Clozapine Orally Disintegrating Tablet and Risperdal

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Talk to your doctor before using cloZAPine together with risperiDONE. CloZAPine can occasionally cause serious cardiovascular side effects such as low blood pressure and cardiac or respiratory arrest, and the risk may be greater in patients that are also receiving medications like risperiDONE. Cardiovascular side effects are most likely to occur when cloZAPine is first started, when it is restarted following an interruption in therapy, or when the dose is increased rapidly. The risk and/or severity of other side effects may also be increased, including dizziness, drowsiness, blurred vision, confusion, dry mouth, abdominal cramping, constipation, difficulty urinating, heat intolerance, palpitation, irregular heart rhythm, Parkinson-like symptoms, and abnormal muscle movements involving primarily the face and sometimes the limbs. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. Let your doctor know if you experience increased or excessive side effects at any time during treatment with these medications, and seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or fast or pounding heartbeats. Avoid driving or operating hazardous machinery until you know how the medications affect you, and use caution when getting up from a sitting or lying position. If you miss your cloZAPine doses for two or more days, contact your doctor before you resume treatment, as you may need to restart at a lower dose. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

MONITOR CLOSELY: Coadministration with other psychotropic agents may potentiate the adverse effects of clozapine on cardiovascular function. Orthostatic hypotension with or without syncope, in rare cases accompanied by profound collapse and cardiorespiratory arrest, has occurred during initiation of clozapine treatment alone and in combination with other psychotropic agents, occasionally even on the first dose. The risk is greatest during initial titration in association with rapid dose escalation. In one report, initial doses as low as 12.5 mg were associated with collapse and respiratory arrest. Other adverse effects that may be increased during use of clozapine with other psychotropic agents include CNS depression, tardive dyskinesia, tachycardia, and ECG changes such as QT interval prolongation. Anticholinergic effects of these agents may also be additively increased. Excessive anticholinergic effects may result in paralytic ileus, hyperthermia, heat stroke, and the anticholinergic intoxication syndrome. Peripheral symptoms of anticholinergic intoxication commonly include mydriasis, blurred vision, flushed face, fever, dry skin and mucous membranes, tachycardia, urinary retention, and constipation. Central symptoms may include memory loss, disorientation, incoherence, hallucinations, psychosis, delirium, hyperactivity, twitching or jerking movements, stereotypy, and seizures.

MONITOR CLOSELY: Coadministration with risperidone may increase the plasma concentrations of clozapine. In one case report, clozapine plasma concentration rose from 344 ng/mL to 598 ng/mL two weeks after risperidone was added to a patient's regimen. The proposed mechanism is competitive inhibition of metabolism via CYP450 2D6 and/or 3A4.

MANAGEMENT: Caution is advised when clozapine is initiated in patients receiving other psychotropic drugs, including risperidone. Vital signs should be closely monitored. Patients who have had even a brief interval off clozapine (i.e., 2 or more days since the last dose) should be restarted with 12.5 mg once or twice daily. Conversely, pharmacologic response and plasma clozapine levels should be monitored more closely whenever risperidone is added to or withdrawn from therapy in patients stabilized on clozapine, and the dosage adjusted as necessary. In addition, the potential for additive effects on the QT interval and increased risk of torsade de pointes arrhythmia should be considered. Serum electrolytes, including potassium, magnesium and calcium, should be measured at baseline and periodically during treatment, and any abnormalities corrected prior to initiating treatment. Routine ECG assessment may detect QTc prolongation but is not always effective in preventing arrhythmias. Therapy with these agents should be discontinued if the QTc interval exceeds 500 msec. Patients should be advised to seek prompt medical attention if they experience symptoms that could indicate the occurrence of torsade de pointes such as dizziness, lightheadedness, fainting, palpitation, irregular heart rhythm, shortness of breath, or syncope. Ambulatory patients may want to avoid activities requiring mental alertness until they know how these agents affect them. A dosage reduction in one or both drugs may be necessary if excessive adverse effects develop.

Clozapine Orally Disintegrating Tablet

Generic Name: clozapine

Brand name: Clozaril, Fazaclo, Versacloz, Clopine, CloZAPine Synthon, Denzapine, Zaponex

Synonyms: CloZAPine, Clozapine

What is Clozapine Orally Disintegrating Tablet?

Risperdal

Generic Name: risperidone

Brand name: Risperdal, Perseris, Risperdal Consta, Risperdal Consta, Risperdal M-Tab

Synonyms: n.a.

What is Risperdal?