clozapine prescribing information geriforte

The Clozapine dose should be increased to the original dose when coadministration of strong CYP1A2 inhibitors is discontinued Moderate or weak CYP1A2 inhibitors include oral contraceptives and caffeine. It is common for nonspecific flu-like symptoms such as malaise, myalgia, pleuritic chest pain, and low-grade fevers to precede more overt signs of heart failure. Subsequently, the dose can be increased once weekly or twice weekly, in increments of up to 100 mg. 1281 28 A growing body of evidence supports the off-label use of clozapine for patients with bipolar disorder as well. Additional evaluation may be needed to determine if baseline neutropenia is due to BEN. Caution patients about engaging in any activity where sudden loss of consciousness could cause serious risk to themselves or othersMyocarditis, Cardiomyopathy and Mitral Valve IncompetenceFatal myocarditis and cardiomyopathy have occurred with Clozapine treatment. Initiate treatment at 12.5 mg once or twice daily; titrate slowly; and use divided dosages. Consider the possibility of myocarditis or cardiomyopathy if chest pain, tachycardia, palpitations, dyspnea, fever, flu-like symptoms, hypotension, or ECG changes occur Increased Mortality in Elderly Patients with Dementia-Related PsychosisElderly patients with dementia-related psychosis treated with antipsychotic drugs are at an increased risk of death. Consider hematology consultation before initiating or during Clozapine treatment as necessary.Patients with BEN require a different ANC algorithm for Clozapine management due to their lower baseline ANC levels. Because of the risks of severe neutropenia and of seizure associated with its use, Clozapine tablets should be used only in patients who have failed to respond adequately to standard antipsychotic treatment The effectiveness of Clozapine tablets in treatment-resistant schizophrenia was demonstrated in a 6-week, randomized, double-blind, active-controlled study comparing Clozapine and chlorpromazine in patients who had failed other antipsychotics Clozapine tablets are indicated for reducing the risk of recurrent suicidal behavior in patients with schizophrenia or schizoaffective disorder who are judged to be at chronic risk for re-experiencing suicidal behavior, based on history and recent clinical state. However, at steady state, approximately dose-proportional changes with respect to AUC (area under the curve), peak, and minimum Clozapine plasma concentrations were observed after administration of 37.5, 75, and 150 mg twice daily.A pharmacokinetic study was conducted in 16 schizophrenic patients who received Clozapine under steady-state conditions. The maximum dose is 900 mg per day. To minimize the risk of orthostatic hypotension, bradycardia, and syncope, it is necessary to use this low starting dose, gradual titration schedule, and divided dosages Clozapine tablets can be taken with or without food Generally, patients responding to Clozapine tablets should continue maintenance treatment on their effective dose beyond the acute episode.Method of treatment discontinuation will vary depending on the patient’s last ANC:When restarting Clozapine tablets in patients who have discontinued Clozapine tablets (i.e., 2 days or more since the last dose), re-initiate with 12.5 mg once daily or twice daily. Results have been positive, and some clinicians there consider clozapine a first-line treatment for this indication.In the largest published study of clozapine’s benefits for bipolar disorder, a Danish group presented a retrospective analysis of 326 patients with bipolar disorder (and no history of a schizophrenia-spectrum disorder) treated with clozapine between 1996 and 2007. In addition, clozapine is an effective treatment for schizophrenia accompanied by persistent suicidal or self-injurious behavior. This case involved a patient who developed recurrent depression, hypersomnia, and behavioral disturbances at age 13 after a viral febrile infection. It is most commonly observed in individuals of African descent (approximate prevalence of 25-50%), some Middle Eastern ethnic groups, and in other non-Caucasian ethnic groups with darker skin. These reactions have resulted in hospitalization, surgery, and death. BECAUSE OF A SIGNIFICANT RISK OF AGRANULOCYTOSIS, A POTENTIALLY LIFE-THREATENING ADVERSE EVENT, CLOZARIL ® 0000004876 00000 n Consider the possibility of pulmonary embolism in patients who present with deep-vein thrombosis, acute dyspnea, chest pain, or with other respiratory signs and symptoms. 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. APA Reference Staff, H. (2009, January 3). These reactions may be dose-related. Observations were made on fetuses at birth and during the postnatal period; the offspring were allowed to reach sexual maturity and mated.

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