Clozapine Dose Range

Doses 450 mg increase the possibility of side effects and adverse events including seizures.

Clozapine dose range.

Clozapine is a substrate for many cytochrome p450 isozymes in particular cyp1a2 cyp2d6 and cyp3a4. If you double the dose you double the level. Dosing up to but not exceeding 900mg day has been used for exceptional cases only. Reduce clozapine dose based on clinical response.

His clozapine level is 100 ng ml ie low range and his norclozapine level is 50 ng ml. For dose optimisation. 4 66 hours after achieving steady state with 100mg twice daily dosing. Recommended maximum daily dose is 600mg.

The mean elimination half life of clozapine after a single 75 mg dose was 8 hours range. If you halve the dose you halve the level. The total daily dose can be increased in increments of 25 mg to 50 mg per day if well tolerated to achieve a target dose of 300 mg to 450 mg per day administered in divided doses by the end of 2 weeks. 4 to12 hours compared to a mean elimination half life of 12 hours range.

Clozapine associated with qt prolongation. Subsequently the dose can be increased once weekly or twice weekly in increments of up to 100 mg. Patients and their carers should be advised to seek immediate medical advice before taking the next dose of clozapine if constipation develops. If a clozapine level is high check the patient for dose related side effects.

A clozapine plasma level can be checked after an initial target dose is reached generally after two weeks in the inpatient setting. Clozapine page 14 therapeutic dose range of clozapine usual dosage range is 200 450 mg day divided dose. To assess the effect of changes in smoking habit tobacco and cannabis on clozapine. Concomitant use of clozapine is not recommended however if a strong cyp450 3a4 inducer is necessary a dose increase of clozapine dose may be needed.

Understanding plasma clozapine and norclozapine measurement can be helpful. Monitor for decreased effectiveness when discontinuing a strong cyp450 3a4 inducer and continuing clozapine. To assess compliance plasma clozapine and norclozapine in the expected range only guarantees adherence over the previous few days. The maximum dose is 900 mg per day.

Clozapine has been associated with varying degrees of impairment of intestinal peristalsis see cautions and contra indications for further information. If well tolerated the dose can be increased gradually typically by 12 5 to 25 mg every one to two days with the target dose and frequency determined by the plasma clozapine level and adverse effects. When interpreting blood levels low clozapine levels can result from low dose non adherence or rapid metabolism.