Before taking clozapine

Before taking clozapine make sure your doctor or pharmacist knows:

• If you are pregnant, trying for a baby or breast-feeding.
• If you have any heart or circulation problems.
• If you have liver or kidney problems.
• If you have epilepsy or diabetes.
• If you have depression.
• If you have glaucoma or prostate problems.
• If you have, or have previously had, bowel problems including constipation.
• If you have any blood disorders (such as neutropenia) or bone marrow problems (such as leukaemia).
• If you have a condition called myasthenia gravis.
• If you have phaeochromocytoma (a tumour on your adrenal gland).
• If you are taking other medicines, including those available to buy without a prescription, herbal or complementary medicines.
• If you have ever had an allergic reaction to this or any other medicine.

How to take clozapine

• Before beginning treatment, read the manufacturer's printed information leaflet and any additional information you have been given by your doctor, clinic or pharmacist.
• Take clozapine exactly as directed by your doctor.
• It is important that you do not change your dose or stop taking clozapine without asking your doctor first. Continue taking the tablets for as long as your doctor tells you. Stopping treatment suddenly can cause problems and you doctor will probably want you to reduce your dose gradually if this is necessary.
• Try to take clozapine at the same time each day to avoid missing any doses.
• If you forget to take a dose, take it as soon as you remember. If you do not remember until the following day, skip the missed dose. Do not take two doses together to make up for a forgotten dose.

Getting the most from your treatment

• Keep your regular doctor's appointment so your progress can be monitored. It is important that you have regular blood tests while you are being treated with clozapine.
• You will need to register with a monitoring service, which will make sure it is safe for you to keep taking clozapine.
• Clozapine may make you sleepy. If this happens, don't drive or use tools or machines.
• Don't drink alcohol whilst you are taking clozapine.
• Smoking may affect the amount of clozapine in your body. Let your doctor know if you start or stop smoking while taking clozapine.
• Clozapine may cause light-headedness and dizziness when getting up from a lying or sitting position, particularly when you begin your treatment - getting up slowly should help.
• If you are having an operation or dental treatment, tell the person carrying out the treatment which medicines you are taking.
• If you buy any medicines, check with a pharmacist that they are safe to take with your other medicines.

Can clozapine cause problems?

Along with their useful effects all medicines can cause unwanted side effects, which usually improve as your body adjusts to the new medicine. Speak with your doctor or pharmacist if any of the following side effects continue or become troublesome.

• Flu like symptoms including fever (high temperature) or a sore throat.
• Jaundice (yellowing of the skin or whites of the eyes), itching or very dark urine.
• Swelling of the mouth, lips or face.
• Severe constipation.
• Muscle spasms, sweating, stupor (feeling dazed).

If you experience any other symptoms which you think may be due to this medicine, speak with your doctor or pharmacist.

How to store clozapine

• Keep all medicines out of the reach and sight of children.
• Store in a cool, dry place, away from direct heat and light.

Important information about all medicines

References

• Manufacturer's PIL, Clozaril® 25mg and 100mg tablets, Novartis Pharmaceuticals UK Ltd, electronic Medicines Compendium. Dated April 2010.
• Manufacturer's PIL, Denzapine® 50 mg/ml Oral Suspension, Merz Pharma UK Ltd, electronic Medicines Compendium. Dated February 2010.
• British National Formulary; 62nd Edition (Sep 2011) British Medical Association and Royal Pharmaceutical Society of Great Britain, London (link to current BNF)