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Benign ethnic neutropenia

Benign ethnic neutropenia (BEN) can be defined as: ‘The occurrence of neutropenia, defined by normative data in white populations, in individuals of other ethnic groups who are otherwise healthy and who do not have repeated or severe infections’.



Eosinophilia is a common (≥1/100 but <1/10) side-effect of Clozaril® (clozapine).


Gastrointestinal side-effects

This information sheet will cover the following side-effects: nausea, vomiting, dysphagia, dry mouth and parotid gland enlargement.


General anaesthesia

If a patient on Clozaril® (clozapine) is going to have surgery it is essential that the anaesthetist is aware that the patient is taking clozapine so that the anaesthetic protocol can be reviewed as necessary.



The Summary of Product Characteristics of Clozaril® (Clozapine) states that hypersalivation is a very common (≥1/10) side effect.


Red alert management

The most well recognised side-effects of clozapine are neutropenia, defined as a neutrophil count of less than 1.5 x 109/L and agranulocytosis which is a neutrophil count of less than 0.5 x 109/L.


Weight gain

The Summary of Product Characteristics (SmPC) for Clozaril® (clozapine) states that: Weight gain has been observed with atypical antipsychotic use, including Clozaril®.


Discontinuing treatment

The Summary of Product Characteristics (SmPC) for Clozaril® (clozapine) states: In the event of planned termination of Clozaril® therapy, a gradual reduction in dose over a 1 to 2-week period is recommended.


Initiating treatment

The Summary of Product Characteristics (SmPC) for Clozaril® (clozapine) includes the following information regarding initiation of treatment with clozapine: For treatment-resistant schizophrenic patients, start therapy with 12.5mg once or twice on the first day, followed by 25mg once or twice on the second day.


​​Clozapine Constipation

The Summary of Product Characteristics (SPC) for Clozaril® (clozapine) lists constipation as a very common (>1/10) reaction to Clozaril®.


Use of clozapine in patients aged 60 years and older

Clozapine has been shown to be effective in treating elderly patients with schizophrenia.


Clozapine and compliance

Compliance may be defined as the extent to which a person's behaviour coincides with the medical advice he/she has


Clozapine therapy: role of therapeutic drug monitoring (TDM)

Although antipsychotic efficacy with Clozaril® (clozapine) can be expected with doses of 200 to 450 mg/day, the approved dose range extends up to 900mg/day


Clozapine and seizures

Clozapine lowers the seizure threshold in a dose-dependent manner and may induce myoclonic jerks or generalised seizures


Clozapine and fever

During Clozaril® therapy, patients may experience transient temperature elevations above 38°C, with the peak incidence within the first 3 weeks of treatment


Clozapine and neuroleptic malignant syndrome

NMS is a serious and potentially fatal symptom complex that has been reported in association with antipsychotic drugs.


Clozapine and cardiovascular events

Tachycardia typically occurs in the first few weeks of treatment and it may persist in some patients. It is usually dose-related.


Clozapine and urinary incontinence/urinary retention

Urinary incontinence and urinary retention are common (≥1/100 but <1/10) side-effects of Clozaril®. Nocturnal enuresis is also listed as an adverse effect which has a frequency of 'not known'.


Clozapine and liver function

The Summary of Product Characteristics (SmPC) for Clozaril® (clozapine) states that: elevation of liver enzymes is a common (≥1/100 but <1/10) reaction to Clozaril®,


Clozapine, diabetes and hyperglycaemia

The Summary of Product Characteristics (SmPC) for Clozaril® (clozapine) states that diabetes mellitus and impaired glucose tolerance are rare (≥1/10,000 but <1/1,000) side effect.


Clozapine Overdose

In cases of acute intentional or accidental Clozaril® overdose for which information on the outcome is available, mortality to date is about 12%.



What to expect from Clozaril®

This booklet is intended only for patients who have been prescribed Clozaril® and/or their family/carers.


Clozaril® leavepiece

NICE defines ‘treatment resistance’ in schizophrenia patients as the lack of satisfactory clinical improvement following sequential treatment with at least two different antipsychotic drugs, including at least one second-generation (atypical) antipsychotic.


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