clozapine; Clozaril, Fazacio ODT (cont.)
The most common side effect of clozapine is
drowsiness. Other side effects include increased heart rate, increased
salivation, headache, tremor, low blood pressure, and
fever. Clozapine has anticholinergic effects that interfere with the function of
smooth muscles. This can lead to blurred vision and difficulty urinating
(when there is enlargement of the prostate) due to effects on the muscles
of the eye and bladder. Clozapine slows the intestine and leads to
constipation in approximately 14% of patients. Paralysis of the intestinal
muscles can lead to paralytic ileus, a condition in which the intestine
stops working.
Clozapine also may cause extrapyramidal effects (sudden, often
jerky,
involuntary motions of the head, neck, arms, body, or eyes).
Like other
anti-psychotics, clozapine also may cause tardive dyskinesia
(potentially
irreversible involuntary movements). The risk of such reactions
appears to
be lower with clozapine than with older anti-psychotics,
perhaps due to
its weaker effects on dopamine type 2 receptors.
Although there is no clear link between clozapine and diabetes, patients should be tested during treatment for elevated blood-sugars. Additionally, persons with risk factors for diabetes, including obesity or a family history of diabetes, should have their fasting levels of blood sugar tested before starting treatment and periodically throughout treatment to detect the onset of diabetes. Any patient developing symptoms that suggest diabetes during treatment should be tested for diabetes.
Clozapine is eliminated from the body by enzymes (P450) in the liver.
Numerous medications can increase or decrease the activities of these enzymes
leading to low (potentially ineffective) or high (potentially toxic) levels of
clozapine in the blood. When used with these medications, the dose of
clozapine may need to be reduced or increased.
Reference: FDA Prescribing Information
Last Editorial Review: 12/22/2010
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
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