Medications
Clozapine - Clozaril
CLOZARIL is an at typical antipsychotic indicated for:
• Treatment-resistant schizophrenia. Efficacy was established in an active controlled study.
• Reducing suicidal behavior in patients with schizophrenia or schizoaffective disorder. Efficacy was established in an active-controlled study.
Most common adverse reactions (≥5%) were:
CNS reactions: (sedation, dizziness/vertigo, headache, and tremor);
cardiovascular reactions: (tachycardia, hypotension, and syncope); autonomic nervous system reactions
(hyper salivation, sweating, dry mouth, and visual disturbances) ;
gastrointestinal reactions (constipation, nausea and fever);
Concomitant use of Strong CYP1A2 Inhibitors:
Reduce CLOZARIL do set o one-third when co administered with strong CYP1A2 inhibitors (e.g., fluvoxamine, ciprofloxacin, enoxacin).
Concomitant use of Strong CYP3A4 Inducers is not recommended.
Discontinuation of CYP1A2 or CYP3A4 Inducers: Consider reducing CLOZARIL dose when CYP1A2 (e.g., tobacco smoke) or CYP3A4 inducers (e.g., carbamazepine) are discontinued.
• Eosinophilia: Assess for organ involvement (e.g., myocarditis, pancreatitis, hepatitis, colitis, nephritis).Discontinue if these occur.
• QT Interval Prolongation: Can be fatal. Consider additional risk factors for prolonged QT interval (disorders and drugs).
• Metabolic Changes: Atypical antipsychotic drugs have been associated with metabolic changes that may increasecardiovascular/cerebrovascular risk.
These metabolic changes include:
• Hyperglycemia and Diabetes Mellitus: Monitor for symptoms of hyperglycemia including polydipsia, polyuria, polyphagia, and weakness. Monitor glucose regularly in patients with diabetes or at risk for diabetes.
• Dyslipidemia: Undesirable alterations in lipids have occurred in patients treated with atypical antipsychotics.
• Weight Gain: Significant weight gain has occurred. Monitor weight gain.
