Package Leaflet: Information for the Patient
Leponex 25 mg Tablets
Clozapine
Read all of this leaflet carefully before you start taking this medicine because it contains important information for you.
Contents of the pack and other information
The active substance of Leponex is clozapine, which belongs to a group of medicines called antipsychotics (also known as neuroleptics) used to treat specific mental disorders such as psychosis.
Leponex is used to treat patients with schizophrenia when other medicines have not worked. Schizophrenia is a mental illness that involves disorders of thought, emotional reactions, and behavioral disorders. You can only use this medicine if you have already tried at least two other neuroleptic medicines, including one of the new atypical neuroleptics to treat schizophrenia, and these medicines have not responded, or have caused severe adverse reactions that cannot be treated.
Leponex is also indicated for treating severe thought disorders, emotional reactions, and behavioral disorders that occur in Parkinson's disease when other treatments have not been effective.
Do not take Leponex if:
Tell your doctor and do not take Leponex if any of the above applies to you.
Leponex must not be given 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 adverse reactions that can be life-threatening.
Before starting treatment with Leponex, tell your doctor if you have or have had any of the following:
Immediately before taking the next dose of Leponex tablets, tell your doctor if:
Medical examinations and blood tests
Before starting treatment with Leponex, your doctor will ask you 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 finishing treatment with Leponex.
Before starting treatment, your doctor will also perform a physical examination. Your doctor may perform an electrocardiogram (ECG) to check your heart, but only if it is necessary for you or if you have any special concerns.
If you have liver disorders, you will have periodic liver function tests throughout treatment with Leponex.
If you have high blood sugar levels (diabetes), your doctor may perform periodic checks of your blood sugar levels.
Leponex may alter your blood lipid levels. Leponex may cause weight gain. Your doctor may monitor your weight and lipid levels.
If you have a mild headache, dizziness, or weakness, or Leponex makes you feel this way, be careful when getting up from a sitting or lying position, as this can increase the risk of falls.
If you need to have surgery or if, for any reason, you cannot walk for a long time, tell your doctor that you are taking Leponex. You may be at risk of having a blood clot (thrombosis).
Children and adolescents under 16 years
If you are under 16 years old, you should not take Leponex, as there is not enough information available for its use in this age group.
Use in elderly patients (60 years and older)
Patient over 60 years may be more susceptible to the following adverse effects during treatment with Leponex: weakness or mild headache after changing position, dizziness, rapid heartbeat, urinary retention, and constipation.
Tell your doctor or pharmacist if you suffer from a disease called dementia.
Using Leponex with other medicines
Tell your doctor or pharmacist if you are taking, have recently taken, or might take any other medicines, including those obtained without a prescription or herbal treatments. You may need to take a different amount of your medicines or different medicines.
Do not take Leponex with other medicines that stop the bone marrow from working properly and/or decrease the number of blood cells produced by the body, such as:
These medicines increase your risk of developing agranulocitosis (deficit of white blood cells in the blood).
Taking Leponex at the same time as other medicinescan affect the proper action ofLeponex and/or theother medicines. Tell your doctor ifyou intend to take, ifyou are taking(even if treatment is about to finish) or if you have recently stopped takingany of the following medicines:
This list is not complete. Your doctor and pharmacist have more information about medicines that should be administered with caution or should be avoided while taking Leponex. They also know if the medicines you are taking belong to any of the groups listed above. Discuss this with them.
Taking Leponex with food and drinks
During treatment with Leponex, do not drink alcohol.
Tell your doctor if you smoke and how often you take drinks containing caffeine (coffee, tea, cola). A sudden change in your smoking habits or consumption of caffeine-containing drinks can also change the effects of Leponex.
Pregnancy and breastfeeding
If you are pregnant or breastfeeding, think you may be pregnant, or plan to become pregnant, consult your doctor before using this medicine. Your doctor will discuss with you the benefits and possible risks of using this medicine during pregnancy. Tell your doctor immediately if you become pregnant during treatment with Leponex.
The following symptoms may occur in newborn babies of mothers who have used Leponex in the last trimester (the last three months of pregnancy): tremors, muscle stiffness and/or weakness, drowsiness, agitation, breathing problems, and difficulty feeding. If your baby develops any of these symptoms, you should contact your doctor.
Some women who take certain medicines for mental illnesses have irregular periods or do not have periods. If this has happened to you, your periods will return to normal when your medication is replaced with Leponex. This means you should use effective contraceptives.
During treatment with Leponex, you should not breastfeed your baby. Clozapine, the active substance of Leponex, can pass into breast milk and affect the baby.
Driving and using machines
Leponex can cause tiredness, drowsiness, and seizures, especially at the start of treatment. Therefore, you should avoid driving or operating machinery while you have these symptoms.
Leponex can cause symptoms such as drowsiness, dizziness, or changes in vision and reduce your reaction ability. These effects, as well as the illness itself, can make it difficult for you to drive vehicles or operate machines. Therefore, do not drive, operate machines, or engage in other activities that require special attention until your doctor assesses your response to this medicine.
Leponex contains lactose.
If your doctor has told you that you have an intolerance to some sugars, contact your doctor before taking this medicine.
To minimize the risk of experiencing epileptic seizures, drowsiness, or hypotension, it is necessary for your doctor to gradually increase the dose. Follow your doctor's administration instructions for Leponex exactly. If in doubt, consult your doctor or pharmacist again.
It is essential that you do not change the dose or stop taking Leponex without first asking your doctor. Continue taking Leponex for the time your doctor has indicated.
If you are a patient 60 years or older, your doctor may start treatment with a lower dose and increase your dose more gradually, as you may be more susceptible to developing unexpected adverse reactions. (See section 2 "What you need to know before taking Leponex").
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 is started with 12.5 mg (half 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 the help of a glass of water. If you tolerate it well, your doctor will gradually increase the dose in amounts of 25 or 50 mg over 2 to 3 weeks until reaching a dose of 300 mg per day. It may be necessary to continue increasing the dose in amounts of 50 or 100 mg twice a week, or preferably once a week.
The normal daily dose of clozapine is between 200 and 450 mg, divided into several doses per day. Some people may need higher doses. Doses of up to 900 mg per day are allowed. At daily doses above 450 mg, adverse reactions (particularly seizures) may increase. Always take the minimum dose that is effective for you. Most patients should take part of the dose in the morning and another 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 Leponex is working well for some time, your doctor will try treatment with lower doses. You will need to take Leponex for at least 6 months.
Treatment of severe thought disorders in patients with Parkinson's disease
The normal initial dose of clozapine is 12.5 mg (half a 25 mg tablet) at night. Swallow the tablet with the help of a glass of water. Your doctor will slowly increase the dose in amounts of 12.5 mg, with a maximum of two increases per week, until reaching a maximum dose of up to 50 mg at the end of the second week. Dose increments should be stopped or postponed if you feel weak, dizzy, or confused. To avoid such symptoms, your blood pressure will be measured during the first weeks of treatment.
The effective daily dose is between 25 and 37.5 mg, taken as a single dose at night. The dose can only be increased to more than 50 mg per day in exceptional cases. The maximum dose is 100 mg per day. Always take the minimum dose that is effective for you.
If you take more Leponex than you should
If you think you have taken more Leponex than you should, or if someone has taken some of your tablets, inform your doctor or pharmacist immediately or call the Toxicology Information Service. Telephone 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 extremities, tremors in the hands, seizures, increased saliva production, dilated pupils, blurred vision, low blood pressure, collapse, rapid or irregular heartbeat, shallow or difficult breathing.
If you forget to take Leponex
If you forget to take a dose, take the missed dose as soon as possible. If it is almost time for the next dose, do not take the missed dose and take the next dose at the scheduled time. Do not take a double dose to make up for the missed dose. If you have stopped taking Leponex for two or more days, do not start treatment again without consulting your doctor first.
If you interrupt treatment with Leponex
Do not interrupt treatment with Leponex without asking your doctor, as you may experience withdrawal symptoms. These symptoms include sweating, headache, nausea (feeling dizzy), vomiting (being dizzy), and diarrhea. If you experience any of these symptoms, consult your doctor immediately. These symptoms can be followed by more severe ones unless you are treated immediately. Your initial symptoms may recur. If you need to interrupt treatment, it is recommended to gradually decrease 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 suddenly, your doctor should examine you. If your doctor decides to restart treatment with Leponex and your last dose of Leponex was two days or more ago, you should start again with the initial dose of 12.5 mg.
If you have any other doubts about the use of this medication, ask your doctor or pharmacist.
Like all medications, Leponex can cause side effects, although not everyone experiences them.
Some side effects can be serious and require immediate medical attention:
Tell your doctor immediately before taking the next Leponex tablet if you experience any of the following circumstances:
Very common(affect more than 1 in 10 patients):
Common(affect up to 1 in 10 patients):
Uncommon(affect up to 1 in 100 patients):
Rare(affect up to 1 in 1,000 patients):
Rare(affect up to 1 in 1,000 patients)or very rare(affect up to 1 in 10,000 patients):
Very rare(affect up to 1 in 10,000 patients):
Skin reaction can appear as a rash with or without blisters. Skin irritation, edema, and fever, as well as flu-like symptoms, may occur. DRESS symptoms usually appear approximately 2 to 6 weeks (possibly up to 8 weeks) after starting treatment.
If any of the above cases apply to you, inform your doctor immediately before taking the next Leponex tablet.
Other side effects:
Very common(affect more than 1 in 10 patients):
Drowsiness, dizziness, increased saliva production.
Common(affect up to 1 in 10 patients):
High levels of white blood cells in the blood (leukocytosis), high levels of a certain type of white blood cells in the blood (eosinophilia), weight gain, blurred vision, headache, tremors, stiffness, restlessness, agitation, seizures, sudden movements, abnormal movements, inability to initiate movement, inability to remain still, changes in the electrocardiogram (ECG) test of the heart, high blood pressure, weakness or mild headache after changing position, nausea (feeling dizzy), vomiting (being dizzy), 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., slurred words).
Uncommon(affect up to 1 in 100 patients):
Low white blood cell count in the blood (agranulocytosis), speech disorder (e.g., stuttering).
Rare(affect up to 1 in 1,000 patients):
High levels of red blood cells in the blood (anemia), restlessness, agitation, confusion, delirium, irregular heartbeat, inflammation of the heart muscle (myocarditis) or the membrane surrounding the heart muscle (pericarditis), fluid accumulation around the heart (pericardial effusion), high blood sugar levels, diabetes mellitus, blood clotting in the lungs (thromboembolism), liver inflammation (hepatitis), liver disease that causes yellowing of the skin/dark urine/itching, elevated levels in the blood of an enzyme called creatine phosphokinase.
Very rare(affect up to 1 in 10,000 patients):
Increased platelet count in the blood with possible blood vessel clotting, uncontrolled movements of the mouth/tongue and lips, obsessive thoughts and repetitive compulsive behaviors (obsessive-compulsive symptoms), skin reactions, swelling of the face (due to inflammation of the salivary glands), difficulty breathing, very high levels of triglycerides or cholesterol in the blood, heart muscle disease (cardiomyopathy), cardiac arrest (heart stoppage), sudden unexpected death.
Unknown(frequency cannot be estimated from the available data):
Changes in brain wave recording (electroencephalogram/EEG), diarrhea, stomach discomfort, heartburn, stomach discomfort after eating, muscle weakness, muscle spasms, muscle pain, nasal congestion, nocturnal enuresis, sudden and uncontrollable increase in blood pressure (pseudopheochromocytoma), involuntary contraction that causes the body to curve to one side (pleurothotonos), if you are a man, ejaculation disorder, in which semen enters the bladder instead of ejaculating through the penis (dry orgasm or retrograde ejaculation), rash, purple-red spots, fever or itching due to blood vessel inflammation, colon inflammation that causes diarrhea, abdominal pain, fever, skin color change, 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 rest periods, especially in the afternoon or evening, and which is temporarily relieved by movement).
In elderly patients with dementia, a small increase in the number of death cases has been reported in patients taking antipsychotics compared to those who do not take them.
Reporting 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 Pharmacovigilance System for Human Use Medicines: https://www.notificaram.es. By reporting side effects, you can contribute to providing more information on the safety of this medication.
Medicines should not be disposed of via wastewater or household waste. Deposit the packaging and any unused medicines in the pharmacy's SIGRE collection point. If in doubt, ask your pharmacist how to dispose of the packaging and any unused medicines. This will help protect the environment.
Composition of Leponex 25 mg tablets
Appearance of the product and package contents
Leponex tablets are yellow, round, flat, and beveled, coded with "L/O" with an angular notch on one side and "CLOZ" on the other side.
Leponex tablets are available in PVC/PVDC/Aluminum or PVC/PE/PVDC/Aluminum blister packs containing 7, 14, 20, 28, 30, 40, 50, 60, 84, 98, 100, 500 (10x50), or 5000 (100x50) tablets; and/or PVC/PVDC/Aluminum or PVC/PE/PVDC/Aluminum single-dose blister packs containing 7x1, 14x1, 20x1, 28x1, 30x1, 40x1, 50x1, 60x1, 84x1, 98x1, 100x1, 500 (10x50x1), and 5000 (100x50x1) tablets, and in a white plastic bottle containing 100 or 500 tablets.
Only some pack sizes may be marketed.
Other presentations:
Leponex 100 mg tablets in a pack of 40 tablets.
Marketing authorization holder
Viatris Healthcare Limited
Damastown Industrial Park
Mulhuddart, Dublin 15
Dublin
Ireland
Manufacturer
Mylan Hungary Kft.
Mylan utca 1
Komárom 2900
Hungary
or
McDermott Laboratories Limited
T/A Gerard Laboratories
T/A Mylan Dublin
Unit 35/36 Baldoyle Industrial Estate
Grange Road
Dublin 13
Ireland
or
Madaus GmbH
Lütticher Straße 5
53842 Troisdorf
Germany
For further information about this medicine, please contact the local representative of the marketing authorization holder:
Viatris Pharmaceuticals, S.L.
C/ General Aranaz, 86
28027 Madrid
Spain
This medicine is authorized in the Member States of the European Economic Area and in the United Kingdom (Northern Ireland) under the following names:
Austria Leponex 25 mg Tabletten
Belgium Leponex 25 mg tabletten/Leponex 25 mg Tabletten/Leponex 25 mg comprimés
Denmark Leponex
Finland Leponex 25 mg tabletti
France Leponex 25 mg comprimé sécable
Germany Leponex 25 mg Tabletten
Greece Leponex 25 mg Δισκ?α
Iceland Leponex 25 mg töflur
Ireland Clozaril 25 mg tablets
Italy Leponex 25 mg compresse
Luxembourg Leponex 25 mg
Netherlands Leponex 25 mg, tabletten
Norway Leponex 25 mg tabletter
Portugal Leponex 25 mg comprimidos
Spain Leponex 25 mg comprimidos
Sweden Leponex 25 mg tabletter
United Kingdom (Northern Ireland) Clozaril 25 mg tablets
Date of last revision of this prospectus:August 2019
Detailed and updated information on this medicine is available on the website of the Spanish Agency for Medicines and Health Products (AEMPS) https://www.aemps.gob.es/
The average price of LEPONEX 25 mg TABLETS in October, 2025 is around 3.54 EUR. Prices may vary depending on the region, pharmacy, and whether a prescription is required. Always check with a local pharmacy or online source for the most accurate information.