Brand Name: Clozaril (not available in generic)

Manufacturer: Novartis Pharmaceuticals

Description: An atypical antipsychotic.  Mechanism of action is unknown.

Indications and Use: Clozaril is indicated for the management of severely ill schizophrenics who fail to respond adequately to at least two standard antipsychotic agents, either because of insufficient effectiveness or the inability to achieve an effective dose due to intolerable side effects from those drugs.

Contraindications, Warnings, and Precautions: Clozaril may cause three very serious medical conditions, including agranulocytosis, seizures and orthostatic hypotension. Agranulocytosis is defined as a neutrophil count of less than 500/mm3. Agranulocytosis puts the patient at risk for severe infections and can be fatal. Signs of agranulocytosis include flu-like symptoms, fever, chills, sore throat, mouth or throat ulceration, lethargy, weakness, malaise, urinary frequency or burning, vaginal or rectal ulceration. Notify your doctor immediately if these symptoms occur. To avoid agranulocytosis, patients on Clozaril must have blood drawn weekly to monitor the white blood count. Clozaril can only be prescribed in one week increments because your doctor and your pharmacy must review the bloodwork before authorizing a refill. There is even a National Registry which keeps track of the white blood counts of every patient on Clozaril. Clozaril has very potent anticholinergic effects and great care should be exercised when using this drug for a patient that has narrow angle glaucoma or prostatic enlargement. Clozaril may potentiate the hypotensive effects of anticholinergic effects of atropine-like drugs. The administration of epinephrine should be avoided in the treatment of drug induced hypotension.

Adverse Reactions: Clozaril may cause constipation, dizziness, sedation, headache, hypersalivation, tachycardia and weight gain.

Dosing Range: Up to 300 to 450mg per day. Cautious titration and a divided dosage schedule are necessary to reduce the risk of hypotension, sedation and seizure.

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© 2000 Red Oak Psychiatry Associates, P.A.    Updated 11/26/2007