A sample titration schedule. Adjustments may be needed based on individual tolerability; we recommend a slower titration when there are greater than mild side effects. We also recommend consolidating to nighttime dosing in cases of excessive daytime sedation OR difficulty with optimal medication adherence. Target dose of 300 mg is the typical minimum dose needed to achieve therapeutic effect, although this varies widely due to individual variability.
Please contact the NCCN Consultation Service for Assistance.
Clozapine initiation and monitoring grid: CBC, Myocarditis, ECG, Glucose, Vitals, ROS
IMPORTANT: If concerned about possible myocarditis and patient is not in distress, obtain ECG and consult cardiology. With any symptomatic distress, have low threshold for bringing patient to ED or instructing patient to go to ED if not in clinic. Must call ED to provide history and clinical details.
- General considerations for weight interventions.
- When to consider Metformin for weight.
- Evidence to support Metformin for weight control.
- Potential added benefits of metformin.
- Metformin Side Effects and (Relative) Contraindications to Metformin.
- Pre–Metformin workup, Initiating Metformin and Ongoing Monitoring
- Clozapine Prescriber Certification and Registration
- Clozapine Pharmacy (and Pharmacist) Certification and Registration