(Legend)

Generic Name

• Clozapine
  T½ = 8–12 h
  Protein binding = 95%
  [FazaClo—orally disintegrating tablets; Versacloz: oral suspension]
  Pregnancy category B

Trade Name

• Clozaril
• FazaClo
• Versacloz

Dose Range/Adult Daily Dose

• Range: 300–900 mg/d po
  Start 25 mg po 1–2 × daily; ↑ 25–50 mg/d over 2 wk to 300–450 mg/d (max 900 mg/d)
  FazaClo: start 12.5 mg 1–2 ×/d; Versacloz: start 12.5 mg 1–2 ×/d to 300–450 mg/d (end of 2 wk); max 900 mg/d

Use/Common Side Effects (CSE)

• Use: Refractive schizophrenia (unresponsive to other treatments)
  CSE: Dizziness, sedation, hypotension, tachycardia, constipation, NMS, SEIZURES, AGRANULOCYTOSIS, LEUKOPENIA, MYOCARDITIS (D/C clozapine)

Geriatric & Dose Considerations

• Use cautiously with CV/hepatic/renal disease; caution: sedation, hypotension, dizziness; polypharmacy (drug interactions); ↑mortality in elderly with dementia-related psychosis

Classification

• Antipsychotic [Atypical]

Assessment Cautions

• Must follow Clozapine REMS Program: Monitor BP/pulse; ANC less than 1000/mcL withhold clozapine. (See Clozapine REMS Program (new since 10-12-2015) in Drug-Lab tab)
  Monitor for signs of myocarditis, akathisia, EPS, and NMS; also BMI, FBS, and lipids. See www.clozapinerems.com.