Package Insert: Information for the Patient
Clozapina Aurovitas 100 mg Tablets EFG
Read this package insert carefully before taking this medication, as it contains important information for you.
The active ingredient of Clozapina Aurovitas is clozapine, which belongs to a group of medications called antipsychotics (medications used to treat specific mental disorders such as psychosis).
Clozapine is used for the treatment of patients with schizophrenia when the use of other medications has not been effective. Schizophrenia is a mental illness that affects how one thinks, feels, and behaves. This medication should only be used if at least two other antipsychotic medications, including one of the new atypical antipsychotics for treating schizophrenia, have been tried and were not effective, or caused severe adverse reactions that could not be treated.
Clozapine is also indicated for the treatment of severe thought disorders, emotional reactions, and behavioral disorders that occur in Parkinson's disease, when other treatments have not been effective.
Do not take Clozapina Aurovitas if:
Inform your doctor and do not take clozapine if any of the above circumstances apply.
Clozapine should not be administered to anyone who is unconscious or in a coma.
Warnings and precautions
The safety measures mentioned in this section are very important. You must comply with them to minimize the risk of severe side effects that may be life-threatening.
Before starting treatment with Clozapina Aurovitas,inform your doctor if you have or have had:
Before taking the next dose of Clozapina Aurovitas tablets, inform your doctor immediately if:
Medical examinations and blood tests
Before starting treatment with clozapine, your doctor will ask about your medical history and perform a blood test to ensure that your white blood cell count is normal. It is essential to know this, as you need white blood cells to fight infections.
Make sure you have regular blood tests before, during, and after stopping treatment with clozapine.
Before starting treatment, your doctor will also perform a physical examination. Your doctor may perform an electrocardiogram (ECG) to examine your heart, but only if necessary for you or if you have a specific concern.
If you have liver abnormalities, you will have periodic liver function tests during treatment with clozapine.
If you have high blood glucose levels (diabetes), your doctor may perform periodic checks of your blood glucose levels.
Clozapine can alter blood lipid levels. Clozapine can cause weight gain. Your doctor may monitor your weight and blood lipid levels.
If you feel dizzy, lightheaded, or lose consciousness, or if clozapine makes you feel this way, be careful when getting up from a sitting or lying position, as this may increase the risk of falls.
If you need to undergo surgery or are unable to walk for a long period, inform your doctor that you are taking clozapine. You may be at risk of developing blood clots (blood clots in a vein).
Children and adolescents under 16 years
If you are under 16 years old, you should not take clozapine as there is not enough information available for its use in this age group.
Older adults (60 years and older)
Older adults (60 years and older) may be more prone to the following side effects during treatment with clozapine: weakness or dizziness after changing position, dizziness, rapid heart rate, difficulty urinating, and constipation.
Inform your doctor or pharmacist if you have a disease called dementia.
Other medications and Clozapina Aurovitas
Inform your doctor or pharmacist if you are taking, have taken recently, or may need to take any other medication. This includes those obtained without a prescription or herbal treatments. You may need to take different amounts of your medications or different medications.
Do not take Clozapina Aurovitas with other medications that prevent the correct functioning of the bone marrow and/or reduce the number of blood cells produced by the body,such as:
These medications increase your risk of developing agranulocytosis (low white blood cell count).
Taking clozapine at the same time as other medications may affect the correct action of clozapine and/or the other medications. Inform your doctor if you intend to take, are taking (even if the treatment is about to end) or have recently stopped taking any of the following medications:
This list is not exhaustive. Your doctor and pharmacist have more information about medications that should be taken with caution or avoided while taking clozapine. They also know if the medications you are taking belong to any of the listed groups. Inform them.
Taking Clozapina Aurovitas with food and drinks
Do not drink alcohol during treatment with clozapine.
Inform your doctor if you smoke and how often you take beverages containing caffeine (coffee, tea, cola). Sudden changes in your smoking or caffeine habits may also change the effects of clozapine.
Pregnancy and breastfeeding
If you are pregnant or breastfeeding, consult your doctor before using this medication. Your doctor will discuss the benefits and potential risks of using this medication during pregnancy. Inform your doctor immediately if you become pregnant during treatment with clozapina.
The following symptoms may appear in newborn babies of mothers who have used clozapine in the last trimester (the last three months of pregnancy): tremors, muscle stiffness, weakness, drowsiness, agitation, breathing difficulties, and feeding difficulties. If your baby develops any of these symptoms, you should contact your doctor.
Some women taking certain medications for mental illnesses have irregular or no menstrual periods. If this has happened to you, your menstrual periods will return to normal when your medication is replaced with clozapine. This means you should use effective birth control.
Do not breastfeed your baby during treatment with clozapine. Clozapine, the active ingredient in Clozapina Aurovitas, may pass into breast milk and affect the baby.
Driving and using machines
Clozapine may cause drowsiness, dizziness, and seizures, especially at the beginning of treatment. Do not drive or use machines while experiencing these symptoms.
Clozapina Aurovitas contains lactose
If your doctor has told you that you have an intolerance to certain sugars, consult with them before taking this medication.
Follow exactly the administration instructions of this medication as indicated by your doctor or pharmacist. In case of doubt, consult your doctor or pharmacist again.
To reduce the risk of hypotension, convulsions, and somnolence, your doctor should gradually increase the dose. Follow exactly the administration instructions of clozapine as indicated by your doctor. In case of doubt, consult your doctor or pharmacist again.
It is essential not to change the dose or stop taking clozapine without asking your doctor first. Continue taking the tablets for the time your doctor has indicated.
If you are a patient 60 years of age or older, your doctor may start treatment with a lower dose and gradually increase your dose, as you may be more susceptible to developing some unexpected adverse reactions (see section 2 "What you need to know before starting to take Clozapine Aurovitas").
If you cannot achieve the prescribed dose with this tablet presentation, other presentations of this medication are available to achieve the prescribed dose.
Treatment of schizophrenia
Treatment begins with 12.5 mg (half of a 25 mg tablet) once or twice on the first day, followed by 25 mg once or twice on the second day. Swallow the tablet with a glass of water. If you tolerate it well, your doctor will gradually increase the dose in amounts of 25-50 mg over the next 2-3 weeks to reach a daily dose of 300 mg. After that, it may be necessary to increase the daily dose in amounts of 50 mg to 100 mg twice a week, or preferably once a week.
The effective daily dose is usually between 200 mg and 450 mg, divided into several single doses per day. Some people may need higher doses. Doses of up to 900 mg per day are permitted. At daily doses above 450 mg, adverse reactions may increase (particularly convulsions). Always take the minimum dose that is effective for you. Most patients should take part of the daily dose in the morning and the other part at night. Your doctor will tell you exactly how to divide your daily dose. If your daily dose does not exceed 200 mg, you can take it as a single dose at night. Once the treatment with clozapine is working well for you over some time, your doctor may try to reduce your dose. You will need to take clozapine for at least 6 months.
Treatment of severe thought disorders in patients with Parkinson's disease
The usual initial dose of clozapine is 12.5 mg (half of a 25 mg tablet) at night. Swallow the tablet with a glass of water. Your doctor will gradually increase the dose in amounts of 12.5 mg, with a maximum of two increases per week, to reach a maximum dose of 50 mg by the end of the second week. Dose increases should be stopped or postponed if you feel weak, dizzy, or confused. To avoid these symptoms, your blood pressure will be measured during the first weeks of treatment.
The effective daily dose is usually between 25 mg and 37.5 mg, taken as a single dose at night. Only in exceptional cases can doses above 50 mg per day be increased. The maximum dose is 100 mg per day. Always take the minimum dose that is effective for you.
If you take more Clozapine Aurovitas than you should
If you think you have taken more clozapine than you should, or if someone has taken one of your tablets, inform your doctor immediately or call the Toxicological Information Service, phone 91 562 04 20, indicating the medication and the amount taken.
The symptoms of overdose are:
Drowsiness, fatigue, lack of energy, unconsciousness, coma, confusion, hallucinations, agitation, incoherent speech, numbness in the limbs, tremors in the hands, convulsions, increased saliva production, dilated pupils, blurred vision, low blood pressure, collapse, rapid or irregular heartbeat, shallow breathing, or difficulty breathing.
If you forgot to take Clozapine Aurovitas
If you forgot to take a dose, take the missed dose as soon as possible. If there is little time left for the next dose, do not take the missed dose and take the next dose at the time it is due. Do not take a double dose to compensate for the missed dose. If you have stopped taking clozapine for two or more days, consult your doctor.
If you interrupt treatment with Clozapine Aurovitas
Do not stop treatment with clozapine without asking your doctor, as you may experience withdrawal symptoms.
These symptoms include sweating, headache, nausea, vomiting, and diarrhea.If you experience any of these symptoms, consult your doctor immediately. These symptoms may be followed by more severe symptoms unless treated immediately. Your initial symptoms may recur. If you need to interrupt treatment, it is recommended to gradually reduce the dose in amounts of 12.5 mg over a period of 1 to 2 weeks. Your doctor will give you instructions on how to reduce your daily dose. If you need to interrupt your treatment with clozapine suddenly, your doctor will need to review you. If your doctor decides to restart treatment with clozapine and your last dose was two days or more ago, they should start with the initial dose of 12.5 mg.
If you have any other questions about the use of this medication, ask your doctor or pharmacist.
Like all medicines, this medicine can cause side effects, although not everyone will experience them.
Some side effects can be serious and require immediate medical attention:
Inform your doctor immediately before taking the next clozapine tablet if you experience any of the following circumstances:
Very common: may affect more than 1 in 10 people
Common: may affect up to 1 in 10 people
Rare: may affect up to 1 in 100 people
Very rare: may affect up to 1 in 1,000 people
Very rare: may affect up to 1 in 1,000 peopleorvery rare: may affect up to 1 in 10,000 people
Very rare: may affect up to 1 in 10,000 patients
Unknown frequency (cannot be estimated from available data):
-Constipation, abdominal pain, abdominal sensitivity, fever, swelling, diarrhea with blood.This may be a symptom of possible megacolon (intestinal dilation) or ischemia/intestinal infarction that may lead to death.Your doctor will need to examine you.
-Acute chest pain with difficulty breathing with or without coughing.
-Appearance or increase in muscle weakness, muscle spasms, muscle pain. This may indicate possible muscle damage (rhabdomyolysis). Your doctor will need to examine you.
If any of the above cases apply to you, inform your doctor immediately before taking the next clozapine tablet.
Other side effects
Very common: may affect more than 1 in 10 people
Drowsiness, dizziness, increased saliva production.
Common: may affect up to 1 in 10 people
High white blood cell count in the blood (leukocytosis), high levels of a specific type of white blood cell in the blood (eosinophilia), weight gain, blurred vision, headache, tremor, stiffness, restlessness, convulsions, involuntary movements, abnormal movements, inability to initiate movement, inability to remain still, changes in the electrocardiogram (ECG) of the heart, high blood pressure, dizziness or fainting after changing position, nausea, vomiting, loss of appetite, dry mouth, minor abnormalities in liver function tests, loss of bladder control, difficulty urinating, fatigue, fever, increased sweating, elevated body temperature, speech disorders (e.g., difficulty articulating words).
Rare: may affect up to 1 in 100 people
Low white blood cell count in the blood (agranulocytosis), speech disorder (e.g., stuttering).
Very rare: may affect up to 1 in 1,000 people
Low red blood cell count in the blood (anemia), restlessness, agitation, confusion, delirium, irregular heart rate, inflammation of the heart muscle (myocarditis) or of the membrane surrounding the heart muscle (pericarditis), accumulation of fluid around the heart (pericardial effusion), high blood sugar levels, diabetes mellitus, blood clots in the lungs (pulmonary embolism), inflammation of the liver (hepatitis), liver disease causing yellowing of the skin/ dark urine/itching, elevated levels in the blood of an enzyme called creatine phosphokinase.
Very rare: may affect up to 1 in 10,000 patients
Increased platelet count in the blood with possible blood vessel clotting, involuntary movements of the mouth/tongue and limbs, obsessive thoughts and repetitive compulsive behaviors (obsessive-compulsive symptoms), skin reactions, swelling in the front of the ear (due to inflammation of the salivary glands), difficulty breathing, very high triglyceride or cholesterol levels in the blood, heart muscle disease (cardiomyopathy), cardiac arrest, sudden unexpected death.
Unknown frequency (cannot be estimated from available data):
Changes in brain wave recording (electroencephalogram/EEG), diarrhea, stomach discomfort, burning, stomach discomfort after eating, muscle weakness, muscle spasms, muscle pain, nasal congestion, nocturnal enuresis, sudden and uncontrolled increase in blood pressure (pseudopheochromocytoma), involuntary contraction causing curvature of the body to one side (pleurototonos), if you are a man, sexual dysfunction, in which semen enters the bladder instead of ejaculating through the penis (dry orgasm or retrograde ejaculation), rash, red-purple spots, fever, or itching due to inflammation of blood vessels, inflammation of the colon causing diarrhea, abdominal pain, fever, change in skin color, butterfly-shaped rash on the face, joint pain, muscle pain, fever, and fatigue (lupus erythematosus), restless legs syndrome (irresistible urge to move the legs or arms, usually accompanied by uncomfortable sensations during periods of rest, especially in the afternoon or at night, and temporarily relieved by movement).
In elderly patients with dementia, a small increase in the number of deaths in patients taking antipsychotics compared to those not taking them has been reported.
Reporting of side effects
If you experience any type of side effect, consult your doctor or pharmacist, even if it is a possible side effect that does not appear in this leaflet. You can also report them directly through the Spanish System for the Pharmacovigilance of Medicines for Human Use:https://www.notificaram.es. By reporting side effects, you can contribute to providing more information on the safety of this medicine.
Keep this medication out of the sight and reach of children.
Do not use this medication after the expiration date that appears on the packaging and blister pack after CAD. The expiration date is the last day of the month indicated.
Store below 30 °C.
Do not use this medication if you notice any change in the appearance of the tablets.
Medications should not be disposed of through drains or in the trash. Dispose of the containers and medications you no longer need at the SIGRE collection point at the pharmacy.Ask your pharmacist how to dispose of the containers and medications you no longer need. This will help protect the environment.
Composition ofClozapina Aurovitas
Appearance of the product and contents of the package
.
Uncoated tablets, pale yellow in color, round, flat, bisected, engraved on one face with a “C” and a “Z” with a groove in the middle and “100” on the other face. The tablet can be divided into two equal doses.
Clozapina Aurovitas 100 mg tablets are available in blisters and high-density polyethylene (HDPE) bottles.
Package sizes:
Blister packs:7, 14, 20, 28, 30, 40, 50, 60, 90, 100, 250, and 1,000 tablets.
HDPE bottles:30, 50, 100, and 250 tablets (for 25 mg and 100 mg only).
Only some package sizes may be commercially available.
Marketing authorization holder and responsible manufacturer
Marketing authorization holder:
Aurovitas Spain, S.A.U.
Avda. de Burgos, 16-D
28036 Madrid
Spain
Tel.: 91 630 86 45
Fax: 91 630 26 64
Responsible manufacturer:
APL Swift Services (Malta) Limited
HF26, Hal Far Industrial Estate, Hal Far
Birzebbugia, BBG 3000
Malta
O
Arrow Generiques – Lyon
26 avenue Tony Garnier,
Lyon, 69007
France
O
Generis Farmacêutica, S.A.
Rua João de Deus, 19
2700-487 Amadora
Portugal
This medicine is authorized in the member states of the European Economic Area with the following names:
Germany:Clozapin PUREN 100 mg Tabletten
Spain:Clozapina Aurovitas 100 mg tablets EFG
France:Clozapine Arrow 100 mg scored tablet
Netherlands:Clozapine Auro 100 mg tablets
Portugal:Clozapina Aurovitas
Last review date of this leaflet: September 2021
For more detailed information about this medicine, please visit the website of the Spanish Agency for Medicines and Medical Devices (AEMPS) (http://www.aemps.gob.es)
Have questions about this medication or your symptoms? Connect with a licensed doctor for guidance and personalized care.