ZIPIX
CLOZAPINE · by SHROOQ
Composition
Tab 25 mg/100 mg: Clozapine 25 mg/ 100 mg.
Indications & Dosage
Schizophrenia in patients unresponsive to, or intolerantof, conventional antipsychotic drugs: Adult 18-59 yrs: 12.5 mg 1-2 times a day for day 1,then 25-50 mg for day 2, then increased, if tolerated, in steps of 25-50 mg daily, dose to be increased gradually over 14-21 days, increased to up to 300 mg daily in divided doses, larger dose to be taken at night,up to 200mg daily may be taken as a single dose atbedtime; increased in steps of 50-100 mg preferably to increase once a week; usual dose 200-450 mg daily, max. 900mg perday, if restarting after interval of more than 48 hours, 12.5 mg once or twice on first day (but may be feasible to increase more quickly than on initiation). Adult 60 yrs and over: 12.5 mg once daily for day 1,then increased to 25-37.5 mg for day 2, then increased,if tolerated, in steps of up to 25 mg daily, dose to be increased gradually over 14-21 days, increased to up to300 mg daily in divided doses, larger dose at to be taken night, up to 200mg daily may be taken as a single dose at bedtime; increased in steps of 50-100 mg preferably to increase once a week; usual dose 200-450 mg daily, max. 900mg per day. Psychosis in Parkinsons disease: Adult: 12.5 mg once daily, dose to be taken at bedtime,then increased in steps of 12.5 mg up to twice weekly,adjusted according to response; usual dose 25-37.5 mg once daily, dose to be taken at bedtime; increased insteps of 12.5 mg once weekly, increased if necessary up to 100 mg daily in 1-2 divided doses; Usual max. 50 mg/24 hours.
Contraindications
Severe cardiac disorders(e.g. myocarditis), severe CNS depression, uncontrolledepilepsy, alcoholic and toxic psychoses, bone-marrow disorders,coma, drug intoxication, history of agranulocytosis, history of circulatory collapse, history of neutropenia,paralytic ileus
Precautions
Prostatic hypertrophy, susceptibility to angle-closure glaucoma, taper off other antipsychotics before starting; extreme caution if previous respiratory or cardiac arrest with initial dosing. Monitor leukocyte counts prior to treatment, then weekly during weeks 1-18, fortnightly for weeks 19-52, then every 4 weeks thereafter; withdraw immediately if low WBC count or low neutrophil count. Patients should report symptoms of infection. Use adequate contraception. Monitor patients with history ofepilepsy and liver disease.
Interactions
: Other drugs which depress bone marrow function; CNS depressants, alcohol, MAOIs, benzodiazepines, lithium, antihistamines, anticholinergics, hypotensives, warfarin, cimetidine, phenytoin.
Pregnancy
Caution advised
Lactation
Contraindicated
Side Effects
Anorexia, hypersalivation, agranulocytosis, constipation, malaise, speech disorders, urinary incontinence, hepatic disorders, hepatic failure, muscle disorders, renal failure. Rare: Circulatory collapse, dysphagia, hepatitis, myocarditis, pancreatitis, pericarditis, pneumonia, pulmonary aspiration