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clozapine

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Brand names: Clozaril

Atypical Antipsychotic Rx

Versacloz is a medicine used to treat severe schizophrenia when other medicines have not worked. It can also help lower the risk of suicidal behavior in people with schizophrenia or schizoaffective disorder.

Drug Pricing (NADAC)

Brand Price

$15.68/unit

Generic Price

$0.56/unit

Generic Savings

96%

Generic Available

Yes (6 manufacturers)

Pricing data from NADAC (CMS), effective December 18, 2024. Compare all drug costs →

What it does

Versacloz is used to treat schizophrenia in people who haven't responded well to other antipsychotic medicines.

Common side effects

Feeling sleepy, Dizziness, Headache

Key warnings

Versacloz can cause several serious side effects: * **Severe Neutropenia:** This means a dangerously low white blood cell count, which increases your risk of infection.

How It Works

Versacloz works by affecting certain chemicals in the brain. These chemicals, like dopamine and serotonin, are involved in mood, behavior, and thinking. By changing the levels of these chemicals, Versacloz can help reduce symptoms of schizophrenia and lower the risk of suicidal behavior.

How to Take It

Start with 12.5 mg once or twice a day. Your doctor may slowly increase the dose by 25 mg to 50 mg each day. The goal is to reach 150 mg to 225 mg twice a day within two weeks. The maximum dose is 450 mg twice a day. You can take Versacloz with or without food.

Pregnancy & Breastfeeding

Tell your doctor if you are pregnant or plan to become pregnant. Babies born to mothers who take Versacloz in the third trimester may have withdrawal symptoms or other problems after birth. There is a pregnancy registry for women who take atypical antipsychotics like Versacloz.

Missed Dose

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule.

Storage

Store Versacloz at room temperature, away from light, and do not refrigerate or freeze. Shake well for 10 seconds before use. Throw away any remaining medicine 100 days after opening the bottle.

Side Effects (from patient reports)

Based on 70,768 FDA adverse event reports.

Low white blood cell count
18,655
Needing to stay in the hospital
12,101
Death
11,398
A mental disorder that affects how a person thinks, feels, and behaves
4,547
High white blood cell count
4,446
Low white blood cell count
4,370
High neutrophil count
4,115
The medicine is not working
3,867
Feeling unwell
3,704
Using the medicine for a purpose it was not approved for
3,565

FDA Adverse Event Report Analysis

Detailed analysis of 121,298 reports from the FDA Adverse Event Reporting System (FAERS). Reports span 2001–2025.

Total Reports

121,298

Death-Related Reports

21,448

Hospitalization Reports

53,005

Top Indication

Product Used For Unknown Indication

Gender Distribution

Female 41,717 (39%)
Male 65,488 (61%)

Age Distribution

0–17 2,071
18–44 30,098
45–64 28,341
65–74 8,530
75+ 4,191

Most Reported Adverse Reactions (FAERS)

# Reaction Reports
1 NEUTROPENIA 18,655
2 HOSPITALISATION 12,101
3 DEATH 11,398
4 SCHIZOPHRENIA 4,547
5 WHITE BLOOD CELL COUNT INCREASED 4,444
6 WHITE BLOOD CELL COUNT DECREASED 4,370
7 NEUTROPHIL COUNT INCREASED 4,114
8 DRUG INEFFECTIVE 3,865
9 MALAISE 3,706
10 OFF LABEL USE 3,566
11 PNEUMONIA 3,190
12 TREATMENT NONCOMPLIANCE 3,093
13 NEUTROPHIL COUNT DECREASED 3,088
14 DRUG INTERACTION 3,056
15 PSYCHOTIC DISORDER 3,037

Reactions in Death Reports

DEATH 11,395
PNEUMONIA 1,078
COMPLETED SUICIDE 743
MYOCARDIAL INFARCTION 736
CARDIAC ARREST 689
NEUTROPHIL COUNT INCREASED 599
WHITE BLOOD CELL COUNT INCREASED 508
TOXICITY TO VARIOUS AGENTS 499
MALAISE 478
LUNG NEOPLASM MALIGNANT 458

Reactions in Hospitalization Reports

HOSPITALISATION 12,089
SCHIZOPHRENIA 3,328
MALAISE 2,582
TREATMENT NONCOMPLIANCE 2,492
PNEUMONIA 2,319
NEUTROPENIA 2,292
PSYCHOTIC DISORDER 2,213
NEUTROPHIL COUNT INCREASED 2,178
WHITE BLOOD CELL COUNT INCREASED 2,169
WHITE BLOOD CELL COUNT DECREASED 1,978

Source: FDA FAERS (Adverse Event Reporting System) FDA FAERS (Adverse Event Reporting System) Reports are voluntary and do not establish causation

Serious Warnings

Versacloz can cause several serious side effects: * **Severe Neutropenia:** This means a dangerously low white blood cell count, which increases your risk of infection. You will need regular blood tests to check your white blood cell count. * **Orthostatic Hypotension, Bradycardia, and Syncope:** This means low blood pressure when standing up, slow heart rate, and fainting. These are most likely when you first start taking Versacloz or when the dose is increased. * **Seizures:** Versacloz can increase your risk of seizures, especially at higher doses. * **Myocarditis, Pericarditis, and Cardiomyopathy:** These are serious heart problems that can be fatal. Tell your doctor right away if you have chest pain, shortness of breath, or other heart-related symptoms. * **Increased Mortality in Elderly Patients with Dementia-Related Psychosis:** Elderly patients with dementia who take antipsychotic medicines like Versacloz have an increased risk of death.

Known Drug Interactions

Anticholinergic Drugs Concomitant treatment with clozapine and other drugs with anticholinergic activity (e.g., benztropine, cyclobenzaprine, diphenhydramine) can increase the risk for anticholinergic toxicity and severe gastrointestinal adverse reactions related to hypomotility.

Mechanism: Both drugs have similar side effects that can slow down your digestive system and cause confusion or dry mouth. Combining them makes these side effects much more likely and can lead to severe constipation or toxicity.

What to do: Your doctor should monitor you for signs of toxicity or severe stomach issues. They may need to adjust your dose or choose a different medication to avoid these complications.

Anticholinergic Drugs Concomitant treatment with clozapine and other drugs with anticholinergic activity (e.g., benztropine, cyclobenzaprine, diphenhydramine) can increase the risk for anticholinergic toxicity and severe gastrointestinal adverse reactions related to hypomotility.

Mechanism: These two drugs both block certain signals in the body, which can lead to a 'double dose' of side effects like extreme sleepiness and severe constipation. This happens because both medications have similar drying and slowing effects on the body.

What to do: Be careful when using these together and watch for signs of severe constipation or confusion. Consult your healthcare provider before taking over-the-counter allergy or sleep aids while on clozapine.

moderate fluoxetine

Monoamine Oxidase Inhibitors (MAOIs): ( 2.9 , 2.10 , 4.1 , 5.2 ) Drugs Metabolized by CYP2D6: Fluoxetine is a potent inhibitor of CYP2D6 enzyme pathway ( 7.7 ) Tricyclic Antidepressants (TCAs): Monitor TCA levels during coadministration with fluoxetine or when fluoxetine has been recently discontinued ( 5.2 , 7.7 ) CNS Acting Drugs: Caution should be used when taken in combination with other centrally acting drugs ( 7.2 ) Benzodiazepines: Diazepam – increased t½, alprazolam - further psychomotor performance decrement due to increased levels ( 7.7 ) Antipsychotics: Potential for elevation of...

Mechanism: Fluoxetine prevents your body from processing clozapine correctly, leading to higher levels of the drug. This increases the risk of experiencing dangerous side effects.

What to do: Your doctor should monitor your blood levels and watch you closely for side effects. They may need to adjust your clozapine dose.

CYP2D6 and CYP3A4 Inhibitors Concomitant treatment with VERSACLOZ and CYP2D6 or CYP3A4 inhibitors (e.g., cimetidine, escitalopram, erythromycin, paroxetine, bupropion, fluoxetine, quinidine, duloxetine, terbinafine, or sertraline) can increase clozapine levels and lead to adverse reactions [see Clinical Pharmacology (12.3) ] .

Mechanism: Sertraline interferes with the way your body gets rid of clozapine. This can cause clozapine to reach high levels in your blood and increase the risk of side effects.

What to do: Your doctor should monitor you closely for side effects and may need to lower your clozapine dose.

CYP2D6 and CYP3A4 Inhibitors Concomitant treatment with VERSACLOZ and CYP2D6 or CYP3A4 inhibitors (e.g., cimetidine, escitalopram, erythromycin, paroxetine, bupropion, fluoxetine, quinidine, duloxetine, terbinafine, or sertraline) can increase clozapine levels and lead to adverse reactions [see Clinical Pharmacology (12.3) ] .

Mechanism: Escitalopram slows down the process of clearing clozapine from your body. This leads to higher amounts of clozapine in your system than intended.

What to do: Watch for increased side effects like extreme sleepiness or dizziness, and talk to your doctor about whether your clozapine dose needs to be changed.

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Common Questions

What should I do if I feel dizzy when standing up?
Stand up slowly to avoid feeling dizzy. If you feel dizzy, sit or lie down until the feeling passes.
Can I drink alcohol while taking Versacloz?
Talk to your doctor before drinking alcohol while taking Versacloz. Alcohol can increase the risk of side effects like sleepiness and dizziness.
How often will I need blood tests?
You will need regular blood tests to monitor your white blood cell count while taking Versacloz. Your doctor will tell you how often you need these tests.
What are the symptoms of a low white blood cell count?
Symptoms of a low white blood cell count include fever, sore throat, and other signs of infection. Tell your doctor right away if you have any of these symptoms.
Can I take other medicines with Versacloz?
Tell your doctor about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Some medicines can interact with Versacloz.
What should I do if I get constipated?
If you get constipated, talk to your doctor. They may recommend a stool softener or other treatment.
Can Versacloz cause weight gain?
Yes, Versacloz can cause weight gain. Talk to your doctor about ways to manage your weight.
Will Versacloz make me sleepy?
Yes, Versacloz can make you sleepy. Be careful when driving or operating machinery.
How long does it take for Versacloz to start working?
It may take several weeks for Versacloz to start working. Talk to your doctor if you don't feel any improvement after a few weeks.
What happens if I stop taking Versacloz suddenly?
Do not stop taking Versacloz suddenly. Stopping suddenly can cause withdrawal symptoms or a return of your symptoms. Talk to your doctor before stopping Versacloz.
What are the common side effects of clozapine?
The most commonly reported side effects of clozapine include Feeling sleepy, Dizziness, Headache, Shaking, Fast heart rate. Based on 70,768 FDA adverse event reports. Always consult your healthcare provider about potential side effects.
Does clozapine interact with other medications?
Yes, clozapine has 42 known drug interactions. Notable interactions include cyclobenzaprine, diphenhydramine, fluoxetine. Always inform your doctor about all medications you are taking.
What drug class is clozapine?
clozapine belongs to the Atypical Antipsychotic drug class. It requires a prescription (Rx). Versacloz is used to treat schizophrenia in people who haven't responded well to other antipsychotic medicines.
Is there a generic version of clozapine?
Yes, generic clozapine is available from 6 manufacturers. The generic costs $0.56 per unit compared to $15.68 for the brand version, saving approximately 96%. Pricing is based on NADAC (National Average Drug Acquisition Cost) data from CMS.
Is clozapine safe during pregnancy?
Tell your doctor if you are pregnant or plan to become pregnant. Babies born to mothers who take Versacloz in the third trimester may have withdrawal symptoms or other problems after birth. Always consult your healthcare provider before using any medication during pregnancy or breastfeeding.

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What the FDA Data Shows for clozapine

The FDA label for clozapine (sold under brand names such as Clozaril) classifies it as a prescription-only medication in the Atypical Antipsychotic class. Versacloz is used to treat schizophrenia in people who haven't responded well to other antipsychotic medicines. Official labeling lists 14 commonly reported side effects, including Feeling sleepy, Dizziness, Headache.

Post-market surveillance from the FDA Adverse Event Reporting System (FAERS) captures real-world experience. For this drug, FAERS contains 70,768 voluntary reports. The database also lists 42 documented drug interactions derived from FDA labeling, with the top-flagged interaction rated moderate severity. NADAC pricing from CMS shows a generic unit cost of $0.56 versus $15.68 for the brand — a 96% generic savings.

Report counts do not establish causation — a FAERS entry documents a temporal association, not proof that the drug produced the outcome. Widely prescribed medications naturally accumulate more reports than niche therapies, so raw totals must be interpreted alongside total exposure. Shortage status, recall history, and patent information further shape supply and switching decisions. This page summarizes public FDA data for educational purposes only and is not a substitute for professional medical advice — always consult a licensed healthcare provider before starting, stopping, or changing any medication.

Data Sources

Drug labeling: FDA Drug Labels (SPL/DailyMed). Adverse events: FDA Adverse Event Reporting System (FAERS). Pricing: CMS National Average Drug Acquisition Cost (NADAC).

FAERS reports are voluntary and do not establish causation. Drug interactions are derived from FDA labeling and clinical references. Always consult a healthcare professional before making medication decisions.

Last updated: June 23, 2025

All federal data sources used on this page