Course of Treatment:_________________________________________________________________________________

 
PURPOSE AND GENERAL INFORMATION
 
1. This medication is used to treat a variety of psychiatric problems such as over-activity, preoccupation with troublesome disorganized thoughts, and unpleasant and unusual experiences such as hearing and seeing things neither normally heard nor seen. This medication will reduce or stop these experiences and help you remain outside the hospital.
2. This medication cannot "cure" the illness, but it can take away many of the symptoms or make them milder. It is important to take this medication as directed, even when you begin to feel better. It is necessary to continue taking this medication in order to keep feeling well. When taken regularly, this medication usually requires up to six weeks before the full effects are noticed.
3. This medication does not produce euphoria (a high feeling) and is not addictive.

 

BENEFITS
 
1. Reduction or elimination of voices or visions not heard nor seen by others.
2. Reduction or elimination of frightening or strange beliefs and ideas not shared by others.
3. Decreased tension and agitation with more calm, relaxed feelings.
4. Improved concentration and clearer thinking; better control over thoughts and feelings with less hostile, strange, or aggressive thoughts.
5. Reduced fears, confusion, and insomnia.
6. Improved coherence of speech with greater ability to express oneself and to be understood by others.
7. Happier, brighter, and healthier feelings.
8. Increased ability to act more appropriately without wanting to laugh, cry, or smile for no apparent reason.
9. Increased ability to care for oneself, reducing the neglect of appearance and personal hygiene.
10. Prevention or delay of relapses and the need for re-hospitalization.

 
 
PROBABLE HEALTH CONSEQUENCES OF NOT TAKING THIS MEDICATION
 
1. If you elect not to take this medication, it is important for you to understand the potential consequences. The symptoms of psychosis will not get better; in fact, they could worsen.
2. When suffering from the symptoms of psychosis, you may "hear voices" or have strange and untrue ideas.
3. You may get excited for no apparent reason, or spend a lot of time off by yourself, or in bed, sleeping during the day and staying awake at night.
4. You may neglect your appearance, and may become difficult to communicate with--saying things that make no sense, or barely talking at all.
5. These symptoms may lead to difficulty with your job, or relationships with your family and friends, or day-to-day functioning.
6. Left untreated, psychosis also could lead to thoughts or attempts of harming oneself or others.

 
 
 
ALTERNATIVE TREATMENTS
 
1. Other antipsychotic medications: "typical neuroleptics" such as chlorpromazine or haloperidol, or "atypical neuroleptics" such as risperidone.
2. "Depot" injectable typical antipsychotic medications.
3. Electroconvulsive therapy.
4. Support groups, as an adjunct to medication, are often helpful in providing support, education, and guidance; however, they do not replace medication.

 
PROPER USE OF THIS MEDICATION
 
1. While you are on clozapine, you must be carefully monitored because clozapine can cause a severe reduction in your body's ability to make white blood cells (agranulocytosis). This happens in 1 or 2 people out of every 100 who receive clozapine. If this happens, it could result in your body not being able to fight off infection. This could lead to a severe infection, getting very sick, being put into a general hospital and possibly death.
2. For this reason you will have a blood test every week while you are taking clozapine. This test is designed to detect any changes in the number of your white blood cells BEFORE any problems occurs. If you do not get your blood drawn, medications will not be prescribed.
3. If you need to travel or if you cannot keep an appointment, other arrangements can be made. After you stop taking clozaril, we will continue to draw your blood once weekly for four weeks to make sure everything is okay. You can also help monitor your white blood cell counts by informing your doctor of any signs of infection, which you might have. It is most important to call right away if you have a fever, or feel like you are getting "the flu", have a sore throat, notice unusual bleeding, or notice you are getting little sores or ulcers on any part of your body or in your stomach.
4. Take with food to lessen stomach upset.
5. Do not take more of this medicine and do not take it more often than your physician has prescribed.
6. Store medicine away from heat and direct light. Keep out of the reach of children. Do not store in the bathroom medicine cabinet since heat and moisture may cause medicine to break down.

 
SIDE EFFECTS
 
1. Drowsiness--this is usually a problem only during the first few days when you start taking the medication or when you adjust the dose. Most of the time, this tiredness goes away as you adjust with time. Until you adjust to this medication, be very cautious driving or performing tasks that require alertness or coordination.
2. Dizziness, lightheadedness, reduced blood pressure--may occur when you get up too quickly or change positions rapidly. This occurs most frequently when clozapine is first started or after the dose is increased. This can be avoided by rising or changing positions slowly.
3. Increased in heart rate, blood pressure--can cause your heart to beat faster than normal or your blood pressure to go up. While this is not usually dangerous, it can sometimes be a problem in certain people who already have heart problems. If you notice your heart beating faster or differently, it is important to tell your doctor.
4. Drooling--can cause some people to drool or have a very wet mouth. If this becomes a problem for you discuss it with your doctor.
5. Weight gain--may occur in some patients while taking this medication. If this is not desired, exercise and dietary restriction may be helpful.
6. Temporary high fever--in the first several weeks of taking clozapine you may experience a high fever for a day or two. Often this fever may just be bothersome and not dangerous. However, the fever could be a sign of a blood problems, so it is very important that you tell your doctor as soon as possible.
7. Seizures, convulsions--Clozapine can cause seizures or convulsions in some patients. The changes of having a seizure while taking clozapine get higher as the dose goes higher. Because a person passes out during the seizures caused by clozapine, you should avoid driving, working with machinery or similar dangerous activities until your dose of clozapine has stay the same for several weeks. If you have a seizure, notify your physician.
8. Neuroleptic Malignancy Syndrome--A rare but potentially fatal side effect that has occurred with antipsychotic medications symptoms includes very high fever, muscle stiffness and confusion, irregular heartbeat and sweating. If these symptoms occur seek immediate medical attention. Individuals who have had a heatstroke maybe at greater risk for this condition.

University Hospital
Psychiatric Unit
4502 Medical Drive
San Antonio, TX 78229
(210) 358-1260

University Health Center Downtown
Psychiatry Services - West Annex
1115 West Martin
San Antonio, TX 78207
(210) 358-3730

PHARMACY INFORMATION

A pharmacist is also available to answer questions about your medication, and your prescription for this medication may be refilled at the following locations:

University Hospital Outpatient Pharmacy
4502 Medical Drive
San Antonio, TX 78229
Pharmacist Line: (210) 358-2905
Refill Line: (210) 358-4186
Outpatient Pharmacy Hours:
Monday thru Friday 9:00 a.m. to 8:00 p.m.
Weekend & Holidays: 9:00 a.m. to 5:00 p.m.

University Health Center Downtown Pharmacy
527 N. Leona St.
San Antonio, TX 78207
Pharmacist Line: (210) 358-3466
Refill Line: (210) 358-3476
Pharmacy Hours:
Monday thru Friday: 8:00 a.m. to 8:00 p.m.
Saturday 8:30 a.m. – 4:00 p.m.
Sundays and Holidays: Closed

University Family Health Center, Southeast Pharmacy
3819 S. Gevers
San Antonio, TX 78223
Pharmacist Line: (210) 358-5534
Refill Line: (210) 358-5535
Pharmacy Hours:
Monday thru Thursday 8:30 a.m.-7:00 p.m.
Fridays: 8:30 a.m.- 5:00 p.m.
Saturdays: 8:00 a.m. – 12:00 p.m.
Sundays and Holidays: Closed

University Family Health Center, Southwest Pharmacy
2121 SW 36th St.
San Antonio, TX 78237
Pharmacist Line: (210) 358-5137
Refill Line: (210) 358-5138
Pharmacy Hours:
Monday thru Thursday: 8:30 a.m. – 5:30 p.m.
Fridays: 8:30 a.m. through 5:00 p.m.
Weekends and Holidays: Closed

FOR ALL REFILLS

PLEASE CALL REFILL LINE 24 HOURS IN ADVANCE. ALLOW 1 BUSINESS DAY (M-F) FOR REFILLS.
PLEASE BE PREPARED TO PROVIDE YOUR NAME, PHONE NUMBER, HEALTH SYSTEM I.D. NUMBER, AND Rx NUMBERS (S).