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Clozapine, while beneficial for certain conditions, carries the potential for serious and even fatal side effects. It is prescribed when other treatments are ineffective or unsuitable. If you are in the United States, you must comply with the requirements of the REMS Program to receive this medication. For those outside the U.S., consult your healthcare provider regarding local regulations.

Key Safety Information:

• Neutropenia Risk: Clozapine can significantly reduce a specific type of white blood cell (neutrophils), which are crucial for fighting infections. Routine blood tests are necessary before and during treatment to monitor your white blood cell levels. Seek immediate medical attention if you experience symptoms of severe neutropenia or infection, such as persistent sore throat, fever, swollen lymph nodes, or unusual fatigue.

• Seizure Precaution: There is an increased risk of seizures, particularly at higher doses. Inform your healthcare provider if you have a history of seizures. Avoid driving or engaging in activities that require alertness and could be dangerous if a seizure occurs, such as operating heavy machinery or swimming.

• Heart-Related Concerns: Clozapine may rarely lead to myocarditis (heart muscle inflammation), pericarditis (heart lining inflammation), or heart failure. Urgently seek medical help if you experience chest pain, rapid or irregular heartbeat, shortness of breath, ankle/foot swelling, unusual tiredness, or sudden weight gain.

• Blood Pressure Issues: The medication can cause low blood pressure or slow heartbeat, increasing the risk of dizziness or fainting when standing up, particularly when starting or adjusting the dosage. To minimize this risk, rise slowly from sitting or lying positions.

• Older Adults Warning: In elderly patients with dementia, there may be a slightly increased risk of serious side effects, including stroke, heart failure, irregular heartbeat, and pneumonia. Clozapine is not approved for managing dementia-related behavior problems. Discuss potential risks and alternative treatments with your healthcare provider.

Always discuss your complete medical history with your doctor, including any pre-existing conditions, to ensure the safe use of clozapine. If you suspect an overdose, seek emergency medical attention immediately.

When taking this medication, you might experience drooling, drowsiness, dizziness, lightheadedness, headache, shaking (tremor), blurred vision, constipation, or weight gain. These are common side effects and often diminish as your body adjusts to the treatment. To ease constipation, consider increasing your intake of dietary fiber, staying hydrated, and maintaining regular physical activity. You might also need a laxative; consult your pharmacist for the best option.

Rarely, this medication may cause a rise in blood sugar, potentially leading to or worsening diabetes. If you notice increased thirst or urination, inform your healthcare provider immediately. If you have diabetes, monitor your blood sugar levels regularly. Additionally, there might be significant weight gain and an increase in cholesterol or triglyceride levels, which could elevate the risk of heart disease. Discuss these potential risks with your healthcare professional.

Serious side effects requiring urgent attention include facial or muscle twitching, seizures, uncontrollable movements, interrupted breathing during sleep, severe constipation, and trouble urinating. If you experience persistent nausea or vomiting, severe dizziness, fainting, mood changes, difficulty breathing during exercise, sudden weakness, pain or swelling in the limbs, abdominal pain, or yellowing of the skin or eyes, seek medical help immediately.

A rare but critical condition called neuroleptic malignant syndrome (NMS) can occur, presenting symptoms such as fever, muscle stiffness, severe fatigue, confusion, sweating, irregular heartbeat, and dark urine. Prompt medical attention is crucial. Allergic reactions are uncommon but require immediate care if symptoms like rash, swelling, severe dizziness, or breathing difficulties arise. This summary does not cover all possible side effects; consult your healthcare provider if you observe any unlisted symptoms.