Clozapine
What is Clozapine?
Clozapine is a prescription antipsychotic medication. It is used to treat schizophrenia in people where other antipsychotic medicines have not worked or are not suitable.
Clozapine is an effective treatment but has some serious adverse effects, including potentially life threatening effects on blood cells and the heart. These warrant monthly testing during treatment and any person receiving clozapine must be part of an approved blood monitoring program. Where these effects occur, specialist treatment for both the adverse effects and to consider the safety of ongoing antipsychotic therapy is needed.
There are two brands of clozapine available in Australia, Clozaril® and Clopine®. Due to the patient monitoring requirements involved these brands are not readily interchangeable.
How is Clozapine prescribed and dispensed?
Clozapine is also an expensive medication. Due to cost and complexity, the supply and funding of clozapine has been limited to the Commonwealth Highly Specialised Drugs Program. Under this program only specialist psychiatrists affiliated with a public or private hospital have been able to prescribe clozapine.
Dispensing of the medicine has also been restricted to public or private hospitals. In some cases dispensing may have been from a community pharmacy, but only where there are specific arrangements connecting this to a public hospital pharmacy.
What has changed?
The Commonwealth Government has acknowledged that for some patients it may still be safe but much more convenient to receive clozapine prescriptions from a community based prescriber and supplies from a community pharmacy.
They have therefore relaxed some of these restrictions which will make clozapine treatment easier for patients. The rules changed on 1 July 2015.
What does this mean for patients?
Patients can now obtain prescriptions from a community based medical practitioner, such as a general practitioner. This is possible where the treating psychiatrist is in agreement that it is safe for the individual patient and where certain conditions are met.
The first 18 weeks of clozapine treatment must be by a psychiatrist. Prescriptions written for clozapine, regardless of where they are prescribed, may now be dispensed at either a hospital pharmacy of a community pharmacy. Usual fees will apply at a community pharmacy.
Patients should discuss these options carefully with their psychiatrist to decide whether changes are right for their own personal circumstances.
Where to get help
- See your doctor
- Visit healthdirect (external site) or call 1800 022 222
- Mental Health Emergency Response Line (MHERL)
Metro: 1300 555 788
Peel: 1800 676 822
- RuralLink
Rural and remote areas: 1800 552 002
Medicines information line
Acknowledgements
Pharmaceutical branch
This publication is provided for education and information purposes only. It is not a substitute for professional medical care. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your healthcare professional. Readers should note that over time currency and completeness of the information may change. All users should seek advice from a qualified healthcare professional for a diagnosis and answers to their medical questions.