Clozaril Warnings

Clozaril can cause agranulocytosis. Its use should be limited to patients: With schizophrenia who are non-responsive to or intolerant of classical antipsychotic agents, or with schizophrenia or schizoaffective disorder who are at risk of recurrent suicidal behavior (see Indications/Uses); who have initially normal leukocyte findings (white blood cell count (WBC) ≥3500/mm³ (3.5 x 10⁹/L), and absolute neutrophil counts (ANC) ≥2000/mm³ (2.0 x 10⁹/L)); and in whom regular white blood cell counts and absolute neutrophil counts can be performed as follows: Weekly during the first 18 weeks of therapy, and at least every 4 weeks thereafter throughout treatment. Monitoring must continue throughout treatment and for 4 weeks after complete discontinuation of Clozaril (see Precautions).
Prescribing physicians should comply fully with the required safety measures. At each consultation, a patient receiving Clozaril should be reminded to contact the treating physician immediately if any kind of infection begins to develop. Particular attention should be paid to flu-like complaints such as fever or sore throat and to other evidence of infection, which may be indicative of neutropenia (see Precautions).
Clozaril must be dispensed under strict medical supervision in accordance with official recommendations (see Precautions).