Clozapine Aurovitas 200 mg tablets

Spain
Brand name Clozapine Aurovitas 200 mg tablets
Form tablets
Active substance / Dosage
CLOZAPINE · 200 mg
Prescription type Prescription Only Medicine
Registration number 83669

Package leaflet: Information for the user

Introduction

Package leaflet: Information for the patient

Clozapine Aurovitas 200 mg tablets

Read the entire leaflet carefully before you start taking this medicine because it contains important information for you.

  • Keep this leaflet. You may need to read it again.
  • If you have any questions, ask your doctor, pharmacist or nurse.
  • This medicine has been prescribed for you only, and you should not give it to other people, even if they have the same symptoms as you. It may harm them.
  • If you experience any adverse effects, consult your doctor or pharmacist, even if they are adverse effects not listed in this leaflet. See section 4.

Contents of the leaflet

  1. What Clozapine Aurovitas is and what it is used for
  2. What you need to know before taking Clozapine Aurovitas
  3. How to take Clozapine Aurovitas
  4. Possible side effects
  5. How to store Clozapine Aurovitas
  6. Contents of the pack and other information

1. What Clozapine Aurovitas is and what it is used for

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

Clozapine is used to treat patients with schizophrenia when other medicines have not worked. Schizophrenia is a mental illness that affects how a person thinks, feels, and behaves. This medicine should only be used if you have already tried at least two other antipsychotic medicines, including one of the newer atypical antipsychotics for the treatment of schizophrenia, and these medicines were ineffective or caused serious adverse reactions that cannot be managed.

2. What you need to know before taking Clozapina Aurovitas

Do not take Clozapina Aurovitas if:

  • You are allergic to clozapine or any of the other components of clozapine (listed in section 6).

  • You have ever been told you have a low white blood cell count (e.g., leukopenia or agranulocytosis), especially if it was caused by other medicines. This does not apply if you had a low white blood cell count caused by previous chemotherapy.

  • You previously had to stop using clozapine due to serious adverse reactions (e.g., agranulocytosis or any heart problems).

  • You are being or have been treated with long-acting depot injections of antipsychotics.

  • You have or have had bone marrow disease.

  • You have uncontrolled epilepsy (seizures or fits).

  • You have had severe mental disorders caused by alcoholic beverages or other medicines (e.g., narcotics).

  • You experience episodes of loss of consciousness and severe drowsiness.

  • You have circulatory collapse that may occur as a result of severe shock.

  • You have severe kidney disease.

  • You have myocarditis (inflammation of the heart muscle).

  • You have any other serious heart disease.

  • You have symptoms or active liver disease such as jaundice (yellowing of the skin and eyes, feeling unwell, and loss of appetite).

  • You have any other serious liver disease.

  • You have paralytic ileus (your intestine does not function properly and you have severe constipation).

  • You are taking any medicine that impairs the proper functioning of your bone marrow.

  • You are taking any medicine that reduces the number of white blood cells in your blood.

Inform your doctor and do not take clozapine if any of the above conditions apply to you.

Clozapine must 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 follow them to minimize the risk of serious adverse reactions that may be life-threatening.

Before starting treatment with Clozapina Aurovitas, inform your doctor if you have or have had:

  • Blood clots or a family history of blood clots, as this type of medicine has been associated with blood clot formation.

  • Glaucoma (increased pressure in the eye).

  • Diabetes. Elevated blood glucose levels (sometimes markedly) have occurred in patients with or without a medical history of diabetes mellitus (see section 4).

  • Prostate problems or difficulty urinating.

  • Any heart, kidney, or liver disease.

  • Chronic constipation or if you are taking medicines that cause constipation (such as anticholinergics).

  • Galactose intolerance, Lapp lactase deficiency, or glucose-galactose malabsorption.

  • Controlled epilepsy.

  • Diseases of the large intestine.

  • Abdominal surgery.

  • Heart disease or a family history of abnormal heart conduction known as "QT interval prolongation."

  • Risk of stroke, for example, if you have high blood pressure, cardiovascular problems, or problems with blood vessels in the brain.

  • If you have ever had a severe skin rash, skin peeling, blistering, or mouth sores after taking clozapine.

  • This medicine may cause serious skin reactions. Stop taking clozapine and seek immediate medical attention if you notice any symptoms related to these serious skin reactions.

Before taking the next dose of Clozapina Aurovitas tablets, immediately inform your doctor if:

  • You have signs of cold, fever, flu-like symptoms, sore throat, or any other infection. You will need an urgent blood test to determine whether these symptoms are related to the medicine.
  • You have a sudden increase in body temperature, muscle rigidity that may lead to loss of consciousness (neuroleptic malignant syndrome), as this may be a serious adverse reaction requiring immediate treatment.
  • You have rapid or irregular heartbeat, even at rest, palpitations, breathing difficulties, chest pain, or unusual tiredness. Your doctor should examine your heart and, if necessary, refer you immediately to a cardiologist.
  • You have nausea, vomiting and/or loss of appetite. Your doctor should examine your liver.
  • You have severe constipation. Your doctor should treat you to prevent further complications.
  • You experience constipation, abdominal pain, abdominal tenderness, fever, abdominal distension and/or bloody diarrhea. Your doctor will need to examine you.
  • You develop signs and symptoms of appendicitis; these may include severe abdominal pain that worsens, starts near the navel, spreads to the lower right side, and intensifies with movement, coughing, or pressure on the area. Other signs may include constipation, abdominal swelling, malaise, low-grade fever, vomiting, loss of appetite, or diarrhea. Your doctor should perform an urgent medical examination.

Medical examinations and blood tests

Before starting treatment with clozapine, your doctor will ask about your medical history and perform a blood test to ensure your white blood cell count is normal. This is important because you need white blood cells to fight infections.

Make sure you have regular blood tests before, during, and after stopping treatment with clozapine.

  • Your doctor will inform you exactly when and where these tests will be performed. You can only take clozapine if you have a normal blood count.

  • Clozapine may cause a severe decrease in white blood cells in your blood (agranulocytosis). Only with regular blood tests can your doctor determine if you are at risk of developing agranulocytosis (see section 4).

  • This blood test must be performed weekly during the first 18 weeks of clozapine treatment, then at least once a month during the following 34 weeks.

  • After 12 months of treatment, blood tests should be performed every 12 weeks for one year, and then annually, if no decrease in white blood cell count is detected.

  • If there is a decrease in the number of white blood cells, you must stop clozapine treatment immediately. Your white blood cell count should return to normal.

  • Blood tests must be performed for 4 weeks after stopping clozapine treatment, if treatment is completely discontinued for hematological reasons (i.e., agranulocytosis), or if monitoring duration is <2 years, or if there is a history of neutropenia that did not lead to treatment discontinuation.

Before starting treatment, your doctor will also perform a physical examination. Your doctor may perform an electrocardiogram (ECG) to examine your heart, but only if necessary for you or if you have a particular concern.

If you have liver impairment, periodic liver function tests will be performed throughout clozapine treatment.

If you have elevated blood glucose levels (diabetes), your doctor may periodically check your glucose levels.

Clozapine may alter blood lipid levels. Clozapine may cause weight gain. Your doctor may monitor your weight and lipid levels.

If you feel dizzy, lightheaded, or faint, or if clozapine makes you feel this way, be careful when rising from a sitting or lying position, as this may increase the risk of falls.

If you are scheduled for surgery or for any reason cannot walk for a prolonged period, inform your doctor that you are taking clozapine. You may be at risk of thrombosis (blood clot in a vein).

Children and adolescents under 16 years of age

If you are under 16 years of age, you should not take clozapine, as there is insufficient information on its use in this age group.

Elderly patients (60 years of age and older)

Elderly patients (60 years of age and older) may be more prone to the following adverse effects during clozapine treatment: weakness or drowsiness after changing position, dizziness, rapid heartbeat, difficulty urinating, and constipation.

Inform your doctor or pharmacist if you have a condition called dementia.

Other medicines and Clozapina Aurovitas

Inform your doctor or pharmacist if you are taking, have recently taken, or might need to take any other medicine. This includes medicines purchased without a prescription or herbal remedies. You may need to take different doses of your medicines or different medicines.

Do not take Clozapina Aurovitas together with other medicines that impair the proper functioning of the bone marrow and/or reduce the number of blood cells produced by the body, such as:

  • Carbamazepine, a medicine used for epilepsy.
  • Certain antibiotics: chloramphenicol, sulfonamides such as cotrimoxazole.
  • Certain pain medicines: analgesics of the pyrazolone group, such as phenylbutazone.
  • Penicillamine, a medicine used to treat rheumatoid arthritis.
  • Cytotoxic agents, medicines used in chemotherapy.
  • Long-acting "depot" injections of antipsychotic medicines.

These medicines increase your risk of developing agranulocytosis (white blood cell deficiency).

Taking clozapine together with other medicines may affect the proper action of clozapine and/or the other medicines. Inform your doctor if you intend to take, are taking (even if treatment is about to end), or have recently stopped taking any of the following medicines:

  • Medicines used to treat depression, such as lithium, fluvoxamine, tricyclic antidepressants, MAO inhibitors, citalopram, paroxetine, fluoxetine, and sertraline.

  • Other antipsychotic medicines used to treat mental illnesses, such as perazine.

  • Benzodiazepines and other medicines used to treat anxiety or sleep disorders.

  • Narcotics and other medicines that may affect your breathing.

  • Medicines used to control epilepsy, such as phenytoin and valproic acid.

  • Medicines used to treat high or low blood pressure, such as adrenaline and noradrenaline.

  • Warfarin, a medicine used to prevent blood clotting.

  • Antihistamines, medicines used for colds and allergies such as allergic rhinitis.

  • Anticholinergic medicines, used to relieve stomach cramps, spasms, and dizziness.

  • Medicines used to treat Parkinson's disease.

  • Digoxin, a medicine used to treat heart problems.

  • Medicines used to treat rapid or irregular heartbeat.

  • Some medicines used to treat stomach ulcers, such as omeprazole or cimetidine.

  • Some antibiotics, such as erythromycin and rifampicin.

  • Some medicines used to treat fungal infections (such as ketoconazole) or viral infections (such as protease inhibitors, used to treat HIV infection).

  • Atropine, a medicine that may be used in certain eye drops or cold and cough preparations.

  • Adrenaline, a medicine used in emergency situations.

  • Hormonal contraceptives (birth control pills).

This list is not complete. Your doctor and pharmacist have more information about medicines that should be used with caution or avoided while taking clozapine. They also know whether the medicines you are taking belong to any of the groups listed above. Discuss this with them.

Taking Clozapina Aurovitas with food and drinks

Do not drink alcohol during treatment with clozapine.

Inform your doctor if you smoke and how frequently you consume beverages containing caffeine (coffee, tea, cola drinks). Sudden changes in your smoking habits or caffeine consumption may also alter the effects of clozapine.

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. Inform your doctor immediately if you become pregnant during treatment with clozapine.

The following symptoms may occur in newborn babies of mothers who have used clozapine during the third trimester (the last three months of pregnancy): tremor, muscle stiffness and/or weakness, drowsiness, restlessness, breathing difficulties, and feeding problems. 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 no periods at all. If this has happened to you, your periods may return to normal when your medication is switched to clozapine. This means you should use effective contraception.

During treatment with clozapine, you must not breastfeed your baby. Clozapine, the active substance in Clozapina Aurovitas, may pass into breast milk and affect the baby.

Driving and using machines

Clozapine may cause tiredness, drowsiness, and seizures, especially at the beginning of treatment. You should not drive or operate machinery while experiencing these symptoms.

Clozapina Aurovitas contains lactose

If your doctor has informed you that you have an intolerance to certain sugars, consult with him before taking this medicine.

3. How to take Clozapine Aurovitas

Follow exactly the instructions for administration of this medicine given by your doctor or pharmacist. If in doubt, consult your doctor or pharmacist again.

To reduce the risk of hypotension, seizures, and drowsiness, your doctor must gradually increase your dose. Follow exactly the instructions for clozapine administration given by your doctor. If in doubt, consult your doctor or pharmacist again.

It is important that you do not change the dose or stop taking clozapine without first consulting your doctor. Continue taking the tablets for as long as your doctor has instructed.

If you are a patient aged 60 years or older, your doctor may start you on a lower dose and increase it more gradually, as you may be more susceptible to developing certain unexpected adverse reactions (see section 2 "What you need to know before starting to take Clozapine Aurovitas").

If with this tablet formulation you cannot achieve the dose prescribed to you, other formulations of this medicine are available to reach the prescribed dose.

Treatment of schizophrenia

Treatment is initiated with 12.5 mg (half of 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 a glass of water. If well tolerated, your doctor will gradually increase the dose by increments of 25–50 mg over the next 2–3 weeks until reaching a dose of 300 mg per day. Afterwards, the daily dose may need to be increased by 50 mg to 100 mg twice weekly, or preferably once weekly.

The effective daily dose is usually between 200 mg and 450 mg, divided into several single doses per day. Some individuals may require higher doses. Doses up to 900 mg per day are permitted. At daily doses exceeding 450 mg, adverse reactions (particularly seizures) may increase. Always take the lowest dose effective for you. Most patients should take part of the dose in the morning and 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 may take it as a single nightly dose. Once clozapine treatment is working well for you over a period of time, your doctor may consider reducing your dose. You will need to take clozapine for at least 6 months.

If you take more Clozapine Aurovitas than you should

If you think you have taken more clozapine than you should, or if someone has taken any of your tablets, inform your doctor immediately or call the Toxicology Information Service at telephone number 91 562 04 20, stating the medicine and the amount taken.

Symptoms of overdose include:

Drowsiness, fatigue, lack of energy, unconsciousness, coma, confusion, hallucinations, agitation, incoherent speech, numbness in the limbs, hand tremor, seizures, increased salivation, pupil dilation, blurred vision, low blood pressure, collapse, rapid or irregular heartbeat, shallow breathing, or difficulty breathing.

If you forget to take Clozapine Aurovitas

If you forget to take a dose, take the missed dose as soon as possible. If it is almost time for your 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 a missed dose. If you have stopped taking clozapine for two or more days, consult your doctor.

If you stop taking Clozapine Aurovitas

Do not stop clozapine treatment without consulting your doctor, as you may experience withdrawal symptoms.

These symptoms include sweating, headache, nausea, vomiting, and diarrhea. If you experience any of these symptoms, consult your doctor immediately. These symptoms may be followed by more severe symptoms unless treated promptly. Your original symptoms may return. If you need to stop treatment, it is recommended to gradually reduce the dose by 12.5 mg increments over a period of 1 to 2 weeks. Your doctor will advise you on how to reduce your daily dose. If you need to stop clozapine treatment suddenly, your doctor should review your condition. If your doctor decides to restart clozapine treatment and your last dose was two or more days ago, treatment should be restarted at the initial dose of 12.5 mg.

If you have any further questions about the use of this medicine, ask your doctor or pharmacist.

4. Possible adverse effects

Like all medicines, this medicine can cause adverse effects, although not everyone will experience them.

Some adverse effects may be serious and require immediate medical attention:

Contact your doctor immediately before taking your next clozapine tablet if you experience any of the following:

Very common: may affect more than 1 in 10 people

  • Severe constipation. Your doctor will need to treat this to prevent further complications.
  • Fast heartbeat.

Common: may affect up to 1 in 10 people

  • Signs of cold, fever, flu-like symptoms, sore throat, or any other infection. You will need to have an urgent blood test to check whether your symptoms are related to your medicine.
  • Seizures.
  • Sudden fainting or sudden loss of consciousness with muscle weakness (syncope).

Uncommon: may affect up to 1 in 100 people

  • A sudden increase in body temperature, muscle stiffness that may lead to loss of consciousness (neuroleptic malignant syndrome), as this may be a serious adverse effect requiring immediate treatment.
  • Dizziness, lightheadedness, or fainting when standing up from a sitting or lying position, as this may increase the risk of falling.

Rare: may affect up to 1 in 1,000 people

  • Signs of respiratory tract infection or pneumonia such as fever, cough, difficulty breathing, wheezing.
  • Severe burning pain in the upper abdomen spreading to the back, accompanied by nausea and vomiting due to inflammation of the pancreas.
  • Fainting and muscle weakness due to a significant drop in blood pressure (circulatory collapse).
  • Difficulty swallowing (which may lead to aspiration of food).
  • Nausea, vomiting, and/or loss of appetite. Your doctor will need to check your liver.
  • Signs of obesity or worsening of obesity.
  • Interruption of breathing with or without snoring during sleep.

Rare: may affect up to 1 in 1,000 people or very rare: may affect up to 1 in 10,000 people

  • Fast and irregular heartbeat, even at rest, palpitations, breathing difficulties, chest pain, or unexplained tiredness. Your doctor should examine your heart and, if necessary, refer you immediately to a cardiologist.

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

  • Persistent and painful erections of the penis, if you are a man. This is known as priapism. If you have an erection lasting more than four hours, immediate medical treatment may be needed to prevent further 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, excessive urination, disorientation or confusion).
  • Abdominal pain, cramps, bloated abdomen, vomiting, constipation, and inability to pass gas, which may be signs and symptoms of intestinal obstruction.
  • Loss of appetite, bloated abdomen, abdominal pain, yellowing of the skin, severe weakness, and malaise. These symptoms may be indicative of developing liver disorder that may rapidly progress to liver necrosis.
  • Nausea, vomiting, fatigue, weight loss, which may be symptoms of kidney inflammation.

Frequency not known (cannot be estimated from available data):

  • Crushing chest pain, sensation of pressure, tightness, or constriction in the chest (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 may be fatal. Seek immediate emergency medical treatment.

  • Chest pressure, sensation of heaviness, tightness, constriction, burning, or suffocation (signs of insufficient blood and oxygen flow to the heart) that may be fatal. Your doctor should evaluate your heart function.

  • Intermittent sensation in the chest of “stabbing,” “pounding,” or “fluttering” (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, lightheadedness, fainting, blurred vision, unusual fatigue, cold and clammy skin, or nausea.

  • Signs of blood clots in the veins, especially in the legs (symptoms include swelling, pain, and redness in the legs), which may travel through blood vessels to the lungs causing chest pain and difficulty breathing.

  • Confirmed or highly suspected infection, accompanied by fever or low body temperature, abnormally rapid breathing, fast heartbeat, altered reaction capacity and consciousness, decreased blood pressure (sepsis).

  • Hematological neoplasm (malignant hematological process).

A small increased risk of developing hematological neoplasm has been observed in patients taking clozapine, especially with longer-term treatment.

Symptoms may include:

    • fever without focus
    • swollen lymph nodes
    • persistent infections during treatment
    • weight loss
    • extreme fatigue
    • redness
    • night sweats
    • easy bleeding or bruising
  • Excessive sweating, headache, nausea, vomiting, and diarrhea (symptoms of cholinergic syndrome).

  • Inflammation of the appendix (appendicitis).

  • Drastic reduction in urine output (signs of kidney failure).

  • Allergic reaction (swelling mainly in the face, mouth, and throat, as well as the tongue, which may cause itching or be painful).

  • Loss of appetite, bloated abdomen, abdominal pain, yellowing of the skin, severe weakness, and malaise. This may indicate possible liver disorders leading to replacement of normal liver tissue with scar tissue, resulting in loss of liver function, including life-threatening hepatic events such as liver failure (which may lead to death), liver damage (damage to liver cells, bile ducts in the liver, or both), and liver transplantation.

  • Burning pain in the upper abdomen, particularly between meals, early in the morning, or after drinking acidic beverages; tarry, black, or bloody stools; bloating, heartburn, nausea or vomiting, early satiety (intestinal ulceration of the stomach and/or intestine), which may be fatal.

  • Severe abdominal pain worsened by movement, nausea, vomiting, even vomiting blood (or fluid resembling ground coffee); abdomen becomes rigid with tenderness (rebound) spreading from the perforation site throughout the abdomen; fever and/or chills (perforation of the stomach and/or intestine or intestinal rupture) which may be fatal.

  • Constipation, abdominal pain, abdominal tenderness, fever, bloating, bloody diarrhea. This may be a symptom of possible megacolon (intestinal dilation) or intestinal ischemia/infarction which may be fatal. Your doctor will need to examine you.

  • Sudden chest pain with difficulty breathing with or without cough.

  • Onset or worsening of muscle weakness, muscle spasms, muscle pain. This may indicate a possible muscle disorder (rhabdomyolysis). Your doctor will need to examine you.

    • Sudden chest pain or abdominal pain with difficulty breathing and with or without cough or fever.
    • During use of clozapine, extremely severe and serious skin reactions have been reported, such as drug reaction with eosinophilia and systemic symptoms (DRESS). The adverse skin reaction may appear as rashes with or without blisters. Skin irritation, edema, fever, and flu-like symptoms may occur. Symptoms of DRESS syndrome 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 clozapine tablet.

Other adverse effects

Very common: may affect more than 1 in 10 people

Drowsiness, dizziness, increased saliva production.

Common: may affect up to 1 in 10 people

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, tremor, stiffness, restlessness, seizures, jerky movements, abnormal movements, inability to initiate movement, inability to stay still, changes in heart electrocardiogram (ECG) test, high blood pressure, dizziness or fainting after changing position, nausea, vomiting, 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., difficulty articulating words).

Uncommon: may affect up to 1 in 100 people

Deficiency of white blood cells in the blood (agranulocytosis), speech disorder (e.g., stuttering).

Rare: may affect up to 1 in 1,000 people

Low levels of red blood cells in the blood (anemia), restlessness, agitation, confusion, delirium, irregular heartbeat, inflammation of the heart muscle (myocarditis) or of the membrane surrounding the heart muscle (pericarditis), fluid accumulation around the heart (pericardial effusion), high blood sugar levels, diabetes mellitus, blood clots in the lungs (thromboembolism), liver inflammation (hepatitis), liver disease causing yellowing of the skin/dark urine/itching, elevated levels in the blood of an enzyme called creatine phosphokinase.

  • Very rare: may affect up to 1 in 10,000 patients

Increase in the number of blood platelets with possible blood vessel clotting, uncontrollable movements of the mouth/tongue and limbs, obsessive thoughts and repetitive compulsive behaviors (obsessive-compulsive symptoms), skin reactions, swelling in the front part of the ear (due to inflammation of the salivary glands), difficulty breathing, very high levels of triglycerides or cholesterol in the blood, heart muscle disease (cardiomyopathy), cessation of heartbeat (cardiac arrest), unexpected sudden death.

Frequency not known (cannot be estimated from available data):

Changes in brain wave recordings (electroencephalogram/EEG), diarrhea, stomach discomfort, burning sensation, stomach discomfort after eating, muscle weakness, muscle spasms, muscle pain, nasal congestion, nocturnal enuresis, sudden and uncontrolled increase in blood pressure (pseudopheochromocytoma), involuntary contraction causing the body to curve to one side (pleurothotonus), if you are a man, ejaculation disorder in which semen enters the bladder instead of being ejaculated through the penis (dry orgasm or retrograde ejaculation), rash, red-purple spots, fever or itching due to inflammation of blood vessels, inflammation of the colon causing diarrhea, abdominal pain, fever, skin color changes, 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 at night, and 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.

Reporting of adverse effects

If you experience any adverse effect, consult your doctor or pharmacist, even if it is a possible adverse effect not listed in this leaflet. You can also report them directly via the Spanish Pharmacovigilance System for Human Medicines: https://www.notificaRAM.es. By reporting adverse effects, you can help provide more information on the safety of this medicine.

5. Storage of Clozapine Aurovitas

Keep this medicine out of the sight and reach of children.

Do not use this medicine after the expiry date stated on the outer packaging and blister after EXP. The expiry date refers to the last day of the month indicated.

Store below 30 °C.

Do not use this medicine if you notice any changes in the appearance of the tablets.

Medicines must not be disposed of via wastewater or household waste. Dispose of containers and unused medicines at the SIGRE collection point at your pharmacy. Ask your pharmacist how to dispose of containers and medicines you no longer need. This will help protect the environment.

6. Contents of the pack and other information

Composition of Clozapine Aurovitas

  • The active substance is clozapine. Each tablet contains 200 mg of clozapine.
  • The other components are: lactose monohydrate, corn starch, povidone (K-30), anhydrous colloidal silica, talc and magnesium stearate.

Appearance of the product and contents of the pack

Uncoated tablets, pale yellow in color, oval-shaped, engraved on one side with a "C" and a "Z" separated by a central groove, and "200" on the other side. The tablet can be divided into two equal doses.

Clozapine Aurovitas 200 mg tablets are available in blisters and high-density polyethylene (HDPE) bottles.

Pack sizes:

Blisters: 7, 14, 20, 28, 30, 40, 50, 60, 90, 100, 250 and 1,000 tablets.

HDPE bottle: 30, 50, 100 and 250 tablets (for 25 mg, 100 mg and 250 mg strengths only).

Only certain pack sizes may be marketed.

Marketing Authorization Holder and Manufacturer

Marketing Authorization Holder:

Aurovitas Spain, S.A.U.

Avda. de Burgos, 16-D

28036 Madrid

Spain

Manufacturer:

APL Swift Services (Malta) Limited

HF26, Hal Far Industrial Estate, Hal Far

Birzebbugia, BBG 3000

Malta

Or

Arrow Generiques – Lyon

26 avenue Tony Garnier,

Lyon, 69007

France

Or

Generis Farmacêutica, S.A.

Rua João de Deus, 19

2700-487 Amadora

Portugal

This medicinal product is authorized in the European Economic Area (EEA) member states under the following names:

Germany: Clozapin PUREN 200 mg Tabletten

Spain: Clozapina Aurovitas 200 mg comprimidos

France: Clozapine Arrow 200 mg comprimé sécable

Netherlands: Clozapine Auro 200 mg tabletten

Portugal: Clozapina Aurovitas

Date of the most recent review of this leaflet: February 2026

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