If the number of white blood cells falls below a critical level, clozaril will be stopped immediately and you must never take clozaril again.
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Older adults may be more sensitive to the side effects of this drugespecially constipationtrouble urinatingdrowsinessdizzinesslightheadednessand QT prolongationsee aboveDrowsinessdizzinessand lightheadedness can increase the risk of falling.
The dose of 50 mg/day should only be exceeded in exceptional casesand the maximum dose of 100 mg/day must never be exceeded.
Clozaril exerts anticholinergic activitywhich may produce undesirable effects throughout the bodyCareful supervision is indicated in the presence of prostatic enlargement and narrow-angle glaucomaProbably on account of its anticholinergic propertiesClozaril has been associated with varying degrees of impairment of intestinal peristalsisranging from constipation to intestinal obstructionfaecal impactionparalytic ileusmegacolon and intestinal infarction ischaemiasee section 4.8On rare occasions these cases have been fatalParticular care is necessary in patients who are receiving concomitant medications known to cause constipationespecially those with anticholinergic properties such as some antipsychotic santidepressants and antiparkinsonian treatmentshave a history of colonic disease or a history of lower abdominal surgery as these may exacerbate the situationIt is vital that constipation is recognised and actively treated.
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