Clozapine

Question 1

What is clozapine licensed for

Answer 1

Resistant schizophrenia
(Must have tried 2 or more drugs for at least 6-8 weeks each)

Question 2

What happens if >2 doses of clozapine are missed

Answer 2

Needs to be retitrated by specialist

Question 3

How often does clozapine blood count monitoring occur

Answer 3

Weekly for 18 weeks
Then every 2 weeks for 1 year
Then monthly as part of clozapine monitoring service

Question 4

How often do blood lipids and weight need monitoring with clozapine

Answer 4

Every 3 months for first year
Then yearly

Question 5

How often does fasting blood glucose need monitoring on clozapine

Answer 5

At 4-6 months
Then yearly

Question 6

What are the side effects of clozapine

Answer 6

• Myocarditis & Myopathy
• Agranulocytosis & Neutropenia
• Constipation / Paralytic ileus
• Hypersalivation (hyoscine used to treat)

Question 7

What is the MHRA Alert 2017 - Clozapine

Answer 7

Fatal risk of intestinal obstruction, faecal impaction or paralytic ileus

Question 8

What is the MHRA Alert 2020 - Clozapine

Answer 8

Monitoring blood concentrations for toxicity
*If a pt stops smoking or switches to ecig
*concomitant meds
*serious infections