Thursday, May 14, 2009

Clozapine in children: Low levels

It is not uncommon to find a real fast metabolizer and hence not be able to reach therapeutic blood levels of Clozapine. In such cases, adding Cimetidine one time a day will boost Clozapine blood levels without the need to increase the dose. Make sure you closely monitor the blood levels and adjust the dose of Clozapine accordingly.
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2 comments:

  1. MpulierMay 22, 2009 at 5:18 PM

    While introducing cimetidine entails risk, the suggested regimen should reduce clozapine metabolites that might conceivably cause trouble in rapid metabolizers on high clozapine dosage. Have you noticed any such easing of adverse effects or anything to confirm this hypothesis?

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  2. UnknownMay 22, 2009 at 5:42 PM

    Yes, some of the side effects like drooling can decrease even though for some it may not be a dose dependent side effect.I have treated children who do develop side effects on higher doses of clozapine (but low blood levels) that go away with lower doses of it with cimetidine and {higher blood levels} and better clinical response. Abilify can also be used to augment the clinical effects of clozapine.

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