ZOLKAR 25 mg TABLETS

Introduction

Package Leaflet: Information for the Patient

Zolkar 25 mg tablets EFG

Clozapine

Read the entire package leaflet carefully before starting to take this medication, as it contains important information for you.

• Keep this package leaflet, as you may need to read it again.
• If you have any questions, consult your doctor or pharmacist.
• This medication has been prescribed to you only, and you should not give it to others, even if they have the same symptoms as you, as it may harm them.
• If you experience side effects, consult your doctor or pharmacist, even if they are not listed in this package leaflet. See section 4.

Contents of the package leaflet:

1. What is Zolkar and what is it used for
2. What you need to know before taking Zolkar
3. How to take Zolkar
4. Possible side effects
5. Storage of Zolkar

1. Package contents and additional information

1. What is Zolkar and what is it used for

The active substance of Zolkar is clozapine, which belongs to a group of medications called antipsychotics (medications used to treat specific mental disorders, such as psychosis).

Zolkar is used to treat patients with schizophrenia when the use of other medications has not been effective.

Schizophrenia is a mental illness that involves disorders of thought, emotional reactions, and behavioral disorders. You can only use this medication if you have already tried at least two other neuroleptic medications, including one of the new atypical neuroleptics to treat schizophrenia, and these medications have not responded, or have caused severe adverse reactions that cannot be treated.

This medication is also indicated to treat thought disorders, emotional reactions, and severe behavioral disorders that occur in Parkinson's disease, when other treatments have not been effective.

2. What you need to know before taking Zolkar

Do not take Zolkar:

• if you are allergic to clozapine or any of the other components of Zolkar (listed in section 6).
• if it will not be possible to perform periodic blood tests on you.
• if you have ever been told that you have a low white blood cell count (e.g., leukopenia or agranulocytosis), especially if it was caused by other medications. This does not apply if you have had a low white blood cell count caused by previous chemotherapy.

• if you have previously had to stop using Zolkar because it caused you severe adverse reactions (e.g., agranulocytosis or heart problems).
• if you are being or have been treated with long-acting depot injections of antipsychotics.
• if you have or have had a bone marrow disease.
• if you have uncontrolled epilepsy (seizures or attacks).
• if you have had severe mental disorders caused by alcoholic beverages or other medications (e.g., narcotics).
• if you have episodes of loss of consciousness and strong drowsiness that is difficult to control.
• if you have circulatory collapse that can occur as a result of severe shock.
• if you have any severe kidney disease.
• if you have myocarditis (inflammation of the heart muscle).
• if you have any other severe heart disease.
• if you have symptoms or active liver disease, such as jaundice (yellowing of the skin and eyes, feeling of discomfort, and loss of appetite).
• if you have any other severe liver disease.
• if you have paralytic ileus (intestinal obstruction, your intestine does not function properly, and you have severe constipation).
• if you use any medication that prevents your bone marrow from functioning properly.
• if you use any medication that reduces the number of white blood cells in your blood.

Tell your doctor and do not take Zolkar if any of the above circumstances apply to you.

Zolkar 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 adverse reactions that can be life-threatening.

Talk to your doctor before taking Zolkarif you have or have had any of the following circumstances:

• blood clots or family history of blood clots, as this type of medication has been associated with the formation of blood clots.
• glaucoma (high eye pressure).
• diabetes. In patients with or without a medical history of diabetes mellitus (see section 4), high blood sugar levels have been reported (sometimes considerably).
• prostate problems or difficulty urinating.
• any heart, kidney, or liver disease.
• chronic constipation or taking medications that cause constipation (such as anticholinergics).
• galactose intolerance, Lapp-lactase deficiency, or glucose-galactose malabsorption.
• controlled epilepsy.
• large intestine diseases.
• abdominal surgery.
• a heart disease or family history of abnormal heart conduction called "prolonged QT interval".
• risk of stroke, for example, if you have very high blood pressure, cardiovascular problems, or problems in the blood vessels of the brain.

Immediately before taking the next dose of Zolkar tablets, inform your doctor if:

• you have signs of a cold, fever, flu-like symptoms, sore throat, or any other infection. You should have an urgent blood test to see if these symptoms are related to the medication.
• you have a sudden increase in body temperature, and/or muscle stiffness that can lead to altered consciousness (neuroleptic malignant syndrome), as it may be a severe adverse reaction that requires immediate treatment.
• you have a rapid and irregular heartbeat, even when you are at rest, palpitations, breathing problems, chest pain, or unusual fatigue. Your doctor should perform a heart check and, if necessary, refer you immediately to a cardiologist.
• you have nausea (feeling of dizziness), vomiting (you are dizzy), and/or loss of appetite. Your doctor should examine your liver.
• you have severe constipation. Your doctor should treat you to avoid other complications.
• you experience constipation, abdominal pain, abdominal sensitivity, fever, abdominal distension, and/or diarrhea with blood. Your doctor will need to examine you.

Medical examinations and blood tests

Before starting treatment with this medication, 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 Zolkar.

• Your doctor will inform you exactly when and where these tests will be performed. You can only take Zolkar if you have a normal blood count.
• This medication can cause a severe decrease in white blood cells in your blood (agranulocytosis). Only with regular blood tests can your doctor know if you are at risk of developing agranulocytosis.
• This test should be performed weekly during the first 18 weeks of treatment with Zolkar and then at least once a month.
• If there is a decrease in the number of white blood cells, you should stop treatment with Zolkar immediately. Your white blood cells should return to normal values.
• Blood tests should be performed during 4 weeks after finishing treatment with Zolkar.

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 this medication.

If you have high blood sugar levels (diabetes), your doctor may perform periodic checks of your blood sugar levels.

This medication can alter your blood lipid levels. This medication can cause weight gain. Your doctor may monitor your weight and lipid levels.

If you have a mild headache, dizziness, or weakness, or this medication 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 undergo surgery or if, for any reason, you cannot walk for an extended period, inform your doctor that you are taking this medication. 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 Zolkar, as there is not enough information available for its use in this age group.

Elderly patients (60 years and older)

Patient over 60 years old may be more susceptible to the following adverse effects during treatment with this medication: 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.

Other medications and Zolkar

Tell your doctor or pharmacist if you are taking, have recently taken, or may need to take any other medication, including those obtained without a prescription or herbal remedies. You may need to take a different amount of your medications or different medications.

Do not take Zolkar with other medications that prevent the proper functioning of the bone marrow and/or decrease the number of blood cells produced by the body, such as:

• carbamazepine, a medication used in epilepsy.
• certain antibiotics: chloramphenicol, sulfonamides such as cotrimoxazole.
• certain pain medications: analgesics of the pyrazolone group, such as phenylbutazone.
• penicillamine, a medication used to treat rheumatic joint inflammation.
• cytotoxic agents, medications used in chemotherapy.
• long-acting depot injections of antipsychotic medications.

These medications increase your risk of developing agranulocytosis (deficit of white blood cells in the blood).

Taking Zolkar at the same time as other medicationsmay affect the proper action ofZolkar and/or theother medications. Inform your doctor ifyou intend to take, ifyou are taking(even if the treatment is about to finish) or if you have recently stopped takingany of the following medications:

• medications used to treat depression, such as lithium, fluvoxamine, tricyclic antidepressants, MAO inhibitors, citalopram, paroxetine, fluoxetine, and sertraline.
• other antipsychotic medications used to treat mental illnesses, such as perazine.
• benzodiazepines and other medications used to treat anxiety or sleep disorders.
• narcotics and other medications that can affect your breathing.
• medications used to control epilepsy, such as phenytoin and valproic acid.
• medications used to treat high or low blood pressure, such as adrenaline and noradrenaline.
• warfarin, a medication used to prevent blood clotting.
• antihistamines, medications used for colds and allergies, such as hay fever (seasonal allergic rhinitis).
• anticholinergic medications, used to relieve stomach cramps, spasms, and dizziness.
• medications used to treat Parkinson's disease.
• digoxin, a medication used to treat heart problems.
• medications used to treat rapid or irregular heartbeat.
• some medications used to treat stomach ulcers, such as omeprazole or cimetidine.
• some antibiotics, such as erythromycin and rifampicin.
• some medications used to treat fungal (such as ketoconazole) or viral infections (such as protease inhibitors, used to treat AIDS).
• atropine, a medication that may be used in some eye drops or in preparations for cough and cold.
• adrenaline, a medication used in emergency situations.
• hormonal contraceptives (birth control pills).

This list is not complete. Your doctor and pharmacist have more information about medications that should be administered with caution or avoided while taking Zolkar. They also know if the medications you are taking belong to any of the groups listed above. Discuss it with them.

Taking Zolkar with food and drinks

During treatment with this medication, do not drink alcohol.

Tell your doctor if you smoke and how often you consume beverages that contain caffeine (coffee, tea, cola). A sudden change in your smoking or caffeine consumption habits can also change the effects of this medication.

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 medication. Your doctor will discuss with you the benefits and possible risks of using this medication during pregnancy. Inform your doctor immediately if you become pregnant during treatment with Zolkar.

The following symptoms may appear in newborns of mothers who have used clozapine 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 medications for mental illnesses have irregular menstrual periods or do not have menstrual periods. If this has happened to you, your menstrual period will return to normal when your medication is replaced by Zolkar. This means you should use effective contraceptives.

During treatment with this medication, you should not breastfeed your baby. Clozapine, the active substance of Zolkar, can pass into breast milk and affect the baby.

Driving and using machines

Zolkar can cause fatigue, drowsiness, and seizures, especially at the beginning of treatment. Therefore, you should avoid driving or operating machinery while you have these symptoms.

Zolkar contains lactose.

If your doctor has informed you that you have an intolerance to some sugars, contact your doctor before taking this medication.

3. How to take Zolkar

To minimize the risk of suffering from hypotension, epileptic seizures, or drowsiness, it is necessary for your doctor to gradually increase the dose. Follow your doctor's administration instructions for Zolkar exactly. If in doubt, consult your doctor or pharmacist again.

It is essential that you do not change the dose or stop taking this medication without first asking your doctor. Continue taking the tablets for the time your doctor has indicated.

If you are a patient over 60 years old, your doctor may start treatment with a lower dose and increase your dose more gradually, as you may be more susceptible to developing some unexpected adverse reactions. (See section 2 "What you need to know before taking Zolkar").

If you cannot achieve the prescribed dose with this tablet presentation, other presentations of this medication are available to achieve the prescribed dose.

The tablet can be divided into two equal parts.

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 you reach 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 Zolkar is working well for you for some time, your doctor will try treatment with lower doses. You will need to take this medication 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 you reach 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 Zolkar than you should

If you think you have taken more Zolkar than you should, or if someone has taken some of your tablets, inform your doctor or pharmacist immediately or call the Toxicology 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, 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 Zolkar

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 Zolkar for more than 48 hours, do not start treatment again without first consulting your doctor.

If you interrupt treatment with Zolkar

Do not interrupt treatment with Zolkar without asking your doctor, as you may have 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 with Zolkar suddenly, your doctor should examine you. If your doctor decides to restart treatment and your last dose of Zolkar was 2 days or more ago, you should start again 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.

4. Possible side effects

Like all medications, this medication can cause side effects, although not everyone will experience them.

Some side effects can be serious and require immediate medical attention:

Tell your doctor immediately before taking the next Zolkar tablet if you experience any of the following circumstances:

Very common(affect more than 1 in 10 patients):

• severe constipation. Your doctor should treat you to avoid other complications.
• rapid heartbeat.

Common(affect up to 1 in 10 patients):

• signs of a cold, fever, flu-like symptoms, sore throat, or any other infection. You will need to have an urgent blood test to check if the symptoms you have are related to your medication.
• seizures.
• sudden fainting or loss of consciousness with muscle weakness (syncope).

Uncommon(affect up to 1 in 100 patients):

• a sudden increase in your body temperature, muscle stiffness that can lead to altered consciousness (neuroleptic malignant syndrome), as it can be a serious side effect that requires immediate treatment.
• mild headache, dizziness, or weakness when standing up from a sitting or lying position, as it can increase the risk of falls.

Rare(affect up to 1 in 1,000 patients):

• signs of respiratory tract infection or pneumonia such as fever, cough, difficulty breathing, wheezing (noisy breathing).
• burning pain in the upper abdomen that spreads to the back accompanied by nausea and vomiting due to pancreas inflammation.
• fainting and muscle weakness due to a significant drop in blood pressure (circulatory collapse).
• difficulty swallowing (which can cause food inhalation).
• nausea (feeling dizzy), vomiting (being dizzy), and/or loss of appetite. Your doctor should examine your liver.
• signs of obesity or increased obesity.
• interrupted breathing with or without snoring during sleep.

Rare(affect up to 1 in 1,000 patients)or very rare(affect up to 1 in 10,000 patients):

• rapid and irregular heartbeat, even at rest, palpitations, breathing problems, chest pain, or unusual fatigue. Your doctor should have your heart checked and, if necessary, immediately refer you to a cardiologist.

Very rare(affect up to 1 in 10,000 patients):

• persistent and painful erections, if you are a man. This is called priapism. If you have an erection that lasts more than four hours, you may need immediate medical treatment to avoid additional complications.
• spontaneous bleeding or bruising, which could be signs of a decrease in the number of platelets in the blood.
• symptoms due to uncontrolled blood sugar levels (such as nausea or vomiting, abdominal pain, excessive thirst, frequent urination, disorientation, or confusion).
• abdominal pain, cramps, bloated abdomen, vomiting, constipation, and lack of gas passage, which can be signs and symptoms of intestinal obstruction.
• loss of appetite, bloated abdomen, abdominal pain, yellowing of the skin, severe weakness, and discomfort. These symptoms can be indicative of the start of liver disease that can progress to sudden liver necrosis.
• nausea, vomiting, fatigue, weight loss, which can be symptoms of kidney inflammation.

Not known(frequency cannot be estimated from available data):

• crushing chest pain, feeling of pressure, tightness, or heaviness (chest pain may radiate to the left arm, jaw, neck, and upper abdomen), difficulty breathing, sweating, weakness, dizziness, nausea, vomiting, and palpitations (symptoms of a heart attack) that can cause death. Seek immediate emergency medical treatment.
• pressure in the chest, heaviness, tightness, constriction, burning, or feeling of suffocation (signs of insufficient blood and oxygen flow to the heart) that can cause death. Your doctor should evaluate your heart function.
• intermittent feeling in the chest of a "stabbing", "racing", or "agitated" nature (palpitations).
• rapid and irregular heartbeats (atrial fibrillation). There may be occasional heart palpitations, fainting, difficulty breathing, or chest discomfort. Your doctor will need to check your heart.
• symptoms of low blood pressure such as dizziness, fainting, blurred vision, unusual fatigue, cool and moist skin, or nausea.
  • signs of blood clots in the veins, especially in the legs (symptoms including swelling, pain, and redness in the legs), which can move through the blood vessels to the lungs causing chest pain and difficulty breathing.
  • confirmed or suspected infection, accompanied by fever or low body temperature, rapid breathing, rapid heartbeat, altered reaction and consciousness, decreased blood pressure (sepsis).
  • excessive sweating, headache, nausea, vomiting, and diarrhea (symptoms of cholinergic syndrome).

• drastic decrease in urine production (signs of kidney failure).
• allergic reaction (swelling mainly in the face, mouth, and throat, as well as the tongue, which can be itchy or painful).
• loss of appetite, bloated abdomen, abdominal pain, yellowing of the skin, severe weakness, and discomfort. This can be indicative of possible liver damage leading to replacement of normal liver tissue with scar tissue, resulting in loss of liver function, including liver events that lead to life-threatening consequences such as liver failure (which can lead to death), liver damage (damage to liver cells, bile duct in the liver, or both), and liver transplant.
• burning pain in the upper abdomen, particularly between meals, early in the morning, or after drinking acidic beverages; black, tarry stools or stools with blood; bloating, heartburn, nausea, or vomiting, early feeling of fullness (intestinal ulceration of the stomach and/or intestine), which can lead to death.
• severe abdominal pain worsened by movement, nausea, vomiting, even vomiting blood (or liquid that looks like coffee grounds); the abdomen becomes rigid with sensitivity (rebound) that spreads from the point of perforation throughout the abdomen; fever and/or chills (perforation of the stomach and/or intestine or intestinal rupture) that can lead to death.
• constipation, abdominal pain, abdominal sensitivity, fever, bloating, diarrhea with blood. This can be a symptom of possible megacolon (expansion of the intestines) or intestinal ischemia/infarction/necrosis, which can lead to death. Your doctor will need to examine you.
• appearance or increase of muscle weakness, muscle spasms, muscle pain. This can indicate possible muscle damage (rhabdomyolysis). Your doctor will need to examine you.
• acute chest or abdominal pain with difficulty breathing with or without cough or fever.
• during the use of clozapine, extremely intense and severe skin reactions have been reported, such as drug reaction with eosinophilia and systemic symptoms (DRESS). The adverse skin reaction can appear as a rash with or without blisters. Skin irritation, edema, and fever, and flu-like symptoms may occur. The symptoms of DRESS syndrome usually appear approximately 2 to 6 weeks (possibly up to 8 weeks) after treatment begins.

Si any of the above cases apply to you, inform your doctor immediately before taking the next Zolkar 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):

Deficit of white blood cells 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), accumulation of fluid 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 number of platelets in the blood with possible blood 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 (cardiac arrest), sudden unexpected death.

Not known(frequency cannot be estimated from 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, red-purple spots, fever or itching due to inflammation of blood vessels, colon inflammation that causes 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 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 deaths 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 is not listed 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.

5. Storage of Zolkar

• This medication does not require special storage conditions.
• Keep this medication out of sight and reach of children.
• Do not use this medication after the expiration date shown on the packaging after CAD. The expiration date is the last day of the indicated month.
• Do not use this medication if you notice that the packaging is damaged or shows signs of alteration.

Medicines should not be disposed of via wastewater or household waste. Deposit the packaging and unused medications at the SIGRE collection point in your pharmacy. In case of doubt, ask your pharmacist how to dispose of the packaging and unused medications. This will help protect the environment.

6. Package Contents and Additional Information

Composition of Zolkar 25 mg EFG tablets

• The active ingredient is clozapine. Each tablet contains 25 mg of clozapine.
• The other components are lactose monohydrate, cornstarch, povidone K30, anhydrous colloidal silica, magnesium stearate, and talc.

Appearance of the Product and Package Contents

Zolkar 25 mg: pale yellow to yellow, round tablet, approximately 6 mm in diameter, without a film coating, engraved on one side with "FC" and "1" on either side of the break line and smooth on the other side.

The tablet can be divided into two equal parts.

Zolkar 25 mg EFG tablets are available in aluminum-PVC/PVDC blister packs containing 7, 14, 28, 30, 40, 50, 100, or 500 tablets.

Marketing Authorization Holder

Accord Healthcare S.L.U.

World Trade Center, Moll de Barcelona, s/n.

Edifici Est 6th floor

08039 - Barcelona

Spain

Manufacturer

Accord Healthcare B.V.,

Winthontlaan 200,

3526 KV Utrecht,

Netherlands

Or

Laboratori Fundació DAU

C/C, 12-14 Pol. Ind. Zona Franca

08040, Barcelona

Spain

Or

Accord Healthcare Polska Sp.z.o.o.

Ul.Lutomierska 50

Pabianice 95-200

Poland

Or

Accord Healthcare Single Member S.A.

64th Km National Road Athens,

Lamia, 32009,

Greece

This medication is authorized in the Member States of the EEA under the following names:

Austria Clozapin Accord 25 mg Tabletten

Germany Clozapin Accord 25 mg Tabletten

Bulgaria Clozapine ????? 25 ?? ????????

Cyprus Clozapine Accord 25mg Tablets

Croatia Klozapin Accord 25 mg tablets

Denmark Clozapin “Accord”

Slovakia Clozapine Accord 25 mg tablets

Slovenia Clozapin Accord 25 mg tablets

Spain Zolkar 25 mg EFG tablets

Estonia Clozapine Accord

Finland Clozapine Accord 25 mg tablets

France CLOZAPINE ACCORD 25 mg scored tablet

Italy Clozapina Accord

Lithuania Clozapine Accord 25 mg tablets

Latvia Clozapine Accord 25 mg tablets

Malta Clozapine Accord 25 mg tablets

Norway Clozapine Accord 25 mg tablets

Netherlands Clozapine Accord 25 mg, tablets

Poland Clopizam

Sweden Clozapine Accord 25mg tablets

Date of the last revision of this prospectus:June 2023

Detailed information about this medication is available on the website of the Spanish Agency for Medicines and Health Products (AEMPS) https://www.aemps.gob.es/