LEPONEX 25 mg. 50 tablets
Before starting LEPONEX you will have a blood test to make sure that you take this medicine.
You will have regular blood tests while you continue to take Clozaril and if you stop Clozaril, for four weeks thereafter. Your doctor will tell you when and where you have the tests. They will be carried out weekly during the first few months, but can later be reduced to every two weeks. Once you've been on Clozaril for one year may be necessary for you to have blood tests every four weeks. It is important not to miss these tests, as For your safety, your doctor can not prescribe more tablets. Your co-operation blood tests is particularly important.
2. Before you take Clozaril tablets
Clozaril will be given to you if you are unconscious.
Tell your doctor if any of these statements apply to you:
• If you have taken this medicine and you were allergic to it or it hurt you, or any of the other ingredients of the tablet are you harm.
• If you are unable to undergo regular blood tests.
• If you have ever had a low white blood cell count (including after taking Clozaril), unless it was after cancer treatment.
• If you have or previously had a disease of the bone marrow.
• If you suffer from epilepsy (seizures, convulsions or seizures).
• If you have problems with alcohol or substance abuse, for example. Drugs.
• If you suffer from any serious heart, liver or kidney problems. If you have ever had a severe disease affecting the heart, it may be necessary to contact a specialist.
• If you have suffered from severe constipation, bowel obstruction or any other condition which has affected your large bowel.
• If you have glaucoma (an eye disorder).
• If you have diabetes.
• If you have difficulty urinating due to an enlarged prostate gland.
• If you have an intolerance to certain sugars, eg. lactose.
Tell your doctor if you are taking any of the following medications:
- Medicines to treat high blood pressure, for example. metoprolol, kaltopril
• Medicines to treat depression, for example. fluvoxamine, paroxetine, phenelzine, citalopram
• Some antipsychotic drug given by injection, for example. flupentixol decanoate, fluphenazine decanoate
• Benzodiazepines (tranquilizers) or sleeping pills, for example. dizaepam, temazepam
• antihistamines used to treat allergic disorders or hayfever, e. loratadine, chlorpheniramine
• Antibiotics, e. cotrimoxazole, chloramphenicol, erythromycin, rifampicin or antifungal agents, for example. fluconazole
• Drugs for treating cancer, for example. cyclophosphamide, busulfan
• Medicines to treat epilepsy, for example. phenytoin, carbamazepine, sodium valproate
• Medicines to treat pain, for example. morphine, codeine, and phenylbutazone
• Digoxin or warfarin
• Some drugs used to treat arthritis, for example. penicillamine, naproxen, indomethacin
• A drug which is known to cause constipation, including drugs used to treat depression or schizophrenia, for example. chlorpromazine, or drugs to treat symptoms of Parkinson's disease, e. pergolide
• adrenaline or noradrenaline
• Some antiviral drug, eg. ritonavir, indinavir
• omeprazole (a drug for treating increased acidity in the stomach)
Some medicines may affect your treatment. It is important to ask your doctor before taking any other medicines, even if they are granted without retsepta.Ne should not drink alcohol while taking Clozaril. Clozaril levels in the blood can be affected by stopping smoking and changes in the number of caffeine - containing drinks you have. Please tell your doctor about any such changes.
Contraception and pregnancy
If you are pregnant, planning to become pregnant or become pregnant during treatment, it is important that you tell your doctor before taking Leponeks.Nyakoi of women taking some antipsychotic medications have irregular or no periods. If you are a woman and you have been affected in this way, your periods may be resumed if your medication is changed to Clozaril. In these circumstances, should be sure to take adequate measures to avoid pregnancy.
Women should not breast-feed while taking Clozaril because the drug can pass through breast milk to the baby.
Driving and using machines
To avoid driving or operating machinery, particularly in the early stages of treatment.
3. How to take Clozaril tablets?
Clozaril is suitable only for adults over 16 years vazrast.Molya follow the instructions given to you by your doctor or pharmacist. He / she will tell you how many tablets to take and how often to take them. You must follow these instructions carefully and it is important to not change your dose or stop taking Clozaril unless your doctor tells you.
Treatment of Schizophrenia
The usual dose of Clozaril is between 200 mg and 450 mg per day. The dose is usually taken in divided doses as some morning and some at night. Treatment usually begins with a half tablet of 25 mg (12,5 mg) once or twice a day during the first day. Then your doctor will slowly increase your dose, until the ideal dose for you. Your Clozaril treatment will continue for at least six months. Some people may need higher doses to a maximum of 900 mg a day.
Treatment of severe thought disturbances in patients with Alzheimer's ParkinsonObichaynata dose is between 25 mg and 37,5 mg per day and is usually given as a single dose each evening. Treatment is usually started with a half tablet of 25 mg (12,5 mg) in the evening and then the dose is gradually increased until the ideal dose for you. Some patients may require doses of up to a maximum of 100 mg per day. During the first weeks of treatment will be measured blood pressure.
Always take the tablet with water and swallow them whole.
Clozaril is long. If it is stopped, it is possible to reappear previous symptoms. It is therefore important to take tablets every day.
If you forget to take Clozaril
Clozaril must be taken regularly every day. If you miss a dose, take another as soon as you remember. If it's time for the next dose, skip the forgotten tablets and take the next dose at the right time. It is important to remember that if you have not taken any Clozaril for more than 48 hours, you should contact your doctor as soon as possible.
If you take more Clozaril tablets than you should
If too much of your medicine you should contact your doctor immediately or go to the nearest emergency room.
4. POSSIBLE SIDE EFFECTS
Effects on blood
Clozaril can cause changes in the number of a certain type of cells (white cells), which are found in the blood. In some cases, patients may cause a reduction in the number of white blood cells called neutrophils. Neutrophils are responsible for fighting infections and so if you decrease your body may be less able to fight infection. You may hear it called 'neutropenia' or 'agranulocytosis'. For this reason, we should have regular blood tests. If a significant decrease in white blood cells will require additional blood tests and if at any time the number of white blood cells drops below a certain level, should immediately stop taking Clozaril. It is important not to miss blood tests. Once Clozaril stop, the number of white blood cells must be restored. If you develop neutropenia or agranulocytosis, you can not get otnovo.Dokato taking Clozaril Clozaril is important that you immediately inform your doctor if you develop signs of infection such as fever and flu-like symptoms or sore throat. This will allow your doctor to perform an urgent blood test to check whether your symptoms are related to your medicine.
Sometimes Clozaril may cause an increase in the number of white blood cells.
Additionally, Clozaril may also cause an increase in a type of white blood cells called eosinophils. If it rises above a certain level, Clozaril treatment should be stopped. Clozaril will start again after the eosinophil count normalizira.Pri some very rare cases, a decrease in the number of platelets (blood cells essential for blood clotting). If the platelet count falls below a certain level, Clozaril treatment will be stopped. May develop also increases the number of platelets.
Effects on the heart
Rarely reported side effects of heart Clozaril. Therefore, before you start taking Clozaril, your doctor will ask you about any previous heart problems, which may have had and will perform a physical examination prior to recording of the heart (electrocardiogram or ECG). Clozaril can cause ECG changes, palpitations and irregular pulse. In rare cases can cause damage to the heart muscle (cardiomyopathy), inflammation of the membrane surrounding the heart muscle (pericarditis), fluid accumulation around the heart (pericardial effusion) and very rarely - cardiac arrest. Moreover, rarely reported that Clozaril can cause inflammation of the heart muscle (myocarditis). In the case of myocarditis, this usually occurs within the first two months of treatment. The symptoms of myocarditis may include: fast heartbeat at rest, fast or difficult breathing, chest pain, palpitations or abnormal heart rhythm, flu symptoms, unexplained fatigue and raised eosinophils in the blood. If you are taking Clozaril in the past and been diagnosed with myocarditis is very important to tell your doctor because you should not take Clozaril again.
Other side effects
In some people, Clozaril can cause the following
• Increased salivation
• Weakness or slightly dizzy if you stand up suddenly from leganalo position
• Weight gain
• Blurred vision "
• shaking, stiffness, agitation, anxiety and abnormal movements
• Seizures (fits, convulsions) and seizures
• Dry mouth
• Increased sweating
• Increased body temperature - especially in the initial weeks of treatment
• High blood pressure
• A feeling of nausea, vomiting, loss of appetite
• Involuntary loss of urine or difficulty urinating
• Mild abnormalities in liver function tests
• Neuroleptic Malignant Syndrome (NMS) - a severe reaction to antipsychotic medication
• Some patients may develop constipation while taking Clozaril, which may become severe. This should be reported to your doctor as you may need treatment.
In rare cases, Clozaril can cause;
• Increased blood sugar levels and diabetes. Very rarely, some patients may be severely affected.
• Confusion and disorientation
• Abnormal muscle movements of the face and body
• Increased levels of a type of fat (triglycerides) in the blood
• blood clots in the blood vessels, for example. legs
• difficulty in swallowing
• Difficulty breathing
• Accidental inhalation of food (aspiration)
• Severe constipation associated with occlusion of the colon, which may cause abdominal pain and abdominal cramping
• Inflammation of the liver and other effects on the liver causing yellowing of the skin, itching and dark urine
• Inflammation of the pancreas, leading to abdominal pain
• Swelling of the salivary glands and increased salivation.
• Inflammation of the kidney
• Increased blood levels of an enzyme called creatine phosphokinase
• prolonged painful erection of the penis
• High levels of blood cholesterol
• Anemia (low hemoglobin)
Tell your doctor immediately if you notice any of the above symptoms or if you have any other unexpected symptoms that are mentioned in this listovka.Osven if your doctor tells you otherwise, should not suddenly stop taking your tablets Clozaril as reactions have been reported on stopping treatment after abrupt discontinuation. These reactions include sweating, headache, nausea, vomiting, diarrhea and recurrence of your initial symptoms.
Very rare cases of sudden unexplained death in patients taking Clozaril. Such cases arise in patients with psychiatric disorders, whether treated or not.
5. Storing Clozaril tablets
Keep your medicine in a place inaccessible to children. Your medicine may harm them.
Do not use this medicine after the expiry date stated on the carton / blistera.Ako your doctor decides to stop your treatment, return any leftover medicine to your pharmacist.
Only keep it if your doctor tells you to.