the floor while raising the other foot slightly, alternating
feet so that you are "pumping" your legs in a pedaling motion.

     Major.

     Tell your doctor about any side effects that are persistent or
particularly bothersome.  IT IS ESPECIALLY IMPORTANT TO TELL YOUR DOCTOR about
anxiety, blurred vision, chest pain, chills, confusion, convulsions,
difficulty in urinating, fainting, fever, increased sweating, loss of bladder
control, mouth sores, muscle stiffness, nightmares, rapid heart rate, rash,
restlessness, severe headache, sore throat, tremor, trouble sleeping, or
unusual bleeding or bruising.

INTERACTIONS

     Clozapine antipsychotic medication interacts with several other types of
medications:
     1. It can cause extreme drowsiness when combined with alcohol or other
central nervous system (brain and spinal cord) depressants, such as
barbiturates, benzodiazepine tranquilizers, muscle relaxants, phenothiazine
tranquilizers, narcotics, and pain medications, or with tricyclic
antidepressants.
     2. Lithium may increase the side effects of this drug.
     3. The effect of clozapine on blood cells may be increased by other
drugs, such as antineoplastics (cancer medicine), antithyroid drugs,
azathioprine, chloramphenicol, colchicine, flucytosine, interferon, and
zidovudine.
     4. The side effects of digoxin, phenytoin, and warfarin may be increased
by this medication.
     Before starting to take clozapine, BE SURE TO TELL YOUR DOCTOR about any
other medications you are currently taking, especially if they are any of
those listed above.

WARNINGS

     * Be sure to tell your doctor about unusual or allergic reactions you
have had to any medications, especially to clozapine.
     * Tell your doctor if you have a history of alcoholism or if you now have
or have ever had blood disease, depression, enlarged prostate,
gastrointestinal problems, glaucoma, heart or circulatory disease, liver
disease, or seizures.
     * To avoid oversedation, avoid drinking alcoholic beverages while taking
this medication.
     * If this drug makes you dizzy or drowsy, do not take part in any
activity that requires alertness, such as driving a car or operating
potentially dangerous equipment.  Be careful on stairs, and avoid getting up
suddenly from a lying or sitting position.
     * Do not stop taking this medication suddenly.  Your doctor may want to
gradually reduce the amount you are taking before stopping the drug.  Be sure
to consult your doctor before stopping this medication.
     * It is very important that you have your blood tested weekly and that
you have your doctor check your progress regularly.  You can only receive the
drug after your blood is drawn and a test is conducted.  The results of your
blood tests will assist your doctor in making safe dosage adjustments for you.
     * Be sure to tell your doctor if you are pregnant.  Although clozapine
appears to be safe in animals, extensive studies in humans have not been
conducted.  Also, it is very important that you tell your doctor if you are
breast-feeding an infant.  Small amounts of this medication pass into breast
milk.

----------------

The material contained here is "FOR INFORMATION ONLY" and should not replace
the counsel and advice of your personal physician.  Promptly consulting your
doctor is the best path to a quick and successful resolution of any medical
problem.