KLOE-za-peen
BEERS REMS
Contraindicated in:
Baseline ANC <1500 cells/mm3 (or <1000 cells/mm3 for patients with benign ethnic neutropenia [BEN])
;Use Cautiously in:
Malnourished or dehydrated patients; patients with cardiovascular, cerebrovascular, hepatic, or renal disease; or patients on antihypertensives (↑ risk of orthostatic hypotension, bradycardia, and syncope; use lower initial dose, titrate more slowly)
;Seizure disorder
;Clozapine-associated myocarditis or cardiomyopathy
;Appears on Beers list. ↑ risk of stroke, cognitive decline, and mortality in older adults with dementia. Avoid use in older adults, except for schizophrenia, bipolar disorder, or psychosis in Parkinson disease
.CV: hypotension, tachycardia, bradycardia, CARDIAC ARREST, DEEP VEIN THROMBOSIS (DVT), HF, hypertension, MITRAL VALVE INCOMPETENCE, MYOCARDITIS, PERICARDITIS, QT interval prolongation, syncope, TORSADES DE POINTES, VENTRICULAR ARRHYTHMIAS
Derm: rash, sweating
EENT: visual disturbances
Endo: hyperglycemia
GI: constipation, ↑salivation, abdominal discomfort, dry mouth, GI ISCHEMIA/INFARCTION/NECROSIS, GI OBSTRUCTION, GI PERFORATION, HEPATOTOXICITY, nausea, ulceration, vomiting
GU: nocturnal enuresis
Hemat: AGRANULOCYTOSIS, NEUTROPENIA
Neuro: dizziness, sedation, extrapyramidal reactions, NEUROLEPTIC MALIGNANT SYNDROME (NMS), SEIZURES
Resp: PULMONARY EMBOLISM (PE)
Misc: fever
Drug-drug:
Drug-Natural Products:
Absorption: Well absorbed after oral administration.
Distribution: Rapid and extensive distribution; crosses blood-brain barrier.
Protein Binding: 95%.
Half-Life: 8–12 hr.
Advise patient to change positions slowly to minimize orthostatic hypotension. Protect from falls.
May cause seizures and drowsiness. Caution patient to avoid driving or other activities requiring alertness while taking clozapine.
Instruct patient to notify health care provider promptly if unexplained fatigue, dyspnea, tachypnea, chest pain, palpitations, sore throat, fever, lethargy, weakness, malaise, constipation, or flu-like symptoms occur.
NDC Code