Clozapine (Systemic)

Brand Names : Clozaril, Leponex

Before Using This Medicine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For clozapine, the following should be considered:

Allergies - Tell your doctor if you have ever had any unusual or allergic reaction to clozapine. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy - Clozapine has not been studied in pregnant women. However, clozapine has not been shown to cause birth defects or other problems in animal studies.

Breast-feeding - Clozapine may pass into breast milk and cause drowsiness, trouble in nursing, restlessness or irritability, convulsions (seizures), or heart or blood vessel problems in nursing babies.

Children - Studies on this medicine have been done only in adult patients, and there is no specific information comparing use of clozapine in children with use in other age groups.

Older adults - Many medicines have not been tested in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults. Clozapine may be more likely to cause side effects in the elderly, including dizziness and fainting, low blood pressure, and confusion or excitement.

Other medicines - Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking clozapine, it is especially important that your health care professional know if you are taking any of the following:

• Alcohol or
• Central nervous system (CNS) depressants (medicines that cause drowsiness) or
• Tricyclic antidepressants (amitriptyline [e.g., Elavil], amoxapine [e.g., Asendin], clomipramine [e.g., Anafranil], desipramine [e.g., Pertofrane], doxepin [e.g., Sinequan], imipramine [e.g., Tofranil], nortriptyline [e.g., Aventyl], protriptyline [e.g., Vivactil], trimipramine [e.g., Surmontil]) - Using these medicines or alcohol with clozapine may cause increased drowsiness, low blood pressure, or trouble in breathing

• Amantadine (e.g., Symmetrel) or
• Antihypertensives (high blood pressure medicine) or
• Antipsychotics (medicine for mental illness) or
• Bromocriptine (e.g., Parlodel) or
• Certain eye drops used to treat glaucoma (carteolol [e.g., Ocupress], levobunolol [e.g., Betagan], metipranolol [e.g., OptiPranolol], timolol [e.g., Timoptic]) or
• Diuretics (water pills) or
• Levodopa (e.g., Dopar) or
• Medicine for heart disease or
• Nabilone (e.g., Cesamet) (with high doses) or
• Narcotic pain medicine or
• Pentamidine (e.g., Pentam) or
• Pimozide (e.g., Orap) or
• Promethazine (e.g., Phenergan) or
• Trimeprazine (e.g., Temaril) - Using these medicines with clozapine may cause low blood pressure, which can cause dizziness or fainting

• Amphotericin B by injection (e.g., Fungizone) or
• Antineoplastics (cancer medicine) or
• Antithyroid agents (medicine for overactive thyroid) or
• Azathioprine (e.g., Imuran) or
• Chlorambucil (e.g., Leukeran) or
• Chloramphenicol (e.g., Chloromycetin) or
• Colchicine or
• Cyclophosphamide (e.g., Cytoxan) or
• Flucytosine (e.g., Ancobon) or
• Ganciclovir (e.g., Cytovene) or
• Interferon (e.g., Intron A, Roferon-A) or
• Mercaptopurine (e.g., Purinethol) or
• Methotrexate (e.g., Mexate) or
• Plicamycin (e.g., Mithracin) or
• Zidovudine (e.g., AZT, Retrovir) - Taking clozapine with any of these medicines may increase the chance that very serious blood problems will occur

• Lithium - Using clozapine with lithium may increase the chance that convulsions (seizures), confusion or problems with movement will occur

• Selective serotonin reuptake inhibitors (fluoxetine [e.g., Prozac], fluvoxamine [e.g., Luvox], paroxetine [e.g., Paxil], sertraline [e.g., Zoloft]) - These medicines can increase the blood levels of clozapine, which increases the chance that unwanted effects will occur

Other medical problems - The presence of other medical problems may affect the use of clozapine. Make sure you tell your doctor if you have any other medical problems, especially:

• Blood diseases or
• Enlarged prostate or difficult urination or
• Gastrointestinal problems or
• Glaucoma, narrow angle or
• Heart or blood vessel problems - Clozapine may make these conditions worse

• Epilepsy or other seizure disorder - Clozapine may increase the chance that seizures will occur

• Kidney or liver disease - Higher blood levels of clozapine may occur, increasing the chance that unwanted effects will occur