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(clozapine) Orally Disintegrating Tablets
- Patient Information:
Details with Side Effects
AGRANULOCYTOSIS; ORTHOSTATIC HYPOTENSION, BRADYCARDIA, AND SYNCOPE; SEIZURE; MYOCARDITIS AND CARDIOMYOPATHY; INCREASED MORTALITY IN ELDERLY PATIENTS WITH DEMENTIA-RELATED PSYCHOSIS
Clozapine treatment has caused agranulocytosis, defined as an absolute neutrophil count (ANC) less than 500/mm³. Agranulocytosis can lead to serious infection and death. Prior to initiating treatment with FAZACLO, obtain a baseline white blood cell count (WBC) and ANC. The ANC must be greater than or equal to 2000/mm³ and the WBC must be greater than or equal to 3500/mm³ for a patient to begin treatment with FAZACLO. During treatment, patients must have regular monitoring of ANC and WBC. Discontinue FAZACLO and do not rechallenge if the ANC is less than 1000/mm³ or the WBC is less than 2000/mm³. Advise patients to immediately report symptoms consistent with agranulocytosis or infection (e.g., fever, weakness, lethargy, or sore throat) [see DOSAGE AND ADMINISTRATION and WARNINGS AND PRECAUTIONS].
Because of the risk of agranulocytosis, FAZACLO is available only through a restricted program called the FAZACLO Patient Registry. Under the FAZACLO Patient Registry, prescribers, patients, and pharmacies must enroll in the program [see WARNINGS AND PRECAUTIONS].
Orthostatic Hypotension, Bradycardia, Syncope
Orthostatic hypotension, bradycardia, syncope, and cardiac arrest have occurred with clozapine treatment. The risk is highest during the initial titration period, particularly with rapid dose escalation. These reactions can occur with the first dose, with doses as low as 12.5 mg per day. Initiate treatment at 12.5 mg once or twice daily; titrate slowly; and use divided dosages. Use FAZACLO cautiously in patients with cardiovascular/cerebrovascular disease or conditions predisposing to hypotension (e.g., dehydration, use of antihypertensive medications) [see DOSAGE AND ADMINISTRATION and WARNINGS AND PRECAUTIONS].
Seizures have occurred with clozapine treatment. The risk is dose-related. Initiate treatment at 12.5 mg, titrate gradually, and use divided dosing. Use caution when administering FAZACLO to patients with a history of seizures or other predisposing risk factors for seizure (CNS pathology, medications that lower the seizure threshold, alcohol abuse). Caution patients about engaging in any activity where sudden loss of consciousness could cause serious risk to themselves or others [see DOSAGE AND ADMINISTRATION, WARNINGS AND PRECAUTIONS].
Myocarditis and Cardiomyopathy
Fatal myocarditis and cardiomyopathy have occurred with clozapine treatment. Discontinue FAZACLO and obtain a cardiac evaluation upon suspicion of these reactions. Generally, patients with FAZACLO-related myocarditis or cardiomyopathy should not be rechallenged with FAZACLO. Consider the possibility of myocarditis or cardiomyopathy if chest pain, tachycardia, palpitations, dyspnea, fever, flu-like symptoms, hypotension, or ECG changes occur [see WARNINGS AND PRECAUTIONS].
Increased Mortality in Elderly Patients with Dementia-Related Psychosis
Elderly patients with dementia-related psychosis treated with antipsychotic drugs are at an increased risk of death. FAZACLO is not approved for use in patients with dementia-related psychosis [see WARNINGS AND PRECAUTIONS].
FAZACLO is available as yellow, orally disintegrating tablets of 12.5 mg, 25 mg, 100 mg, 150 mg, and 200 mg for oral administration without water. FAZACLO tablets may be chewed.
Each orally disintegrating tablet contains clozapine equivalent to 12.5 mg, 25 mg, 100 mg, 150 mg, and 200 mg.
The active component of FAZACLO is clozapine. The remaining components are aminoalkyl methacrylate copolymer E, mannitol, aspartame, microcrystalline cellulose*, silicified microcrystalline cellulose**, crospovidone, natural and artificial mint flavor, sodium bicarbonate, citric acid, ferric oxide (yellow), and magnesium stearate
THIS PRODUCT CONTAINS ASPARTAME AND IS NOT INTENDED FOR USE BY INFANTS. PHENYLKETONURICS: CONTAINS PHENYLALANINE [see WARNINGS AND PRECAUTIONS ]. Phenylalanine is a component of aspartame. Each 12.5 mg, orally disintegrating tablet contains 1.6 mg aspartame, thus, 0.87 mg phenylalanine. Each 25 mg, orally disintegrating tablet contains 3.1 mg aspartame, thus, 1.74 mg phenylalanine. Each 100 mg, orally disintegrating tablet contains 12.4 mg aspartame, thus, 6.96 mg phenylalanine. Each 150 mg, orally disintegrating tablet contains 18.6 mg aspartame, thus, 10.44 mg phenylalanine. Each 200 mg, orally disintegrating tablet contains 24.8 mg aspartame, thus, 13.92 mg phenylalanine. The allowable daily intake of aspartame is 50 mg per kilogram of body weight per day.
*12.5, 25, and 100 mg tablets
**150 and 200 mg tablets
Last reviewed on RxList: 8/9/2013
This monograph has been modified to include the generic and brand name in many instances.
Additional Fazaclo Information
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