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Clozapine Oral disintegrating tablet

What is this medicine?

CLOZAPINE (KLOE za peen) is used to treat schizophrenia. This medicine is only used when others have not worked. It has a risk of serious side effects and is only available through a monitoring and dispensing system that includes special doctors, pharmacists, and laboratories. For the first few months of treatment, you will be required to have routine blood testing before your prescription can be refilled.

How should I use this medicine?

Take this medicine by mouth. Follow the directions on the prescription label. These tablets are made to dissolve in the mouth. Place the tablet in the mouth and allow it to dissolve, then swallow. While you may take these tablets with water, it is not necessary to do so. This medicine may be taken with or without food. Take your doses at regular intervals. Do not take your medicine more often than directed. Do not suddenly stop taking this medicine. If your doctor wants you to stop the medicine, the dose will be slowly lowered over time to avoid any side effects.

The tablets should stay in the unopened blister package until immediately before you take your dose. If you split the tablet as part of your dose, the half-tablet that is not taken should be destroyed. Do not save this half-tablet for later use.

Talk to your pediatrician regarding the use of this medicine in children. Special care may be needed.

What side effects may I notice from receiving this medicine?

Side effects that you should report to your doctor or health care professional as soon as possible:

  • allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue

  • breathing problems

  • changes in vision

  • chest pain, fast or irregular heartbeat

  • confusion

  • difficulty sleeping, nightmares

  • excessive thirst and/or hunger

  • feeling faint or lightheaded, falls

  • fever, chills, sore throat, or mouth sores

  • muscle and joint aches and pains

  • nausea, vomiting, or severe loss of appetite

  • restlessness

  • seizures

  • stiffness, spasms, trembling

  • trouble passing urine or change in the amount of urine

  • trouble with balance, talking, walking

  • uncontrollable tongue or chewing movements, smacking lips or puffing cheeks

  • unusually weak or tired

  • yellowing of the eyes, skin

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):

  • constipation

  • dry mouth

  • headache

  • increased watering of the mouth, drooling

  • weight gain

What may interact with this medicine?

Do not take this medicine with any of the following medications:

  • certain antipsychotics like chlorpromazine, droperidol, mesoridazine, pimozide, thioridazine, ziprasidone

  • certain medicines used to treat infections like chloroquine, clarithromycin, erythromycin, pentamidine

  • certain medicines for irregular heart beat like amiodarone, disopyramide, dofetilide, ibutilide, procainamide, propafenone, quinidine, sotalol

  • cisapride

  • halofantrine

  • levomethadyl

  • medicines for treating cancer

  • medicines that lower your chance of fighting infection

  • methadone

  • probucol

This medicine may also interact with the following medications:

  • caffeine

  • carbamazepine

  • certain medicines used to treat infections like ciprofloxacin, gatifloxacin, mefloquine, moxifloxacin, sparfloxacin

  • certain medicines for psychotic disturbances

  • cimetidine

  • diuretics

  • dolasetron

  • general anesthesia

  • lithium

  • medicines for anxiety or sleeping problems, such as diazepam or temazepam

  • medicines for colds, hay fever, and other allergies

  • medicines for high blood pressure

  • medicines for mental depression, anxiety, or other mood problems

  • nicotine

  • phenytoin

  • rifampin or rifabutin

  • some medicines used to treat irregular heartbeats

  • tacrolimus

What if I miss a dose?

If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses. If you miss your medicine for more than 2 days, you should not restart your medicine at the same dose. Contact your doctor for instructions.

Where should I keep my medicine?

Keep out of the reach of children.

Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F). Keep the tablets in the packaging until the time of use. Protect from moisture. Throw away any unused medicine after the expiration date.

What should I tell my health care provider before I take this medicine?

They need to know if you have any of these conditions:

  • being treated for cancer

  • blood disease or disorder, like leukemia

  • constipation, fecal impaction, or a history of an obstruction of the intestine

  • dementia

  • diabetes

  • heart disease

  • history of irregular heartbeat

  • kidney disease

  • liver disease

  • low blood counts, like low white cell, platelet, or red cell counts

  • low levels of potassium or magnesium in the blood

  • lung or breathing disease, like asthma

  • Parkinson's disease

  • phenylketonuria

  • seizures

  • an unusual or allergic reaction to clozapine, other medicines, foods, dyes, or preservatives

  • pregnant or trying to get pregnant

  • breast-feeding

What should I watch for while using this medicine?

Visit your doctor or health care professional for regular checks on your progress. It may be several weeks before you see the full effects of this medicine. Contact your doctor or health care professional if your symptoms get worse or if you have new symptoms.

You must have a weekly blood test when you first begin this medicine. If your blood counts stay in the right range, your tests may be reduced after 6 months to every other week. Your name will go on a national registry of patients that take this medicine, to make sure that you have never had a serious reaction to it.

You may get drowsy or dizzy. Do not drive, use machinery, or do anything that needs mental alertness until you know how this drug affects you. Do not stand or sit up quickly, especially if you are an older patient. This reduces the risk of dizzy or fainting spells. Alcohol can make you more drowsy and dizzy. Avoid alcoholic drinks.

Do not treat yourself for colds, fever, diarrhea or allergies. Ask your doctor or health care professional for advice, some nonprescription medicines may increase possible side effects.

If you are going to have surgery tell your doctor or health care professional that you are taking this medicine.

If you have phenylketonuria, you should be aware that each 25 mg, orally-disintegrating tablet contains 3.1 mg of aspartame (1.74 mg of phenylalanine) and each 100 mg, orally-disintegrating tablet contains 12.4 mg of aspartame (6.96 mg of phenylalanine).