药品详情：
【氯氮平片Clozaril 简述】
氯氮平片商品名为Clozaril，英文名Clozapine tablets，属二苯二氮杂卓类抗精神病药品。
【氯氮平片Clozaril 适应症】
本品适用于急性与慢性精神分裂症的各个亚型，对幻觉妄想型、青春型效果好。也可用于与精神分裂症有关的情感症状（如抑郁、负罪感、焦虑等）
【氯氮平片Clozaril 规格】
本品为片剂，每片含有效成分25mg/100mg，每瓶100片装。
【氯氮平片Clozaril 服用方法】
本品服用时应从小剂量开始，首次剂量为一次25mg，一日两至三次，逐渐增加至常用量每日200至400mg，最高量可达每日600mg。维持剂量为每日100至200mg。
【氯氮平片Clozaril 注意事项】
1．出现过敏性皮疹及恶性综合征应立即停药并进行相应的处理。
2．中枢神经抑制状态者慎用。尿潴留患者慎用。
3．治疗头3个月内应坚持每1～2周检查白细胞计数及分类，以后定期检查。
4．定期检查肝功能与心电图。
5．定期检查血糖，避免发生糖尿病或酮症酸中毒。
6．用药期间不宜驾驶车辆、操作机械或高空作业。
7．用药期间出现不明原因发热，应暂停用药。
【氯氮平片Clozaril 不良反应】
1．镇静作用强和抗胆碱能不良反应较多，常见有头晕、无力、嗜睡、多汗、流涎、恶心、呕吐、口干、便秘、体位性低血压、心动过速。
2．常见食欲增加和体重增加。
3．可引起心电图异常改变。可引起脑电图改变或癫痫发作。
4．也可引起血糖增高。
5．严重不良反应为粒细胞缺乏症及继发性感染。
6.较少见的有：①不安与易激惹；②精神错乱；③视力模糊；④血压升高与严重连续的头痛。这些反应都与剂量有关。
7.体温升高：以治疗的前3周多见，有自行调节倾向，可并发白细胞升高或降低，如同时产生肌强直和自主神经并发症时，须排除恶性综合征。
Clozaril(Clozapine)
Clozapine, sold under the brand name Clozaril among others,[2] is an atypical antipsychotic medication.[1] It is mainly used for schizophreniathat does not improve following the use of other antipsychotic medications.[1] In those with schizophrenia and schizoaffective disorder it may decrease the rate of suicidal behavior.[1] It is more effective than typical antipsychotics, particularly in those who are treatment-resistant.[4][5][6] It is used by mouth,[1] or by injection into a muscle.[7]
Clozapine is associated with a relatively high risk of low white blood cells (agranulocytosis), a condition of suppressed immunity which may result in death.[1] To decrease this risk, it is recommended that the white blood cell count be regularly monitored.[1] Other serious risks include seizures, inflammation of the heart, high blood sugar levels, and, in older people with psychosis as a result of dementia, an increased risk of death.[1][8] Common side effects include drowsiness, decreased or increased saliva production, low blood pressure, blurred vision, and dizziness.[1] The potentially permanent movement disorder tardive dyskinesiaoccurs in about 5% of people.[8] Its mechanism of action is not entirely clear.[1]
Clozapine was first made in 1958 and sold commercially in 1972.[9] It was the first atypical antipsychotic.[10] It is on the WHO Model List of Essential Medicines, which lists the most effective and safe medicines needed in a health system.[11] It is available as a generic medication.[1] The wholesale cost in the developing world is between US$0.05 and US$2.10 per day as of 2014.[12]
Medical uses
Clozapine is an atypical antipsychotic drug primarily used in people who are unresponsive to or intolerant to other antipsychotics.[5] This means that they have failed to respond satisfactorily to at least two different antipsychotics.[13] It has been shown to be more effective in reducing symptoms of schizophrenia than typical antipsychotics, with more pronounced effects in those who have responded poorly to other medication.[4]
Clozapine is usually given by mouth in tablet or liquid form,[1] however a short-acting intramuscular injectable formulation is available. It is not a depot injection, and instead has a similar duration of action as clozapine by mouth. The injectable formulation may be used in highly agitated people with schizophrenia who consistently refuse clozapine by mouth, but are predicted to respond well to clozapine therapy, with the injection being administered with the intention of transitioning the person to oral clozapine.[7] The injectable form is reportedly difficult to use due to painful administration, higher doses requiring injection into multiple sites simultaneously, and even more stringent monitoring than oral clozapine (with the additional difficulty of withdrawing blood samples for testing from agitated individuals).[7]
In a 2013 study in a comparison of 15 antipsychotic drugs in effectiveness in treating schizophrenic symptoms, clozapine was ranked first and demonstrated very high effectiveness. 25% more effective than amisulpride (2nd), 33% more effective than olanzapine (3rd), and twice as effective as haloperidol, quetiapine, and aripiprazole.[4]
The effect of clozapine, however, is not (at least in the short term) reflected in measures of global functioning such as ability to leave the hospital and maintain an occupation. The relapse rate is lower and patient acceptability is better.[5] There is some evidence clozapine may reduce propensity for substance abuse in schizophrenic patients.[14]
It may be better than other antipsychotics in people with both schizophrenia and Parkinson's disease.[15]
Clozapine is not recommended for the treatment of behavior problems in older adults with dementia.
注：药品如有新包装,以新包装为准。以上资讯来源于网络或由高等医药院校的学生志愿者翻译（如有错漏，请帮忙指正）,仅供医护人员内部讨论,不作任何用药依据,具体用药指引,请咨询主治医师。
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