What side effects can Clozapine have?
Below you will find the most important information about possible known side effects of clozapine.
These side effects do not occur, but you can. Because every person reacts differently to medication. Please also note that the type and frequency of side effects may vary depending on the drug formulation (eg tablet, syringe, ointment).
Very common side effects:
tiredness, drowsiness, dizziness, palpitations, rapid heartbeat, excessive salivation and constipation.
Common side effects:
Disturbance of white blood cell formation in the bone marrow, weight gain, blurred vision, headache, tremors, involuntary twitching or tics (dyskinesia), inability to sit still (akathisia), high blood pressure, blood pressure fluctuations, drop in blood pressure when getting up lying position, short-term unconsciousness, seizures, nausea and vomiting, loss of appetite, dry mouth, urinary problems (micturition disorders), fever, disturbance of sweat and temperature regulation.
Uncommon side effects:
Very strong white blood cell depletion (agranulocytosis).
Rare side effects:
restlessness, confusion, cardiac arrhythmias, myocarditis, vascular occlusions, hepatitis, jaundice, heavy dysphagia, developing or exacerbating diabetes (diabetes mellitus), hypersensitivity reactions (skin rashes, swelling due to fluid leakage from the blood vessels (angioedema), itching ).
Very rare side effects:
Deficiency of platelets (thrombocytopenia), hyperacidity of the blood due to a metabolic disorder (metabolic acidosis), high blood sugar levels (up to diabetic coma), severe lipid metabolism disorders, movement control disorders, cardiac arrest, enlargement the parotid gland, intestinal obstruction (ileus), acute liver failure, kidney inflammation, painful chronic erections (priapism), unexplained sudden death.
If a malignant neuroleptic syndrome occurs (characterized by muscle rigidity, high fever, clouding of consciousness and circulatory collapse), the treatment must be stopped.
What interactions does clozapine show?
Please note that the interactions may vary depending on the drug formulation of a drug (eg tablet, syringe, ointment).
Cimetidine and erythromycin may potentiate the effects and side effects of clozapine. Caffeine and nicotine also affect the effectiveness of clozapine, so coffee consumption and smoking habits should not be abruptly changed during therapy.
Phenytoin can reduce the plasma concentration and thus the effectiveness of clozapine.
During treatment, no substances should be given that also affect blood cell formation in the bone marrow, such as chloramphenicol, sulfa drugs, cytostatics, carbamazepine and phenylbutazone.
Clozapine enhances the action of substances that depress the central nervous system. Ingestion of the active ingredient enhances the effects of alcohol, benzodiazepines, sedatives, anticholinergics (eg tiotropium), H1 antihistamines (anti-allergic agents), antihypertensive agents and anesthetics.
The effects of alpha-sympathomimetics and levodopa (a treatment for Parkinson’s disease) are attenuated by clozapine.
Co-administration of lithium increases central nervous system side effects such as confusion and seizures.
With simultaneous therapy with tri- and tetracyclic antidepressants, the heartbeat (tachycardia) can be greatly accelerated.