{"id":7763,"date":"2016-12-01T10:44:25","date_gmt":"2016-12-01T07:44:25","guid":{"rendered":"http:\/\/seragpsych.com\/wordpress\/?p=7763"},"modified":"2016-12-03T10:53:10","modified_gmt":"2016-12-03T07:53:10","slug":"clozapine-clozaril","status":"publish","type":"post","link":"https:\/\/seragpsych.com\/wordpress\/clozapine-clozaril\/","title":{"rendered":"Clozapine (Clozaril\u00ae)"},"content":{"rendered":"
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Clozapine (US brand names Clozaril\u00ae, Fazaclo\u00ae ODT,\u00a0Versacloz\u00ae,\u00a0and generic)\u00a0is a second-generation (\u201catypical\u201d) antipsychotic. Here is\u00a0basic information about this medication.<\/p>\n

FDA-approved indications<\/h4>\n

1. Treatment resistant schizophrenia<\/p>\n

2. Reducing suicidal behavior in patients with schizophrenia or schizoaffective disorder<\/p>\n

Dosage<\/h4>\n

Starting: 12.5 mg once or twice daily, with or without food<\/p>\n

Titration: Increase the total daily dosage in increments of 25 mg to 50 mg per day<\/p>\n

Target: 300 \u2013 450 mg per day, in divided doses, by the end of 2 weeks<\/p>\n

Subsequent increases: Increments of 100 mg or less, once or twice weekly<\/p>\n

Maximum: 900 mg daily<\/p>\n

Important instructions<\/p>\n

1. Clozapine can cause severe neutropenia. As a result clozapine is available only through a restricted program under a Risk Evaluation Mitigation Strategy (REMS) called the Clozapine REMS Program (see Related Pages below).<\/p>\n

Prior to initiating treatment with clozapine, a baseline ANC must be obtained. The baseline ANC must be at least 1500\/\u00b5L for the general population, and at least 1000\/\u00b5L for patients with documented Benign Ethnic Neutropenia (BEN). To continue treatment, the ANC must be monitored regularly.<\/p>\n

2. Dose adjustments may be necessary in patients with concomitant use of:<\/p>\n

Strong CYP1A2 inhibitors (e.g., fluvoxamine, ciprofloxacin, or enoxacin): Use 1\/3rd dose of clozapine<\/p>\n

Moderate or weak CYP1A2 inhibitors (e.g., oral contraceptives, or caffeine): Monitor for side effects and consider reducing the dose of clozapine if necessary.<\/p>\n

CYP2D6 or CYP3A4 inhibitors (e.g., cimetidine, escitalopram, erythromycin, paroxetine, bupropion, fluoxetine, quinidine, duloxetine, terbinafine, or sertraline); Monitor for side effects and consider reducing the dose of clozapine if necessary.<\/p>\n

Strong CYP3A4 inducers (carbamazepine, phenytoin, St. John\u2019s wort, and rifampin): Concomitant use of clozapine is not recommended. If necessary, consider increasing clozapine dose. Also, consider reducing the clozapine dosage when discontinuing co-administered enzyme inducers.<\/p>\n

Moderate or weak CYP1A2 (tobacco smoking) or CYP3A4 inducers: Monitor for decreased effectiveness. Consider increasing the clozapine dose if necessary.<\/p>\n

3. Seizures have occurred with clozapine treatment. The risk is dose-related. Use caution when administering clozapine to patients with a history of seizures or other predisposing risk factors for seizure.<\/p>\n

Dosage forms and strengths<\/h4>\n

Oral tablet (Clozaril\u00ae and generic): 25 mg (scored) and 100 mg (scored).\u00a0Generic also available in 12.5 mg, 50 mg, and 200 mg strengths.<\/p>\n

Orally disintegrating tablet (Fazaclo\u00ae ODT and generic): 12.5 mg, 25 mg, 100 mg, 150 mg, and 200 mg<\/p>\n

Oral suspension (Versacloz\u00ae): 50 mg\/mL<\/p>\n

Please refer to Prescribing Information (see link below) for complete discussion of dosage, administration, warnings and precautions, contraindications, etc.<\/p>\n

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Clozapine (US brand names Clozaril\u00ae, Fazaclo\u00ae ODT,\u00a0Versacloz\u00ae,\u00a0and generic)\u00a0is a second-generation (\u201catypical\u201d) antipsychotic. Here is\u00a0basic information about this medication. FDA-approved indications 1. Treatment resistant schizophrenia 2. Reducing suicidal behavior in patients with schizophrenia or schizoaffective disorder Dosage Starting: 12.5 mg once or twice daily, with or without food Titration: Increase the total daily dosage in increments […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[5,151],"tags":[],"class_list":["post-7763","post","type-post","status-publish","format-standard","hentry","category-5","category-151","entry"],"_links":{"self":[{"href":"https:\/\/seragpsych.com\/wordpress\/wp-json\/wp\/v2\/posts\/7763","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/seragpsych.com\/wordpress\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/seragpsych.com\/wordpress\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/seragpsych.com\/wordpress\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/seragpsych.com\/wordpress\/wp-json\/wp\/v2\/comments?post=7763"}],"version-history":[{"count":1,"href":"https:\/\/seragpsych.com\/wordpress\/wp-json\/wp\/v2\/posts\/7763\/revisions"}],"predecessor-version":[{"id":7764,"href":"https:\/\/seragpsych.com\/wordpress\/wp-json\/wp\/v2\/posts\/7763\/revisions\/7764"}],"wp:attachment":[{"href":"https:\/\/seragpsych.com\/wordpress\/wp-json\/wp\/v2\/media?parent=7763"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/seragpsych.com\/wordpress\/wp-json\/wp\/v2\/categories?post=7763"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/seragpsych.com\/wordpress\/wp-json\/wp\/v2\/tags?post=7763"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}