Clozapine, Oral

What are other names for this medicine?

Type of medicine: antipsychotic

Generic and brand names: clozapine, oral; Clozaril; FazaClo Orally Disintegrating Tablets

What is this medicine used for?

This medicine is taken by mouth to treat schizophrenia. It is a very powerful medicine that is used when other treatments have not helped. It may be used for other conditions as determined by your health care provider.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

• an allergic reaction to any medicine
• Alzheimer's disease or dementia
• an enlarged prostate gland
• blood clots or bleeding disorders
• bone marrow disorders
• diabetes
• glaucoma
• heart problems
• kidney or liver disease
• lung disease
• myasthenia gravis
• phenylketonuria (PKU). The dissolving tablet contains phenylalanine.
• seizures
• stomach or intestinal blockage or constipation

Females of childbearing age: Tell your healthcare provider if you are pregnant or plan to become pregnant. Do not breast-feed while taking this medicine without your healthcare provider's approval.

How do I take it?

It is very important to take this medicine exactly as your healthcare provider prescribes. Check the label on the medicine for directions about your specific dose. Do not take more of it or take it longer than prescribed. Taking too much may cause very serious side effects. Do not stop taking this medicine without your healthcare provider's approval.

You may take this medicine with or without food. Taking it with meals or milk may lessen the chance the drug will upset your stomach.

If you are taking the disintegrating tablets, place the tablet in the mouth and allow it to dissolve, then swallow. You do not need to drink water with this tablet. Keep the tablets in the unopened blister pack until you take your dose. If you take half-tablets, throw the other part of the tablet away. Do not save this half-tablet for later use.

What if I miss a dose?

If you miss a dose, take it as soon as you remember unless it is almost time for the next scheduled dose. In that case, skip the missed dose and take the next one as directed. Do not take double doses. If you stop taking this medicine for more than 2 days, DO NOT start taking it again at the same dosage. If you are not sure of what to do if you miss a dose, or if you miss more than one dose, contact your healthcare provider.

What if I overdose?

If you or anyone else has intentionally taken too much of this medicine, call 911 or go to the emergency room right away. If you pass out, have seizures, weakness or confusion, or have trouble breathing, call 911. If you think that you or anyone else may have taken too much of this medicine, call the poison control center. Do this even if there are no signs of discomfort or poisoning. The poison control center number is 800-222-1222.

Symptoms of an acute overdose may include: drowsiness, coma, change in behavior, confusion, fast or irregular heartbeat, drowsiness, drooling, slow breathing.

What should I watch out for?

You need to have blood tests before you start taking this medicine and regularly while you are taking it. Taking this medicine without regular blood tests can be very dangerous. Keep all your appointments.

This medicine may cause heart problems, severe infections, seizures, and uncontrollable movements such as twitching of the face, mouth, or jaw. If you have any of these side effects, contact your healthcare provider right away.

Older adults with dementia are at greater risk for side effects. Talk with your provider about this.

While taking this medicine, be careful when you exercise, especially when it is hot. This medicine affects your body's ability to cool down, and you may get too hot. If you get too hot, you might vomit, feel dizzy, have a fast heartbeat, get very stiff muscles, or be confused. Contact your provider right away if you have these symptoms.

For the first 3 months that you take this medicine, you may sometimes have a high fever. If this happens often or is severe, contact your healthcare provider.

If you need emergency care, surgery, or dental work, tell the healthcare provider or dentist you are taking this medicine.

This medicine may make you drowsy or dizzy. Do not drive or operate machinery unless you are fully alert.

You may feel faint when you get up from sitting or lying down. Getting up slowly may help.

This medicine may increase the risk of developing diabetes, especially if you are overweight or have a family history of diabetes. If you have diabetes, this medicine may affect your blood sugar level and change the amount of insulin or other diabetes medicines you may need. Talk to your healthcare provider about this.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Serious (report these to your healthcare provider right away): Tiredness, fever, weakness, sore throat, seizures, fainting, loss of balance, tremors, muscle twitching, muscle stiffness or spasms, restlessness or need to keep moving, fast or irregular heartbeat, chest pain, shortness of breath, changes in vision, uncontrollable eye movements, trouble speaking or swallowing, trouble urinating, yellowing of the skin or eyes.

Other: Headache, drowsiness, dizziness, confusion, constipation, dry mouth, trouble sleeping, nightmares, nausea, vomiting, change in sexual ability or desire, sweating, drooling, heavy sweating, loss of appetite.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• alcohol
• ACE inhibitors such as benazepril (Lotensin), captopril (Capoten), enalapril (Vasotec), fosinopril (Monopril), lisinopril (Prinivil, Zestril), quinapril (Accupril), and ramipril (Altace)
• alpha blockers such as prazosin (Minipress) and doxazosin (Cardura)
• antiarrhythmic medicines propafenone (Rythmol), quinidine, and flecainide (Tambocor)
• antibiotics such as erythromycin (Erythrocin, EES, E-Mycin, Ery-Tab, EryPed), telithromycin (Ketek), clarithromycin (Biaxin), ciprofloxacin (Cipro), and rifampin (Rifadin)
• anticancer medicines such as busulfan (Myleran, Busulfex), altretamine (Hexalen), thiotepa (Thioplex), methotrexate (Rheumatrex) cytarabine (Tarabine, Cytosar-U), gemcitabine (Gemzar), fludarabine (Fludara), cisplatin (Platinol), hydroxyurea (Hydrea), doxorubicin (Adriamycin, Rubex, Doxil), vinblastine (Velban, Alkaban-AQ), vincristine (Oncovin, Vincasar), and thioguanine (Lanvis)
• antidepressants such as fluoxetine (Prozac), fluvoxamine (Luvox), paroxetine (Paxil), sertraline (Zoloft), citalopram (Celexa), venlafaxine (Effexor), amitriptyline, nortriptyline (Aventyl, Pamelor), imipramine (Tofranil), and doxepin (Sinequan)
• antiseizure medicines such as carbamazepine (Tegretol) and phenytoin (Dilantin)
• atropine or similar medicines such as scopolamine, belladonna, and methscopolamine (Pamine)
• benzodiazepines such as alprazolam (Xanax), chlordiazepoxide (Librium), clorazepate (Tranxene, Gen-XENE), diazepam (Valium), triazolam (Halcion), midazolam (Versed), lorazepam (Ativan), and oxazepam (Serax)
• beta blockers such as atenolol (Tenormin), acebutolol (Sectral), betaxolol (Kerlone), carteolol, bisoprolol (Zebeta), pindolol, metoprolol (Lopressor, Toprol XL), timolol, sotalol (Betapace), nadolol (Corgard), propranolol (Inderal), labetalol (Normodyne, Trandate), and carvedilol (Coreg)
• buspirone (BuSpar)
• caffeine
• calcium channel blockers such as diltiazem (Cardizem, Dilacor, Tiamate, Tiazac), nicardipine (Cardene), nifedipine (Procardia, Adalat), isradipine (DynaCirc), felodipine (Plendil), amlodipine (Norvasc), and verapamil (Calan, Isoptin, Verelan)
• cimetidine (Tagamet)
• digoxin (Lanoxin)
• epinephrine (Adrenalin)
• lithium (Lithobid, Eskalith)
• narcotic analgesics (painkillers) such as codeine, hydrocodone (Vicodin, Lortab), oxycodone (Percocet, Tylox, OxyContin), morphine (MS Contin), propoxyphene (Darvocet N-100), pentazocine (Talwin), meperidine (Demerol), fentanyl (Duragesic patches), methadone (Dolophine), and hydromorphone (Dilaudid)
• natural remedies such as St. John's Wort, kava, gotu kola, and valerian
• nicotine (NicoDerm, Nicorette, Nicotrol, Habitrol) or cigarette smoking
• omeprazole (Prilosec)
• other antipsychotic medicines such as chlorpromazine (Thorazine), fluphenazine (Permitil, Prolixin), haloperidol (Haldol), olanzapine (Zyprexa), prochlorperazine (Compazine), risperidone (Risperdal), thioridazine, and trifluoperazine (Stelazine)
• sleeping pills such as phenobarbital (Solfoton), amobarbital (Amytal), zolpidem (Ambien), triazolam (Halcion), butabarbital (Butisol), and zaleplon (Sonata)
• stimulants such as dextroamphetamine (Dexedrine), methamphetamine (Desoxyn), methylphenidate (Concerta, Methylin, Ritalin), dexmethylphenidate (Focalin), and pemoline (Cylert)
• warfarin (Coumadin)

Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

How should I store this medicine?

Store this medicine at room temperature. Do not open the package until you are ready to take the medicine. Protect from heat, high humidity, and bright light.

This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicine in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.