DRUG INTERACTIONS: Your healthcare professionals (e.g., doctor or pharmacist) may already be aware of any possible drug interactions and may be monitoring you for it. Do not start, stop or change the dosage of any medicine before checking with them first.

This drug should not be used with the following medication because a very serious interaction may occur: sibutramine.

If you are currently using the medication listed above, tell your doctor or pharmacist before starting clozapine.

Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially of: antispasmodic or drying medications (e.g., anticholinergics such as belladonna alkaloids), benzodiazepines (e.g., lorazepam, clonazepam, diazepam), carbamazepine, certain antidepressants (e.g., citalopram, SSRIs-especially fluvoxamine), lithium, medications for high blood pressure (e.g., beta blockers such as propranolol, water pills such as furosemide, ACE inhibitors such as lisinopril), drugs affecting liver enzymes that remove clozapine from the body (such as azole antifungals including itraconazole, macrolide antibiotics including erythromycin, tobacco and other nicotine-containing products, cimetidine, ciprofloxacin, rifampin, certain anti-seizure medicines including phenytoin, antiarrhythmics such as propafenone/flecainide/quinidine).

Tell your doctor or pharmacist about any medications or treatment that may decrease your blood cell count such as chemotherapy, radiation therapy, or medications for autoimmune disorders such as rheumatoid arthritis (e.g., methotrexate, azathioprine).

Also report the use of drugs which might increase seizure risk (decrease seizure threshold) when combined with clozapine such as isoniazid (INH), phenothiazines (e.g., thioridazine), theophylline, or tricyclic antidepressants (e.g., amitriptyline), among others. Consult your doctor or pharmacist for details.

Tell your doctor or pharmacist if you also take drugs that cause drowsiness such as certain antihistamines (e.g., diphenhydramine), anti-seizure drugs (e.g., valproate), medicines for sleep or anxiety (e.g., alprazolam, zolpidem), muscle relaxants, narcotic pain relievers (e.g., codeine), psychiatric medicines (e.g., chlorpromazine, risperidone, trazodone).

Check the labels on all your medicines (e.g., cough-and-cold products) because they may contain drowsiness-causing ingredients. Ask your pharmacist about the safe use of those products.

This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist.

OVERDOSE: If overdose is suspected, contact your local poison control center or emergency room immediately. US residents can call the US national poison hotline at 1-800-222-1222. Canadian residents should call their local poison control center directly.

NOTES: Do not share this medication with others.

Laboratory tests (e.g., blood tests) should be performed weekly for the first 6 months of treatment. During the next 6 months, they should be performed at least every 2 weeks. After that, they should be performed regularly no less often than once a month while you are on clozapine and for at least 4 weeks after you stop taking it. Your testing schedule may be changed if you develop a low white blood cell count, or if your treatment is interrupted. Your doctor may also order other laboratory and/or medical tests (e.g., liver function, blood sugar, weight) from time to time. Consult your doctor for more details.

MISSED DOSE: If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. If you miss doses for longer than a day or two, consult your doctor for a new schedule to get back to the dose you were taking. Do not double the dose to catch up.

STORAGE: Store at room temperature no higher than 86 degrees F (30 degrees C) away from light and moisture. Store the dissolving tablets at 77 degrees F (25 degrees C) in their blister packets, and do not remove each dose until immediately before taking. Brief storage between 59-86 degrees F (15-30 degrees C) is permitted. Do not store in the bathroom. Keep all medicines away from children and pets.

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 pharmacist or local waste disposal company for more details about how to safely discard your product.

Information last revised January 2012. Copyright(c) 2012 First Databank, Inc.