Clozaril Tablet: Uses, Dosage, Side Effects, Precautions and Alternates

Quick overview

Clozaril is an antipsychotic tablet that contains clozapine, used to treat severe schizophrenia that has not improved with other treatments. It may help reduce hallucinations, delusions, and disorganized thinking, and can lower the risk of repeated suicidal behavior in people with schizophrenia or schizoaffective disorder. This medicine requires careful dosing and monitoring, and it should never be stopped suddenly.

What is Clozaril Tablet

Clozaril is an antipsychotic medicine that contains the active ingredient clozapine. It belongs to the atypical antipsychotic (second-generation antipsychotic) drug class. It is used to treat severe schizophrenia that has not improved with other treatments.

Clozaril Tablet uses

• Treats severe schizophrenia in adults who have not responded well to at least two other antipsychotic medicines, or who could not tolerate them because of severe side effects
• Reduces the risk of repeated suicidal behavior in people with schizophrenia or schizoaffective disorder
• Used for severe thought, emotional, and behavioral problems in people with Parkinson's disease when other treatments have failed

Benefits of Clozaril Tablet

• May improve hallucinations, delusions, and disorganized thinking
• May reduce lack of motivation and other negative symptoms of schizophrenia
• Can lower the risk of suicidal behavior in people with schizophrenia
• May lead to improved stability and better quality of life when other medicines have not worked

How Clozaril Tablet works

Clozaril works by balancing the levels of dopamine and serotonin in the brain, chemicals that help regulate mood and thinking.

Clozaril Tablet dosage

Take Clozaril by mouth with a full glass of water. It can be taken with or without food. Take your doses at about the same time each day, and do not take more often than directed.

Do not stop taking this medicine suddenly; your doctor will need to lower your dose gradually if you need to stop. If you stop for more than a couple of days, contact your care team before restarting, since the dose may need to be reduced.

Special care may be needed when used in children; talk to your care team about this. Your doctor may recommend a laxative — use only the type your doctor suggests.

Available forms and strengths

• Tablet

Side effects of Clozaril Tablet

Common

• Drowsiness, sedation, tiredness, or dizziness
• Constipation
• Increased salivation or dry mouth
• Rapid heartbeat
• Weight gain and changes in blood sugar or lipids
• Low blood pressure upon standing, causing lightheadedness or fainting
• Headache
• Tremor
• Nausea
• Vision problems
• Fever and increased sweating

Serious

• Agranulocytosis or severe drop in white blood cells, which lowers your ability to fight infection
• Myocarditis (inflammation of the heart muscle)
• Seizures, especially at higher doses
• Severe bowel problems, including severe constipation, fecal impaction, or bowel blockage
• Neuroleptic malignant syndrome — high fever, severe muscle stiffness, and confusion
• Serious skin reactions with fever, rash, and blistering or peeling skin
• Signs of infection such as fever, sore throat, mouth ulcers, or flu-like symptoms
• Liver injury — yellowing skin or eyes, dark urine, loss of appetite
• Blood clots — leg pain or swelling, chest pain, shortness of breath
• Stroke symptoms — sudden numbness, trouble speaking, loss of balance
• Uncontrolled movements, muscle stiffness, or tremors (extrapyramidal symptoms)
• Trouble passing urine

Warnings and precautions

• This medicine can slow down or block movement in the intestines, causing severe constipation or bowel blockage, which can lead to serious or fatal outcomes. Report any changes in bowel habits right away.
• This medicine may cause myocarditis, a serious and potentially fatal inflammation of the heart muscle.
• Never stop taking this medicine suddenly, as this can cause your condition to worsen or trigger a severe reaction. Your dose should be lowered gradually under medical supervision.
• This medicine can lower your white blood cell count, making infections more dangerous. Regular blood tests are required to monitor for this.
• This medicine is not approved for older adults with dementia-related psychosis and may increase the risk of death in this group.
• High doses or long-term use can cause a serious movement disorder that may not go away, especially in women and older adults.
• Tell your doctor right away if you become pregnant while taking this medicine. Taking antipsychotics late in pregnancy may cause breathing, feeding, or withdrawal problems in the newborn. Do not stop taking Clozaril without your doctor's advice.
• This medicine can pass into breast milk and may harm your baby. Talk to your doctor about the best way to feed your baby if you are taking this medicine.
• Tell your doctor if you have kidney disease before starting this medicine, as it may affect how the medicine should be used.
• Tell your doctor if you have liver disease. Severe liver disease is a reason not to take this medicine.
• Do not drink alcohol while taking this medicine. It can increase drowsiness and dizziness and may cause dangerous side effects.
• This medicine may affect your coordination, reaction time, and judgment. Do not drive or use machinery until you know how it affects you.

Storage

• Store at room temperature below 30 degrees C (86 degrees F)
• Keep tablets in their original pack until it is time to take them
• Store in a cool, dry place away from moisture, heat, or sunlight; do not store in the bathroom or in a car
• Keep out of the reach of children
• Throw away any unused medication after the expiration date
• If no longer needed or expired, take it to a pharmacy for safe disposal

When to see a doctor

• Get emergency help for signs of an allergic reaction, such as hives, trouble breathing, or swelling of the face, lips, tongue, or throat.
• Call your doctor right away if you have signs of infection such as fever, flu-like symptoms, extreme weakness, mouth sores, or a sore throat.
• Seek emergency care for chest pain, fast or pounding heartbeat, shortness of breath, swelling in the feet or legs, or sudden dizziness, which may be signs of a heart problem.
• Call your doctor immediately if you have a high fever, stiff muscles, sweating, confusion, or a fast or uneven heartbeat, which can be signs of a serious nervous system reaction.
• Tell your doctor right away if you are having fewer than 3 bowel movements per week, as untreated constipation can lead to serious complications.
• Seek urgent medical attention if you think you or someone else has taken too much of this medicine, even if there are no symptoms.
• Call your doctor straight away if you develop a fever, signs of infection, or changes in your bowel movements, or if you become pregnant.

Alternatives

• Aripiprazole
• Quetiapine
• Risperidone
• Olanzapine