You or someone you know may have been prescribed Clozapine by your doctor for a mental health condition that has been difficult to control with other medications. The name may sound a little scary to you. But don't worry. Today, we'll talk in simple terms about how to use this medication, what it does, and what you need to be aware of.
Simply put, what is Clozapine?
Clozapine is a type of medication used to treat mental illnesses such as schizophrenia . It is usually prescribed when other medications have not worked or when the body cannot tolerate them. Simply put, it is a relatively strong medication that should be used with caution.
This medication belongs to a class of medications called antipsychotics. It works by balancing the levels of neurotransmitters called dopamine and serotonin in our brains. These help control our mood, emotions, and thoughts.
Things you need to tell your doctor before starting medication
Before starting Clozapine, it is very important to give your doctor a complete description of your health condition. Because this medicine should be used with caution in certain medical conditions. Be sure to tell your doctor if you have any of the following conditions:
| Health status | Description |
|---|---|
| Digestive system problems | Intestinal obstruction, frequent constipation |
| Blood-related problems | Decreased levels of blood cells (white blood cells, red blood cells, platelets) |
| Heart disease | Any heart disease, irregular heartbeat, high cholesterol, high blood pressure, history of stroke |
| Other medical conditions | Diabetes, Seizures, Liver or Kidney Disease, Glaucoma, Parkinson's Disease, Dementia, Prostate Problems |
| Habits and other matters | Tobacco use (smoking), swallowing difficulties, urination difficulties, muscle control difficulties |
| Allergies | If you have an allergy to Clozapine or any other medicine, food, or dye. |
| Special occasions | If you are pregnant, trying to get pregnant, or breastfeeding |
How exactly do I use this medicine?
Since this is a liquid medicine (suspension), you need to be a little careful when using it.
- Shake well: Before each use, shake the bottle well for about 10 seconds .
- Accurate measurement: Use only the special oral syringe that comes with the medicine and measure the exact amount your doctor tells you to take. Never use household teaspoons or soup spoons. They are not accurate.
- Drink immediately: Drink the medicine immediately after you draw it into the syringe. Do not save it for later.
- Food: This medicine can be taken before or after food. There is no special rule about it.
- Take it on time: Try to take your medicine at the same time every day. Take your medicine at the prescribed intervals, as directed by your doctor. Do not take more than the prescribed amount.
- Don't stop: Avoid stopping the medication suddenly without your doctor's advice. Doing so can cause serious reactions.
What to do if you miss a dose of medicine?
If you forget to take a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and take your next dose at the regular time. Do not take a double dose to make up for a missed dose. If you miss more than two days of medication, be sure to talk to your doctor about the correct dosage before starting again.
What if you take too much medicine? (Overdose)
If you think you have taken too much medicine, immediately call the National Poisons Information Centre at the Colombo National Hospital, or go to the Emergency Department (ETU) of the nearest hospital.
This medicine has been prescribed for you only. Therefore, never share it with anyone else.
Other medications to be careful with when used with Clozapine
Clozapine is a medication that can interact with many other medications. This means that taking it with other medications can change how well Clozapine works or increase its side effects. So tell your doctor about all the medications you are taking (including vitamins and herbal remedies).
| Never take Clozapine with these. | |
|---|---|
| Dronedarone | Pimozide |
| Metoclopramide | Thioridazine |
| Be especially careful if you take Clozapine with these. | |
| Alcohol | Caffeine-containing beverages (coffee, tea) |
| Some types of antibiotics | Medication for depression |
| Medications for sleep or anxiety | Medicines for allergies, coughs, and colds |
| Blood pressure medication | Medicine for seizures |
This list is not complete, so it is very important to tell your doctor about any medications you are taking.
Things to pay special attention to when taking the medicine
- Weekly blood tests: When you start Clozapine , you will need to have a blood test once a week for the first few months. This will check to see if your white blood cell count is getting dangerously low. If your blood counts are good for the first 6 months, your doctor may decide to reduce the frequency of blood tests. This is something that you should definitely do.
- Skin reactions: Sometimes severe skin reactions can occur weeks after starting the medication. Seek immediate medical attention if you develop red or purple blisters on your skin along with symptoms such as fever or chills, peeling skin, or swollen lymph nodes in your face, lips, neck, or armpits.
- Constipation: There is a risk of constipation with this medicine. Tell your doctor if you are unable to go to the bathroom as usual, if you have fewer than three bowel movements per week, or if you have symptoms such as stomach pain, bloating, nausea, or vomiting. Drink plenty of water.
- Drowsiness and dizziness: This medication may cause drowsiness and dizziness. Therefore, avoid driving or operating machinery until you know how this affects you. To avoid dizziness, get up slowly when getting up from a sitting position or out of bed.
- Smoking: Tell your doctor if you smoke, as smoking can affect the way this medicine works. Also tell your doctor if you are planning to quit smoking.
- Body temperature: This medication may affect your ability to control your body temperature. Protect yourself from extreme cold and heat. Drink plenty of water.
Side effects that may occur with this medicine
Like any medication, Clozapine can cause side effects. Some are serious, while others are common.
| Serious side effects that you should report to your doctor immediately | |
|---|---|
| Allergies | Skin blisters, itching, swelling of the face, lips, tongue, or throat |
| Heart problems | Abnormal heartbeat, chest pain, difficulty breathing, swelling of the legs/ankles, extreme fatigue |
| Signs of infection | Fever, chills, cough, sore throat (may be a sign of low white blood cell count) |
| Stroke symptoms | Sudden numbness/weakness of the face, arm, or leg, difficulty speaking, confusion, difficulty walking, severe headache |
| Other serious symptoms | Seizures, high fever with muscle stiffness (Neuroleptic Malignant Syndrome), uncontrollable body movements (EPS), severe constipation, signs of liver damage (yellowing of the skin/eyes, dark urine) |
| Usually not serious (but tell your doctor if it persists) | |
| Dizziness/drowsiness | Excessive salivation |
| Headache | Weight gain |
This list does not include all possible side effects. If you experience anything unusual, talk to your doctor immediately.
How to store the medicine?
- Keep away from children.
- Store at room temperature (between 20-25 Celsius). Do not refrigerate or freeze.
- Protect from light.
- Discard any remaining medicine 100 days after opening the bottle.
- Do not use expired medicine.
Take-Home Message
- Clozapine is a medication that should be used with special care. Follow your doctor's instructions exactly.
- Be sure to tell your doctor about your other medical conditions and all medications you are taking.
- Do not skip any scheduled blood tests. This is very important for your safety.
- Avoid stopping the medication suddenly without medical advice.
- If you experience a serious side effect such as fever, skin blisters, chest pain, or difficulty breathing, see a doctor immediately.
- If you have any questions about this medicine, don't be afraid to ask your doctor.
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