clozapine - oral, Clozaril (cont.)

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.

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