CLOZARIL table. 100 mg.50 table

Tablet 100 mg:

 
Yellow, round, flat tablet with beveled edge. Inscription "Z / A" with a slash on one side and "SANDOZ" in one line on the other.
 
In addition to the active ingredient, the tablets also contain the following inactive ingredients: lactose monohydrate, maize starch, povidone, colloidal silicon dioxide, magnesium stearate and talc.
Both tablets are available in packs of 50 tablets.

What Clozaril and what it is used?

CLOZARIL is an antipsychotic (sometimes called neuroleptics) and belongs to a group of medicines known as dibenzodiazepines.

Clozaril is used to treat people suffering from schizophrenia. It is used to treat people who are either at least two other antipsychotic drugs or antipsychotics are tolerated because of side effects.

Clozaril is also used to treat severe thought disturbances in patients with Parkinson's disease when other treatments have failed.

Blood tests

Before starting Clozaril will have a blood test to make sure that you take this medicine.

You will have regular blood tests while still taking Clozaril Clozaril and if you stop for a period of four weeks. Your doctor will tell you when and where you will have tests. They will be performed weekly for the first few months, but may later be reduced to every two weeks. Once you've been on Clozaril for one year, it may be necessary for you to have blood tests every four weeks. It is important not to miss these studies as to your safety, your doctor can not prescribe more tablets. Your co-operation with the blood testing is essential.

 Before you take Clozaril tablets

Clozaril will be given to you if you are unconscious.

Tell your doctor if any of these statements apply to you:

  If you are taking this medication before and you were allergic to it or it hurt you, or any of the other ingredients of the tablets are harmful.

  If you are unable to undergo regular blood tests.

  If you have low white blood cells (including after taking Clozaril), unless it was after cancer treatment.

 If you have or have previously suffered from a disease of the bone marrow.

  If you suffer from epilepsy (seizures, convulsions or seizures).

  If you have problems with alcohol or substance abuse, eg. Drugs.

  If you suffer from any severe heart, liver or kidney problems. If you've ever had a serious illness affecting the heart, it may be necessary to contact a specialist.

  If you suffer from severe constipation, intestinal blockage, or any other condition that is affecting your large bowel.

  If you have glaucoma (eye disease).

  If you have diabetes.

  If you have difficulty urinating due to an enlarged prostate gland.

  If you have an intolerance to certain sugars, eg. lactose.

Tell your doctor if you are taking any of the following:

  Medicines used to treat high blood pressure, for example. metoprolol kaltopril

  Medicines to treat depression eg. fluvoxamine, paroxetine, phenelzine, citalopram

  Some antipsychotic drug given by injection, eg. flupentixol decanoate, flufenazin decanoate

  Benzodiazepines (tranquilizers) or sleeping pills, for example. dizaepam, temazepam

  Lithium

  Antihistamines used to treat allergies or hay fever, for example. loratadine, chlorpheniramine

  Antibiotics, for example. cotrimoxazole, chloramphenicol, erythromycin, rifampicin and antifungal agents, for example. fluconazole

  Drugs for the treatment of cancer, eg. cyclophosphamide, busulfan

  Medicines to treat epilepsy, eg. phenytoin, carbamazepine, sodium valproate

  Medicines to treat pain, eg. morphine, codeine and phenylbutazone

 digoxin or warfarin

  Cimetidine

 Some medicines used to treat arthritis, for example. penicillamine, ibuprofen, indomethacin

  A drug which is known to cause constipation, including other drugs used to treat depression or schizophrenia, for example. chlorpromazine, or medicines to treat symptoms of Parkinson's disease, for example. pergolide

 adrenaline or noradrenaline

  Any antiviral agents, eg. ritonavir, indinavir

  omeprazole (a drug to treat excess stomach acidity)

Some medicines may affect your treatment. It is important to ask your doctor before taking any other medicines, even if they are not prescribed.

You should not drink alcohol while taking Clozaril. Clozaril levels in the blood can be affected by smoking cessation and changes in the number of caffeine - containing drinks are taking. Tell your doctor about any such changes.

Birth control and pregnancy

If you are pregnant, planning to become pregnant, or become pregnant during your treatment, it is important that you tell your doctor before taking Clozaril.

Some women taking certain antipsychotic drugs have irregular or no periods. If you are a woman and have been affected in this way, your periods may be resumed if your medication is changed Clozaril. In these circumstances, you must ensure that you take adequate measures to prevent pregnancy.

Breastfeeding

Women should not breast-feed while taking Clozaril because the drug can pass through breast milk to the baby.

Driving and operating machinery

You should avoid driving or operating machinery, especially in the early stages of treatment.

 How to take Clozaril tablets?

Clozaril is only suitable for adults over 16 years of age.

Please follow the instructions given to you by your doctor or pharmacist. He / she will tell you how many tablets to take and how often to take them. You must follow these instructions carefully and it is important not to change your dose or stop taking Clozaril unless your doctor tells you to.

Treatment of Schizophrenia

The usual dose of Clozaril is between 200 mg and 450 mg daily. The dose is usually taken in divided doses, some morning and some at night. Treatment is usually started with half a tablet of 25 mg (12,5 mg) once or twice a day the first day. Then your doctor will slowly increase your dose until you reach your ideal dose. Your Clozaril treatment will continue for at least six months. Some people may require higher doses up to 900 mg daily.

Treatment of severe thought disturbances in patients with Parkinson's disease

The usual dose is between 25 mg and 37,5 mg per day and is usually given as a single dose every night. Treatment is usually started with half a tablet of 25 mg (12,5 mg) at night and then the dose is gradually increased until the ideal dose for you. Some patients may require doses up to 100 mg per day. During the first weeks of treatment will be measured blood pressure.

Always take the tablet with water and swallow them whole.

Clozaril is long. If it stops, it may reappear previous symptoms. It is therefore important to take tablets every day.

If you forget to take Clozaril

Clozaril should be taken regularly every day. If you miss a dose, take another as soon as you remember. However, if it is time for your next dose, skip the forgotten tablets and take the next dose at the right time. It is important to remember that if you are taking any Clozaril for more than 48 hours, you should contact your doctor as soon as possible.

If you take more tablets than Clozaril dose

If too much of your medicine, you should contact your doctor immediately or go to the nearest emergency room.

 POSSIBLE SIDE EFFECTS

Effects on blood

Clozaril may cause changes in the numbers of certain cells (white cells), which are found in the blood. In some cases, patients may develop a decrease in the number of a type of white blood cells called neutrophils. Neutrophils are responsible for fighting infections and so if you fall, your body may be less able to fight infection. You may hear this called "neutropenia" or "agranulocytosis". For this reason, we should have regular blood tests. If a significant decrease in white blood cells will require additional blood tests and if at any time the number of white blood cells drops below a certain level, should immediately stop taking Clozaril. It is very important not to miss blood tests. After Clozaril stop the white blood cells to recover. If you develop neutropenia or agranulocytosis, you can not get Clozaril again.

While taking Clozaril is important to immediately tell your doctor if you develop signs of infection such as fever and flu-like symptoms and sore throat. This will allow your doctor to perform an urgent blood test to check whether your symptoms are related to your medicine.

Sometimes Clozaril may cause an increase in the number of white blood cells.

Furthermore, Clozaril may also cause an increase in a type of white blood cells called eosinophils. If it rises above a certain level, Clozaril should be discontinued. Clozaril will start again after the number of eosinophils.

In some very rare cases, a decrease in the number of platelets (blood cells essential for blood clotting). If the platelet count falls below a certain level, Clozaril treatment will be stopped. May develop also increases platelet counts.

Effects on the heart

Rarely reported side effects on the heart, Clozaril. Therefore, before you start taking Clozaril, your doctor will ask you about any previous heart problems, you may have had and will perform a physical examination prior to recording of the heart (electrocardiogram or ECG). Clozaril can cause ECG changes, changes in heartbeat and pulse. In rare cases it can cause damage to the heart muscle (cardiomyopathy), inflammation of the membrane surrounding the heart muscle (pericarditis), fluid around the heart (pericardial effusion) and very rarely - heart failure. Moreover, rarely that Clozaril can cause inflammation of the heart muscle (myocarditis). In case of myocarditis, it usually happens within the first two months of treatment. Symptoms of myocarditis may include increased heart rate at rest, fast or difficult breathing, chest pain, palpitations or irregular heartbeat, flu symptoms, unexplained fatigue and an increased number of eosinophils in the blood. If you are taking Clozaril in the past and was diagnosed with myocarditis, it is important to tell your doctor because you should not take Clozaril again.

Other side effects

Some people Clozaril may cause the following

  Drowsiness

  Dizziness

  Fatigue

  Increased salivation

  Weakness or slightly dizzy if you stand up suddenly from a position leganalo

 Weight gain

  Blurred vision "

  Headache

  Shivering, numbness, agitation, restlessness, and abnormal movements

  Epileptic seizures (seizures, convulsions) and seizures

  Dry mouth

  Increased sweating

  Increased body temperature - especially in the initial weeks of treatment

  High blood pressure

  Feelings of nausea, vomiting, loss of appetite

  Involuntary loss of urine or difficulty urinating

  Mild disturbances in liver function tests

  Neuroleptic Malignant Syndrome (NMS) - a severe reaction to antipsychotic treatment

  Some patients may develop constipation while taking Clozaril, which may become severe. This should be reported to your doctor as you may need treatment.

In rare cases, Clozaril can cause;

  Increased levels of blood sugar and diabetes. Very rarely, some patients may be severely affected.

  Confusion and disorientation

  Abnormal muscle movements of the face and body

  Increased levels of a type of fat (triglycerides) in the blood

  blood clots in blood vessels, for example. feet

  difficulty in swallowing

  Shortness of breath

  accidental inhalation of food (aspiration)

  Severe constipation associated with obstruction of the colon, which can cause abdominal pain and stomach cramps

  Inflammation of the liver and other effects on the liver, causing yellowing of the skin, itching and dark urine

  Inflammation of the pancreas leading to abdominal pain

  Enlargement of the salivary glands and increased salivation.

  Inflammation of the kidneys

  Rash

  Increased blood levels of an enzyme called creatine

  prolonged painful erection of the penis

  High levels of cholesterol in the blood

  Anemia (low hemoglobin)

Tell your doctor immediately if you notice any of these symptoms or if you have any other unexpected symptoms are not mentioned in this leaflet.

Unless your doctor tells you otherwise, you should not suddenly stop taking your tablets Clozaril, as has been reported for the effects of stopping treatment after his sudden termination. These effects include sweating, headache, nausea, vomiting, diarrhea and recurrence of your original symptoms

Very rare cases of sudden unexplained deaths in patients taking Clozaril. Such cases occur in patients with psychiatric disorders, whether treated or not.

Store Clozaril tablet

Keep your medicine in a safe place, inaccessible to children. Your medicine may harm them.

Do not use this medicine after the expiry date stated on the carton / blister.

If your doctor decides to stop your treatment, return any leftover medicine to your pharmacist.

Only keep it if your doctor tells you to.

 Additional Information

REMEMBER: This medicine is only for you. Only a doctor can prescribe it for you. Never give it to other people. It may harm them even if their symptoms are the same as yours.

If you have further questions about your medicine or you are unsure about any of the advice in this leaflet, ask your doctor or pharmacist.