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Where can I get more information?

Instruct patients and caregivers beginning treatment with Clozapine about the risk of developing severe neutropenia and infection. Clozapine is an antipsychotic medication. It works by changing the actions of chemicals in the brain. Ask your doctor if there is another medicine you can try. While you are taking clozapine, your blood will need to be tested often. Do not miss any follow-up visits to your doctor. Weekly ANC monitoring is required for all patients during the first 6 months of treatment.

Keep out of the reach of children

The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the substances you are taking, check with your doctor, nurse, or pharmacist. Do not stop taking any medications without consulting your healthcare provider. If you need surgery, tell the surgeon ahead of time that you are using clozapine.

Keep out of reach of children

Many medicines have not been tested in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults. Clozapine may be more likely to cause side effects in the elderly, including dizziness and fainting, low blood pressure, and confusion or excitement. This medicine should not be used for behavioral problems in older adults with dementia. The dose of clozapine will be different for different patients. This drug may also cause significant weight gain and a rise in your cholesterol or triglyceride levels. These effects, along with diabetes, may increase your risk for developing heart disease. Discuss the risks and benefits of treatment with your doctor.

Important information

Dose reduction may be necessary in patients with significant impairment of renal or hepatic function. The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine. What are the uses for clonazepam?



Reviews for clozapine

In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345. Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your or local waste disposal company. Along with its benefits, this medication may rarely cause abnormal drug-seeking behavior addiction. This risk may be increased if you have abused alcohol or drugs in the past. Use this medication exactly as prescribed to lessen the risk of addiction. This is known as an anticonvulsant or antiepileptic drug. Keep all medicines away from children and pets. Tell your doctor if you smoke or drink products that contain caffeine. Clozaril clozapine tablets US prescribing information. Severity Scale score of at least 4 moderately ill. Avoid food and drink high in caffeine, like coffee, tea, cocoa, cola, and chocolate. Women and patients of Jewish background may be at greater risk of developing blood problems with clozapine solution. Elderly patients, particularly those with compromised cardiovascular functioning, may be more susceptible to these effects. Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive. Two separate management algorithms are provided below, the first for patients in the general population, and the second for patients identified to have baseline neutropenia. Use one third of the FAZACLO dose. This medication is given by injection into a vein or deep into a muscle as directed by your doctor. You should be closely monitored for several hours after receiving this medication. Consult with the treating oncologist in patients receiving concomitant chemotherapy.



Use of clozapine

Take this medication by as directed by your doctor. The dosage is based on your age, medical condition, and response to therapy. D2 and the serotonin type 2A 5-HT2A receptors. Dosing regimens for each treatment group were determined by individual investigators and were individualized by patient. A09” on one side. Follow your doctor's directions carefully. The manufacturer recommends that you not take more than 16 milligrams of or 200 milligrams of per day. Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking clozapine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive. This medication can cause a serious decrease of a certain type of white blood cells neutropenia. To make sure you have enough white blood cells, your doctor will order lab tests before starting and while your are taking clozapine. Neutropenia may lower your ability to fight infections. Get medical help right away if you have any signs of severe neutropenia or infection such as sore throat that doesn't go away, fever, swollen lymph nodes, unusual tiredness, weakness. nimotop



Clozapine side effects

In some cases, this condition may be permanent. Patients treated with Clozapine had a statistically significant longer delay in the time to recurrent suicidal behavior in comparison with olanzapine. This result should be interpreted only as evidence of the effectiveness of Clozapine in delaying time to recurrent suicidal behavior and not a demonstration of the superior efficacy of Clozapine over olanzapine. Children may not experience relief of with lorazepam. It may have the opposite effect on children, causing symptoms including agitation, shaking, or hallucinations. This medication may rarely cause a very serious condition called NMS. Hyperglycemia, in some cases extreme and associated with ketoacidosis or hyperosmolar coma or death, has been reported in patients treated with atypical antipsychotics including Clozapine. Assessment of the relationship between atypical antipsychotic use and glucose abnormalities is complicated by the possibility of an increased background risk of diabetes mellitus in patients with schizophrenia and the increasing incidence of diabetes mellitus in the general population. Given these confounders, the relationship between atypical antipsychotic use and hyperglycemia-related adverse reactions is not completely understood. However, epidemiological studies suggest an increased risk of treatment-emergent, hyperglycemia-related adverse reactions in patients treated with the atypical antipsychotics. Precise risk estimates for hyperglycemia-related adverse reactions in patients treated with atypical antipsychotics are not available. The total daily dose can be increased in increments of 25 mg to 50 mg per day, if well-tolerated, to a target dose of 300 mg to 450 mg per day administered in divided doses by the end of 2 weeks. Subsequently, the dose can be increased weekly or twice weekly, in increments of up to 100 mg. The maximum dose is 900 mg per day. Constipation; dizziness; drowsiness; dry mouth; headache; heartburn; increased sweating or saliva production; light-headedness; nausea; trouble sleeping; weight gain. Loss of coordination, drowsiness, and sleeping problems may increase the risk of falling. current zyloprim zyloprim



Clozapine uses

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing. Clozapine can cause some very serious blood problems that you will not be able to feel. Your doctor will check your blood at regular visits and it is important that you have your blood tests done when they are scheduled. The pharmacy will give you clozapine only if your blood tests show that it is safe for you to take it. Your doctor will make sure the medicine is working properly and change the dosage if needed. Allow the tablets to dissolve on your and swallow. You not need to take the dissolving tablets with water. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist. During pregnancy, this medication should be used only when clearly needed. Keep out of reach of children. The total daily dose can be increased in increments of 25 mg to 50 mg per day, if well-tolerated, to achieve a target dose of 300 mg to 450 mg per day administered in divided doses by the end of 2 weeks. Subsequently, the dose can be increased once weekly or twice weekly, in increments of up to 100 mg. The maximum dose is 900 mg per day. What other drugs will affect clozapine Clozaril? Monitor for adverse reactions. Consider reducing the CLOZARIL dose if necessary. Take this medication by mouth with or without food, as directed by your doctor. If you are taking the tablets that dissolve in the mouth, carefully remove each tablet from the blister pack immediately before taking your dose. Allow the tablets to dissolve on your tongue and swallow. You do not need to take the dissolving tablets with water. They demonstrated moderate-to-severe suicidal ideation accompanied by command hallucinations to do self-harm within one week prior to their baseline evaluation. The amount of clozapine in your blood may increase and cause more side effects, such as a fast heartbeat, weakness, fatigue, dizziness, increased salivation, or decreased breathing. You may also experience a change in your heart rhythm, which may increase your risk of irregular heartbeat, which may be life-threatening. CLOZARIL, a baseline ANC must be obtained.



Side effects of clozapine

Older adults may be more sensitive to the side effects of this drug, especially drowsiness, which can increase the risk of falling. Take this medication regularly to get the most benefit from it. To help you remember, take it at the same times each day. Do not increase your dose or take this drug more often or for longer than prescribed. Your condition will not improve any faster, and your risk of side effects will increase. Avoid drinking alcohol. It can increase some of the side effects of clozapine. Glycine is also marketed for a host of other uses, despite the lack of scientific evidence that it is effective or safe for any of them. Carefully select Clozapine doses in elderly patients, taking into consideration their greater frequency of decreased hepatic, renal, or cardiac function, as well as other concomitant disease and other drug therapy. Animal studies have revealed no evidence of harm to the fetus, however, there are no adequate studies in pregnant women OR animal studies have shown an adverse effect, but adequate studies in pregnant women have failed to demonstrate a risk to the fetus. If you notice any of these symptoms in your especially during their first month, tell the doctor right away. Clozapine therapy, to aid in evaluation for neutropenia and to institute prompt and appropriate management. The reason that this treatment was sought was because the alternitive tretments were so devistateing to her general health and mental behavior. The alternitive medications were stelzine, thorzine, and heldol. Currently she is recieving 500 mg per day of clozapine along with other medications but as of the last 6 months she has been experianceing total regression of her illness, in other words she now is worse than she's been in the past 15 years. I would like to find a alternitive to clozapine. I would like to try a medication that was designed for a female if at all possible. She has been hospitalized 4 times in the last 6 months and I'm running out of options. Any sugestions would be greatly appretiated. Include favorite foods at each meal. If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip themissed dose and resume your usual dosing schedule. CLOZARIL may be administered with or without food. This medication is usually given by injection into a vein or a muscle as directed by your doctor. The dosage is based on your medical condition and response to therapy. Clozapine under steady-state conditions. After coadministration of fluvoxamine for 14 days, mean trough concentrations of Clozapine and its metabolites, N-desmethylClozapine and Clozapine N-oxide, were elevated about three-fold compared to baseline steady-state concentrations. Contact your doctor as soon as possible if you have chest pain or discomfort, a fast or slow heartbeat, trouble breathing, or fever and chills. These can be symptoms of a very serious problem with your heart. WBC counts can be monitored every other week in order to monitor for the occurrence of agranulocytosis, and that CLOZARIL tablets will be made available only through a special program designed to ensure the required blood monitoring. Patients should be advised to report immediately the appearance of lethargy, weakness, fever, sore throat, malaise, mucous membrane ulceration or other possible signs of infection. kles.info cabergoline



Prescribing information for clozapine

Patients should not breast-feed an infant if they are taking CLOZARIL. St. John's wort or vitamin supplements. Older adults may be more sensitive to the side effects of this drug, especially constipation, dizziness, and QT prolongation see above. Dizziness can increase the risk of falling. Treatment of overdose is symptomatic and supportive. Use this medication exactly as prescribed. not increase your dose, take it more frequently or use it for a longer period of time than prescribed because this drug can be habit-forming. Also, if used for an extended period of time or for control, do not suddenly stop using this drug without your doctor's approval. Some conditions may become worse when the drug is abruptly stopped. Your dose may need to be gradually decreased. Metabolic Changes hyperglycemia and diabetes mellitus, dyslipidemia, weight gain: Educate patients and caregivers about the risk of metabolic changes and the need for specific monitoring. The risks include hyperglycemia and diabetes mellitus, dyslipidemia, weight gain, and cardiovascular reactions. To prevent withdrawal reactions, your doctor may reduce your dose gradually. Report any withdrawal reactions right away. The central dopaminergic blocking effects of neuroleptic agents may precipitate or aggravate a potentially fatal symptom complex known as neuroleptic malignant syndrome NMS. NMS is observed most frequently when high-potency agents like haloperidol are administered intramuscularly, but may occur with any neuroleptic agent given for any length of time. Clinical manifestations of NMS include hyperpyrexia, muscle rigidity, altered mental status and autonomic instability irregular pulse or blood pressure, tachycardia, diaphoresis and cardiac arrhythmias. Additional signs may include elevated creatine phosphokinase, myoglobinuria, and acute renal failure. Neuroleptic agents should not be given to patients with active NMS and should be immediately discontinued if currently being administered in such patients. In patients with a history of NMS, introduction or reintroduction of neuroleptic agents should be carefully considered, since NMS may recur. Clozapine was not genotoxic when tested in the following gene mutation and chromosomal aberration tests: the bacterial Ames test, the in vitro mammalian V79 in Chinese hamster cells, the in vitro unscheduled DNA synthesis in rat hepatocytes or the in vivo micronucleus assay in mice. FAZACLO has potent anticholinergic effects. Combinations containing any of the following medications, depending on the amount present, may also interact with this medication. Lab tests, including complete blood cell counts and heart function, may be performed while you use clozapine solution and for at least 4 weeks after you stop taking it. These tests may be used to monitor your progress or check for side effects. Be sure to keep all doctor and lab appointments. Myocarditis and cardiomyopathy have occurred with the use of Clozapine. These reactions can be fatal. Discontinue Clozapine and obtain a cardiac evaluation upon suspicion of myocarditis or cardiomyopathy. Generally, patients with a history of Clozapine-associated myocarditis or cardiomyopathy should not be rechallenged with Clozapine. However, if the benefit of Clozapine treatment is judged to outweigh the potential risks of recurrent myocarditis or cardiomyopathy, the clinician may consider rechallenge with Clozapine in consultation with a cardiologist, after a complete cardiac evaluation, and under close monitoring. pharma price indomethacin



Clozapine forms and strengths

Use caution when administering Clozapine to patients with a history of seizures or other predisposing risk factors for seizure CNS pathology, medications that lower the seizure threshold, alcohol abuse. Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. The studies revealed no evidence of impaired fertility or harm to the fetus due to Clozapine. Because animal reproduction studies are not always predictive of human response, Clozapine should be used during pregnancy only if clearly needed. Monitor neonates for symptoms of agitation, hypertonia, hypotonia, tremor, somnolence, respiratory distress, and feeding difficulties. The severity of complications can vary from self-limited symptoms to some neonates requiring intensive care unit support and prolonged hospitalization. Clozapine rechallenge, and the severity and characteristics of the neutropenic episode. Clozapine can cause low blood pressure or a slow heartbeat, which can make you dizzy or cause you to faint when you stand up. The risk is higher when you first start or increase your dose of medication. To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position. Seizures have occurred with the use of clozapine solution. The risk of seizures may be greater with higher doses, or if you have a history of seizures, if you take medicines that increase the risk of seizures, or if you abuse alcohol. Do not perform activities in which a sudden loss of consciousness could cause harm to yourself or others eg, driving, swimming. Inform patients and caregivers Clozapine is available only through a restricted program called the Clozapine REMS Program designed to ensure the required blood monitoring, in order to reduce the risk of developing severe neutropenia. If you have any questions about clozapine solution, please talk with your doctor, pharmacist, or other health care provider. Orthostatic Hypotension, Bradycardia, and Syncope: Inform patients and caregivers about the risk of orthostatic hypotension and syncope, especially during the period of initial dose titration. Take this medication by with or without food, as directed by your doctor. Clozapine. A hematology consultation may be useful in deciding to rechallenge a patient. In general, however, do not rechallenge patients who develop severe neutropenia with Clozapine or a Clozapine product.



Highlights for clozapine

What brand names are available for clonazepam? Clozapine can cause sedation and impairment of cognitive and motor performance. Caution patients about operating hazardous machinery, including automobiles, until they are reasonably certain that Clozapine does not affect them adversely. These reactions may be dose-related. Consider reducing the dose if they occur. Concomitant use is not recommended. However, if the inducer is necessary, it may be necessary to increase the FAZACLO dose. Monitor for decreased effectiveness. Suicide Monitoring Board SMB a group of experts blinded to patient data. Clozapine is available in pale yellow tablets of 25 mg and 100 mg for oral administration. Ativan lorazepam injection US prescribing information. Use the measuring device that comes with clozapine solution to measure your dose. Ask your pharmacist for help if you are unsure of how to measure your dose. comprar tenormin en argentina



What other drugs will affect clozapine

Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children. Tell your doctor if you are a descendent of Ashkenazi Jews because you may be at a higher risk for a drop in your white blood cells. Neutropenia may lower your ability to fight infections. Take this medication by as directed by your doctor, usually 2 or 3 times daily. Drink plenty of fluids. Avoid strenuous in hot weather. Clozapine solution may be taken with or without food. If stomach upset occurs, take with food to reduce stomach irritation. ANC level. Fever is often the first sign of neutropenic infection. Clozaril is often prescribed for people whose negative or positive symptoms have not improved after treatment with at least two other antipsychotic drugs, or who encountered unusually severe side effects from taking other antipsychotic medications. Clozaril improves symptoms in 50-60% of patients who are not helped by other antipsychotic medications. It is not known whether this drug passes into milk. Discuss the risk and benefits with your doctor before -feeding. online dramamine purchase



KEEP OUT OF REACH OF CHILDREN

While clozapine can provide great benefits, it can rarely cause serious, possibly fatal side effects. For this reason, clozapine is used when other treatments have not worked or you cannot take them. It is not intended as medical advice for individual conditions or treatment. It is not a substitute for a medical exam, nor does it replace the need for services provided by medical professionals. Talk to your doctor, nurse or pharmacist before taking any prescription or over the counter drugs including any herbal medicines or supplements or following any treatment or regimen. Only your doctor, nurse, or pharmacist can provide you with advice on what is safe and effective for you. Therefore, discuss the risks and benefits of treatment with clonazepam with your doctor. National Library of Medicine and Drugs. CYP2D6 can increase levels of these CYP2D6 substrates. Check the labels on all your medicines such as allergy or cough-and-cold products because they may contain ingredients that cause drowsiness. Ask your pharmacist about using those products safely. Syringe should be washed with warm water after each use; the bottle cap may be closed without removing the syringe adaptor. Haring C, Meise U, Humpel C, et al. Dose-related plasma levels of clozapine: influence of smoking, behavior, sex and age. Psychopharmacology l989; 99 Suppl: S38-S40. Upon initiating therapy or adding a strong CYP450 1A2 inhibitor to clozapine therapy, reduce clozapine dose to one-third. Do not start, stop, or change the dosage of any medicine before checking with them first. Monitor for adverse reactions. Consider reducing the FAZACLO dose if necessary. Because of the risk of severe neutropenia, Clozapine is available only through a restricted program under a Risk Evaluation Mitigation Strategy REMS called the Clozapine REMS Program. CLOZARIL with other drugs that cause QT interval prolongation.



Monitor all patients for these symptoms

Aztreonam is used to treat a wide variety of bacterial infections. This medication is an antibiotic that works by stopping the growth of bacteria. For a listing of dosage forms and brand names by country availability, see Dosage Forms sections. Using clozapine with any of the following is usually not recommended, but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use clozapine, or give you special instructions about the use of food, alcohol, or tobacco. Postmarketing, very rare events of ventricular tachycardia, cardiac arrest, and QT prolongation which may be associated with Torsades de pointes have been observed, although there is no conclusive causal relationship to use of this drug. Monitor all patients for these symptoms. Food does not appear to affect the systemic bioavailability of Clozapine. Thus, Clozapine may be administered with or without food. QT prolongation. It may cause fainting or serious side effects in some patients. Contact your doctor right away if you have any symptoms of heart rhythm problems, such as fast, pounding, or uneven heartbeats. The use of atypical antipsychotic agents has been associated with orthostatic hypotension and syncope. Therapy with atypical antipsychotics should be administered cautiously in patients with hypotension or conditions that could be exacerbated by hypotension, such as a history of myocardial infarction, angina, or ischemic stroke. Patients should be advised of the risk of orthostatic hypotension, especially during the period of initial dose titration. One study showed some improvement in memory among young and middle-aged men. But the results need to be confirmed by more research. These reactions can be fatal. The syndrome is consistent with neurally mediated reflex bradycardia NMRB. Take clozapine solution as soon as you draw it into the oral syringe. Do not store the medicine in the oral syringe for later use. What should I discuss with my healthcare provider before taking clozapine Clozaril? This medication works by calming the brain and nerves. Diazepam belongs to a class of drugs known as benzodiazepines. Store at room temperature away from light and moisture. Do not refrigerate or freeze. Do not store in the bathroom. Keep all medications away from children and pets. Do not use a household spoon because you may not get the correct dose. terazosin price walmart canada



Clozapine drug interactions

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose. PDR Network. Establish and maintain an airway; ensure adequate oxygenation and ventilation. Monitor cardiac status and vital signs. Use general symptomatic and supportive measures. There are no specific antidotes for Clozapine. Continue to use aztreonam until the full prescribed amount is finished, even if symptoms disappear after a few days. Stopping the medication too early may allow bacteria to continue to grow, which may result in a relapse of the infection. If you are using the liquid form of this medication, shake the bottle well for 10 seconds before each use. Titration and Maintenance: May increase total daily dose in increments of 25 mg to 50 mg per day to a target dose of 300 mg to 450 mg per day administered in divided doses by the end of week 2. Subsequent dose increases can be in increments of up to 100 mg once or twice weekly. CloZAPine may occasionally cause serious cardiovascular side effects such as low blood pressure and cardiac or respiratory arrest, and combining it with other medications that can can also have these effects such as ARIPiprazole may increase the risk. Cardiovascular side effects are most likely to occur at the beginning of treatment, following a dose increase, or when treatment is restarted after an interruption. Other side effects that may also be increased include dizziness, drowsiness, blurred vision, confusion, dry mouth, abdominal cramping, constipation, difficulty urinating, heat intolerance, low white blood cell count, palpitation, and irregular heart rhythm. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. You should avoid or limit the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you, and use caution when getting up from a sitting or lying position. If you miss your cloZAPine doses for two or more days, contact your doctor before you resume treatment, as you may need to restart at a lower dose. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor. keflex



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Clozapine ingredients

Pharmacokinetic interactions of clozapine with selective serotonin reuptake inhibitors: differential effects of fluvoxamine and paroxetine in a prospective study. FAZACLO can be dispensed. The orally disintegrating tablet contains phenylalanine, which can make this condition worse. D3 Ki 555 nM. Benign Ethnic Neutropenia BEN.

The maximum dose is 900 mg per day

SEVERE NEUTROPENIA: Treatment has caused severe neutropenia, defined as an absolute neutrophil count ANC less than 500 per microliter microL. Severe neutropenia can lead to serious infection and death. Prior to initiating treatment, a baseline ANC must be at least 1500 per microL for the general population; and must be at least 1000 per microL for patients with documented Benign Ethnic Neutropenia BEN. During treatment, patients must have regular ANC monitoring. This drug may make you dizzy or drowsy. not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely. Avoid beverages.

Clozapine warnings

There is no known treatment for TD. However, the syndrome may remit partially or completely if treatment is discontinued. Antipsychotic treatment, itself, may suppress or partially suppress the signs and symptoms, and it has the potential to mask the underlying process. The effect of symptom suppression on the long-term course of TD is unknown. Patients with BEN require a different ANC algorithm for Clozapine management due to their lower baseline ANC levels. provides guidelines for managing Clozapine treatment and ANC monitoring in patients with BEN. FAZACLO with other drugs that cause QT interval prolongation.

Indications and usage of clozapine

Safety and effectiveness in pediatric patients have not been established. CYP2D6 CYP2D6 poor metabolizers. These individuals may develop higher than expected plasma concentrations of Clozapine when given usual doses. Laboratories International SRL May, 2016. Although you may notice some improvement in your symptoms soon after starting this medication, it may take several weeks to months before you get the full benefit of this drug.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. Use one third of the CLOZARIL dose. Because of the risk of myocarditis, the patient should be instructed to report immediately any unexplained fatigue, dyspnea, tachypnea, fever, chest pain, palpitations, tachycardia or other signs or symptoms of heart failure. Myocarditis should be considered in patients who present with electrocardiographic findings such as ST-T wave abnormalities or arrhythmias. Patients who present with tachycardia during the first month of therapy should be closely monitored for other signs of myocarditis. Clozapine therapy should be promptly discontinued if myocarditis is suspected. Patients with clozapine-related myocarditis should not be rechallenged with clozapine. gabapentin

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