Brand
name: LOZAPIN
(Lozapin, Clozapine)
Pronounced: KLOH-zah-ril
Generic name: Clozapine
Why is Lozapin prescribed?
Lozapin is given to help people with severe schizophrenia who have
failed to respond to standard treatments. It is also used to help reduce
the risk of suicidal behavior in people with schizophrenia. Lozapin
is not a cure, but it can help some people return to more normal lives.
Most important fact about Lozapin without prescriptions
Even though it does not produce some of the disturbing side effects
of other antipsychotic medications, Lozapin may cause agranulocytosis,
a potentially lethal disorder of the white blood cells. Because of
the risk of agranulocytosis, anyone who takes Lozapin is required
to have a blood test once a week for the first 6 months. The drug is
carefully controlled so that those taking it must get their weekly
blood test before receiving the following week's supply of medication.
If your blood counts have been acceptable for the 6-month period, you
will need to have your blood tested only every other week thereafter.
Anyone whose blood test results are abnormal will be taken off Lozapin
either temporarily or permanently, depending on the results of an additional
4 weeks of testing.
How should you take Lozapin ?
Take Lozapin exactly as directed by your doctor. Because of the significant
risk of serious side effects associated with Lozapin, your doctor
will periodically reassess the need for continued Lozapin therapy.
Lozapin is distributed only through the Lozapin Patient Management
System, which ensures regular white blood cell testing, monitoring,
and pharmacy services prior to delivery of your next supply.
Lozapin may be taken with or without food.
If you miss a LOZAPIN (Clozaril, Clozapine) dose...
Take it as soon as you remember. If it is almost time for your next
dose, skip the one you missed and go back to your regular schedule.
Do not take 2 doses at once.
If you stop taking Lozapin for more than 2 days, do not start taking
it again without consulting your physician.
Storage instructions...
Store at room temperature.
Lozapin side effects
Side effects cannot be anticipated. If any develop or change in intensity,
inform your doctor as soon as possible. Only your doctor can determine
if it is safe for you to continue taking Lozapin.
The most feared side effect is agranulocytosis, a dangerous drop in
the number of a certain kind of white blood cell. Symptoms include
fever, lethargy, sore throat, and weakness. If not caught in time,
agranulocytosis can be fatal. That is why all people who take Lozapin
must have a blood test every week. About 1 percent develop agranulocytosis
and must stop taking the drug.
Seizures are another potential side effect, occurring in some 5 percent
of people who take Lozapin. The higher the dosage, the greater the
risk of seizures.
* Side effects may include:
Abdominal discomfort, agitation, blood disorders, confusion, constipation,
disturbed sleep, dizziness, drowsiness, dry mouth, fainting, fever, headache,
heartburn, high blood pressure, inability to sit down, loss or slowness of
muscle movement, low blood pressure, nausea, nightmares, rapid heartbeat
and other heart conditions, restlessness, rigidity, salivation, sedation,
sweating, tremors, vertigo, vision problems, vomiting, weight gain
Why should Lozapin not be prescribed?
Lozapin is considered a somewhat risky medication because of its
potential to cause agranulocytosis and seizures. It should be taken
only by people whose condition is serious, and who have not been helped
by more traditional antipsychotic medications such as Haldol or Mellaril.
You should not take Lozapin if:
* You have a bone marrow disease or disorder.
* You have epilepsy that is not controlled.
* You ever developed an abnormal white blood cell count while taking Lozapin.
* You are currently taking some other drug, such as Tegretol, that could cause
a decrease in white blood cell count or a drug that could affect the bone marrow.
* You have ever had an allergic reaction to any of its ingredients.
Special warnings about Lozapin
Lozapin can cause drowsiness, especially at the start of treatment.
For this reason, and also because of the potential for seizures, you
should not drive, swim, climb, or operate dangerous machinery while
you are taking Lozapin, at least in the early stages of treatment.
Even though you will have blood tests weekly for the first 6 months
of treatment and every other week after that, you should stay alert
for early symptoms of agranulocytosis: weakness, lethargy, fever, sore
throat, a general feeling of illness, a flu-like feeling, or ulcers
of the lips, mouth, or other mucous membranes. If any such symptoms
develop, tell your doctor immediately.
Especially during the first 3 weeks of treatment, you may develop
a fever. If you do, notify your doctor.
While taking Lozapin, do not drink alcohol or use drugs of any kind,
including over-the-counter medicines, without first checking with your
doctor.
If you take Lozapin, you must be monitored especially closely if
you have either the eye condition called narrow-angle glaucoma or an
enlarged prostate; Lozapin could make these conditions worse.
On rare occasions, Lozapin can cause intestinal problems--constipation,
impaction, or blockage--that can, in extreme cases, be fatal.
In very rare cases, Lozapin has been known to cause a potentially
fatal inflammation of the heart. This problem is most likely to surface
during the first month of treatment, but has also occurred later. Warning
signs include unexplained fatigue, shortness of breath, fever, chest
pain, and a rapid or pounding heartbeat. If you develop these symptoms,
see your doctor immediately. Even a suspicion of heart inflammation
warrants discontinuation of Lozapin.
Especially when you begin taking Lozapin, you may be troubled by
a dramatic drop in blood pressure whenever you first stand up. This
can lead to light-headedness, fainting, or even total collapse and
cardiac arrest. Lozapin also tends to increase your heart rate. Both
problems are more dangerous for someone with a heart problem. If you
suffer from one, make sure the doctor knows about it.
Also, if you have kidney, liver, or lung disease, or a history of
seizures or prostate problems, you should discuss these with your doctor
before taking Lozapin. Nausea, vomiting, loss of appetite, and a yellow
tinge to your skin and eyes are signs of liver trouble; call your doctor
immediately if you develop these symptoms.
Drugs such as Lozapin can sometimes cause a set of symptoms called
Neuroleptic Malignant Syndrome (NMS). Symptoms include high fever,
muscle rigidity, irregular pulse or blood pressure, rapid heartbeat,
excessive perspiration, and changes in heart rhythm. Your doctor will
have you stop taking Lozapin while this condition is being treated.
There is also a risk of developing tardive dyskinesia, a condition
of involuntary, slow, rhythmical movements. It happens more often in
older adults, especially older women.
Lozapin has been known to occasionally raise blood sugar levels,
causing unusual hunger, thirst, and weakness, along with excessive
urination. If you develop these symptoms, alert your doctor. You may
have to switch to a different medication.
In very rare instances, Lozapin may also cause a blood clot in the
lungs. If you develop severe breathing problems or chest pain, call
your doctor immediately.
Possible food and drug interactions when taking Lozapin
If Lozapin is taken with certain other drugs, the effects of either
could be increased, decreased, or altered. It is especially important
to check with your doctor before combining Lozapin with the following:
Alcohol
Antidepressants such as Paxil, Prozac, and Zoloft
Antipsychotic drugs such as chlorpromazine and Mellaril
Blood pressure medications such as Aldomet and Hytrin
Caffeine
Chemotherapy drugs
Cimetidine (Tagamet)
Digitoxin (Crystodigin)
Digoxin (Lanoxin)
Drugs that depress the central nervous system such as phenobarbital
and Seconal
Drugs that contain atropine such as Donnatal and Levsin
Epilepsy drugs such as Tegretol and Dilantin
Epinephrine (EpiPen)
Erythromycin (E-Mycin, Eryc, others)
Fluvoxamine
Heart rhythm stabilizers such as Rythmol, quinidine, and Tambocor
Nicotine
Rifampin (Rifadin, Rimactane)
Tranquilizers such as Valium and Xanax
Warfarin (Coumadin)
Special information if you are pregnant or breastfeeding
The effects of Lozapin during pregnancy have not been adequately
studied. If you are pregnant or plan to become pregnant, inform your
doctor immediately. Lozapin treatment should be continued during pregnancy
only if absolutely necessary. You should not breastfeed if you are
taking Lozapin, since the drug may appear in breast milk.
Recommended dosage for Lozapin
ADULTS
Overdosage
Any medication taken in excess can have serious consequences. If you
suspect an overdose, seek emergency medical attention immediately.
* Symptoms of overdose with Lozapin may include:
Coma, delirium, drowsiness, excess salivation, low blood pressure, faintness,
pneumonia, rapid heartbeat, seizures, shallow breathing or absence of breathing
