Clozapine

Clozapine – It is an atypical antipsychotic medication used in the treatement of schizophrenia and is also sometimes off label for the treatment of bipolar disorder and borderline personality disorder.

Common Brands: Clorazil, FazaClo, Versacloz, clopine, Denzapine,Zaponex

Normal dose range: Initial dose : 12.5 mg orally once or twice a day.
Mantainance dose : If the dose is well-tolerated , dosages may then be tiltrated in daily increments of 25 mg to 5omg for approximately two weeks until a daily dse of 300 to 450 mg is achieved.If, after the initial tiltration , a larger dose is necessary a slower increase in dose , not exceed a 100mg increment once or twice a week , may be initiated.

Common side effects
Blurred vision
Confusion
Dizziness, faintness
Fever
Shakiness in the legs, arms , hands
Sweating
Trembling
Unusual tiredness or drowsiness
Irregular heartbeat or pulse

Contradictions
Clorazil is contraindicated in patients with a history of hypersensitivity to clozapine or any other component of clorazil.

Special monitoring /nursing care requirements
Differential blood counts must be normal on commencement and monitored regularly
Due to potential for myocarditis and cardiomyopathy, patients should have a full physical examination and medical history
Specialist examination if there are any cardiac problems
Use with caution in conjunction with drugs causing constipation.

Education requirements for patients /families /carers
Patients must immediately report symptoms of infection , especially flu-like symptoms
Avoid hot baths or showers as hypotension can occur
Oral hygiene is important to avoid oral candidiasis
Avoid overexposure to the sun as heatstroke can occur