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$Title{CLOZAPINE}
$Subject{Clozaril (Sandoz)}
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Copyright (C) 1991 Publications International, Ltd.


CLOZAPINE
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BRAND NAME (Manufacturer):
     Clozaril (Sandoz)
TYPE OF DRUG:
     Antipsychotic
INGREDIENT:
     clozapine
DOSAGE FORM:
     Tablets (25 mg and 100 mg)
STORAGE:
     Clozapine tablets should be stored at room temperature in the unit-dose
       packages provided by the manufacturer.

USES

     Clozapine is prescribed for the treatment of schizophrenia in patients
who have not been helped by or could not tolerate other medications.  It is
available only through the Clozaril Patient Management Program, which your
doctor will arrange for you.  This program provides a week's supply of the
drug at the time your blood is drawn for testing.  Clozapine is not available
from your pharmacy or drugstore.

TREATMENT

     To avoid stomach irritation, you can take this medication with a meal or
a glass of water or milk (unless your doctor directs you to do otherwise).
     If you miss a dose of this medication, take the missed dose as soon as
possible, then return to your regular dosing schedule.  If it is almost time
for the next dose, however, skip the one you missed and return to your regular
schedule.  Do not double the next dose (unless your doctor directs you to do
so).
     The full effects of this medication for the control of emotional
or mental symptoms may not become apparent for two weeks after
you start to take it.

SIDE EFFECTS

     Minor.

     Abdominal discomfort, constipation, dizziness, drowsiness, dry mouth,
headache, heartburn, increased saliva production, light-headedness, nausea,
vomiting, or weight gain.  As your body adjusts to the medication, these side
effects should disappear.
     If you are constipated, increase the amount of fiber in your diet (fresh
fruits and vegetables, salads, bran, and whole-grain breads), exercise, and
drink more water (unless your doctor directs you to do otherwise).
     Chew sugarless gum or suck on ice chips or a piece of hard candy to
reduce mouth dryness.
     To avoid dizziness or light-headedness when you stand, contract and relax
the muscles of your legs for a few moments before rising.  Do this by pushing
one foot against the floor while raising the other foot slightly, alternating
feet so that you are "pumping" your legs in a pedaling motion.

     Major.

     Tell your doctor about any side effects that are persistent or
particularly bothersome.  IT IS ESPECIALLY IMPORTANT TO TELL YOUR DOCTOR about
anxiety, blurred vision, chest pain, chills, confusion, convulsions,
difficulty in urinating, fainting, fever, increased sweating, loss of bladder
control, mouth sores, muscle stiffness, nightmares, rapid heart rate, rash,
restlessness, severe headache, sore throat, tremor, trouble sleeping, or
unusual bleeding or bruising.

INTERACTIONS

     Clozapine antipsychotic medication interacts with several other types of
medications:
     1. It can cause extreme drowsiness when combined with alcohol or other
central nervous system (brain and spinal cord) depressants, such as
barbiturates, benzodiazepine tranquilizers, muscle relaxants, phenothiazine
tranquilizers, narcotics, and pain medications, or with tricyclic
antidepressants.
     2. Lithium may increase the side effects of this drug.
     3. The effect of clozapine on blood cells may be increased by other
drugs, such as antineoplastics (cancer medicine), antithyroid drugs,
azathioprine, chloramphenicol, colchicine, flucytosine, interferon, and
zidovudine.
     4. The side effects of digoxin, phenytoin, and warfarin may be increased
by this medication.
     Before starting to take clozapine, BE SURE TO TELL YOUR DOCTOR about any
medications you are currently taking, especially any of those listed above.

WARNINGS

     * Tell your doctor about unusual or allergic reactions you have had to
any medications, especially to clozapine.
     * Tell your doctor if you have a history of alcoholism or if you now have
or have ever had blood disease, depression, enlarged prostate,
gastrointestinal problems, glaucoma, heart or circulatory disease, liver
disease, or seizures.
     * To avoid oversedation, avoid drinking alcoholic beverages while taking
this medication.
     * If this drug makes you dizzy or drowsy, do not take part in any
activity that requires alertness, such as driving a car or operating
potentially dangerous equipment.  Be careful on stairs, and avoid getting up
suddenly from a lying or sitting position.
     * Do not stop taking this medication suddenly.  Your doctor may want to
gradually reduce the amount you are taking before stopping the drug.
     * It is very important that you have your blood tested weekly and that
your doctor check your progress regularly.  You can only receive the drug
after your blood is drawn.  The results of your blood tests will assist your
doctor in making safe dosage adjustments for you.
     * Be sure to tell your doctor if you are pregnant.  Although clozapine
appears to be safe in animals, extensive studies in humans have not been
conducted.  Also, tell your doctor if you are breast-feeding an infant.  Small
amounts of this medication pass into breast milk and may cause unwanted
effects in the nursing infant.

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The material contained here is "FOR INFORMATION ONLY" and should not replace 
the counsel and advice of your personal physician.  Promptly consulting your 
doctor is the best path to a quick and successful resolution of any medical 
problem.
