Introduction
Sizopin 100 is a prescription medicine used in the treatment of schizophrenia (a mental disorder that can result in hallucinations or delusions and also adversely affects a person’s ability to think and behave).
Sizopin 100 may be taken with or without food. However, it is advised to take it at the same time each day as this helps to maintain a consistent level of medicine in the body. Take this medicine in the dose and duration as advised by your doctor and if you have missed a dose, take it as soon as you remember. Do not skip any doses and finish the full course of treatment even if you feel better. It is important that this medication is not stopped suddenly without talking to your doctor as it may worsen your symptoms.
Some common side effects of this medicine include increased sweating, visual disturbance and decreased blood pressure. Please consult your doctor if these side effects do not get better or worse.
Before taking this medicine it is important to inform your doctor if your suffering from high body temperature and muscle stiffness (neuroleptic malignant syndrome), have had abnormal tongue or face movements (dyskinesia), heart disease, diabetes, Parkinson's disease, dementia, fits (epilepsy), difficulty in swallowing (dysphagia), or liver problems.
Side effects of Sizopin 100
Common
- Increased sweating
- Visual impairment
- Decreased blood pressure
How to use Sizopin 100
Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Sizopin 100 may be taken with or without food, but it is better to take it at a fixed time.
How Sizopin 100 works
Sizopin 100 is an atypical antipsychotics. It works by modulating the action of certain chemical messengers in the brain that affects thoughts.
Indication
Indicated for reducing risk of recurrent suicidal behavior in patients with schizophrenia, or schizoaffective disorder in patients who are judged to be at chronic risk to re-experience suicidal behavior
Treatment-resistant schizophrenia, in patients who fail to respond adequately to standard antipsychotic treatment
Psychotic disorders in people with Parkinson's disease, when standard treatment has failed to control symptoms.
Administration
May be taken with or without food.
Adult Dose
Adults: PO: Schizophrenia
12.5 mg PO once daily or q12hr initially; increased daily in increments of 25-50 mg/day, if well tolerated, to achieve target dosage of 300-450 mg/day by end of 2 weeks
On occasion, may have to be increased to 600-900 mg/day to obtain acceptable response
Maintenance: Generally, patients who respond should continue maintenance treatment on their effective dose beyond the acute episode
Psychoses in Parkinson's disease Initial: 12.5 mg/day at night, increase gradually in steps of 12.5 mg up to twice weekly. Usual range: 25-37.5 mg/day at bedtime. Max: 100 mg/day in 1-2 divided doses.
Elderly: Lower initial dosage of 12.5-25 mg/day indicated; may be titrated more slowly than in younger adults
Hepatic impairment: Use with caution and avoid in symptomatic or progressive liver disease or hepatic failure.
Renal Dose
Renal impairment: Severe: Contraindicated.
Contraindication
History of bone marrow disorders including agranulocytosis, circulatory collapse, alcoholic or toxic psychosis, drug intoxication, uncontrolled epilepsy, severe renal, hepatic or cardiac disease; paralytic ileus. Pregnancy and lactation.
Mode of Action
Clozapine has relatively weak dopamine receptor-blocking activity at D1, D2, D3 and D5 receptors but has high affinity for the D4 receptor. It has also blocking effects on serotonin, ?-adrenergic histamine H1 and cholinergic receptors.
Precaution
Medication should not be stopped abruptly; should be tapered off over 1-2 weeks. If conditions warrant abrupt discontinuation (leukopenia, myocarditis, cardiomyopathy), monitor patient for psychosis and cholinergic rebound (headache, nausea, vomiting, diarrhea). Elderly patients are more susceptible to adverse effects (including agranulocytosis, cardiovascular, anticholinergic, and tardive dyskinesia). Significant risk of agranulocytosis, potentially life-threatening. Leucocyte counts should be monitored regularly and for at least 4 wk after treatment discontinuation. Renal, hepatic or cardiac impairment; prostatic enlargement, narrow-angle glaucoma; elderly; immobilised patients.
Lactation: Drug enters breast milk; not recommended (American Academy of Pediatrics Committee states that this is "of concern")
Side Effect
Commonly: Sedation, wt gain, reversible neutropenia, eosinophilia, tachycardia, orthostatic hypotension, dizziness, hypersalivation at night, headache, nausea, vomiting, constipation, urinary incontinence and retention, fatigue, transient fever, abnormalities of glucose homoeostasis and the onset of DM, obsessive compulsive symptoms.
Rarely: Anaemia, thrombocytopenia, thrombocythaemia, extrapyramidal disorders including tardive dyskinesia, circulatory collapse w/ cardiac and resp arrest, HTN, dysphagia, parotid gland enlargement, confusion, delirium, thromboembolism, acute pancreatitis, hepatitis and cholestatic jaundice.
Potentially Fatal: Agranulocytosis, myocarditis, cardiomyopathy, cardiac arrhythmias, pericarditis/pericardial effusion, neuroleptic malignant syndrome, pulmonary embolism, lower resp tract infection.
Pregnancy Category Note
Pregnancy category: B
Neonates exposed to antipsychotic drugs during 3rd trimester of pregnancy are at risk for EPS or withdrawal symptoms after delivery; these complications vary in severity, with some being self-limited and others requiring ICU support and prolonged hospitalization
Lactation: Drug enters breast milk; not recommended (American Academy of Pediatrics Committee states that this is "of concern")
Interaction
Increased risk and/or severity of bone marrow suppression w/ bone marrow suppressants (e.g. carbamazepine, chloramphenicol), sulfonamides (e.g. co-trimoxazole), pyrazolone analgesics (e.g. phenylbutazone), penicillamine, cytotoxic agents or long-acting depot inj of antipsychotics. Concomitant use w/ benzodiazepines may increase risk of circulatory collapse which may lead to cardiac and/or resp arrest. Additive CNS depression and cognitive and motor performance interference w/ MAOIs and CNS depressants including antihistamines, benzodiazepines and opioid analgesics.
May potentiate effects of anticholinergics or antihypertensives. Increased plasma concentration of highly protein bound substances (e.g. warfarin, digoxin). Decreased plasma concentrations w/ phenytoin. Concomitant use w/ lithium can increase the risk of development of neuroleptic malignant syndrome. Decreased clozapine levels w/ CYP1A2 inducers (e.g. omeprazole). Increased clozapine levels w/ CYP1A2 inhibitors (e.g. fluvoxamine, caffeine, ciprofloxacin).