Prior to initiating treatment with CLOZARIL, a baseline ANC must be obtained. Prior to initiating treatment with CLOZARIL, a baseline ANC must be obtained. NOT for patients with other medical conditions that may result in an increase in side effects e.g. • Recommence at 12.5mg once or twice daily on the first day. cardiac, renal impairment. Healthcare professionals are advised to use clinical discretion and consideration of the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian when using the chart for patient clozapine titration medication management. The NIMC medication chart must be annotated clearly to identify when a Clozapine Initiation Chart is in use. The length of stay following initiation of clozapine was shorter in the rapid-titration group, although this was not statistically significant. Subsequently, the dose can be increased once weekly or twice weekly, in increments of up to 100 mg.

When a patient has previously been on clozapine and they tolerated the titration. To minimize the risk of orthostatic hypotension, bradycardia, and syncope, it is necessary to use this low starting dose, gradual titration schedule, and divided dosages Generally, patients responding to CLOZARIL should continue maintenance treatment on their effective dose beyond the acute episode.Method of treatment discontinuation will vary depending on the patient’s last ANC:When restarting CLOZARIL in patients who have discontinued CLOZARIL (i.e., 2 days or more since the last dose), re-initiate with 12.5 mg once daily or twice daily.

Further information is available at Method of treatment discontinuation will vary depending on the patients last ANC: If well tolerated the dose may be increased slowly as per the Clozapine Titration Schedule. Available for Android and iOS devices. The baseline ANC must be at least 1500/µL for the general population, and at least 1000/µL for patients with documented Benign Ethnic Neutropenia (BEN). Rapid clozapine titration appeared safe and effective. The maximum dose is 900 mg per day. All orders are to written legibly in black ink. Table 1. The Clozapine Initiation Chart must be kept with all the other medication charts. Severe neutropenia can lead to serious infection and death.WARNING: SEVERE NEUTROPENIA; ORTHOSTATIC HYPOTENSION, BRADYCARDIA, AND SYNCOPE; SEIZURE; MYOCARDITIS AND CARDIOMYOPATHY; INCREASED MORTALITY IN ELDERLY PATIENTS WITH DEMENTIA-RELATED PSYCHOSISPrescribers, pharmacies and patients must be enrolled with the Clozapine REMS Program. To continue treatment, the ANC must be monitored regularly [see Warnings and Precautions (5.1)]. Target dose: 300 mg to 450 mg per day, in divided doses, by the end of 2 weeks. However starting clozapine earlier together with rapid titration has significantly shortened the length of hospital stay in patients with treatment refractory schizophrenia. This is necessary to minimize the risk of hypotension, bradycardia, and syncope Dose adjustments may be necessary in patients with concomitant use of: strong CYP1A2 inhibitors (e.g., fluvoxamine, ciprofloxacin, or enoxacin); moderate or weak CYP1A2 inhibitors (e.g., oral contraceptives, or caffeine); CYP2D6 or CYP3A4 inhibitors (e.g., cimetidine, escitalopram, erythromycin, paroxetine, bupropion, fluoxetine, quinidine, duloxetine, terbinafine, or sertraline); CYP3A4 inducers (e.g., phenytoin, carbamazepine, St. John’s wort, and rifampin); or CYP1A2 inducers (e.g., tobacco smoking) (It may be necessary to reduce the CLOZARIL dose in patients with significant renal or hepatic impairment, or in CYP2D6 poor metabolizers Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. Initial dose: 12.5 mg orally once or twice a day Titration and Maintenance dose: May increase total daily dose in increments of 25 mg to 50 mg per day to a target dose of 300 mg to 450 mg per day (administered in divided doses) by the end of week 2.

Dosing recommendations if clozapine dose is missed for greater than 48 hours • Obtain psychiatric review prior to recommencing clozapine. Generally this dose is 100mg OM and 200mg ON. Clozapine can cause severe neutropenia. Dosing and Administration.

The baseline ANC must be at least 1500/µL for the general population, and at least 1000/µL for patients with documented Benign Ethnic Neutropenia (BEN). This makes it harder for your body to fight infections which could lead to serious infections and death.Clozapine treatment has caused severe neutropenia, defined as an absolute neutrophil count (ANC) less than 500/μL. The clozapine titration chart is based on the best evidence available at the time of development. This is a guide only - for further dosing options refer The Clozapine Initiation and Titration Chart should be completed for all inpatients initiated and re-titrated on clozapine.

CLOZAPINE TITRATION PRESCRIPTION CHART – Quick titration . To continue treatment, the ANC must be monitored regularly The starting dose is 12.5 mg once daily or twice daily. Starting Dose: 12.5 mg once daily or twice daily. Prescribe the dose on prescription chart.