DEFINITION OF LEUKOPENIA, GRANULOCYTOPENIA AND AGRANULOCYTOSIS INDUCED BY CLOZAPINE – SUGGESTED CLINICAL PROCEDURE

Blood work should be done for all patients treated with Clozapine, if clinical signs of infection are present, to rule out possible Leukopenia.

LEUKOPENIA* GRANULOCYTOPENIA* TOTAL WHITE BLOOD CELLS X MM3 NEUTROPHILS X MM3 PROCEDURE MILD 3500 - 3000 2000 - 1500 Blood count every 48 hours. Do not suspend medication. MODERATE 3000 - 2000 1500 - 1000 Daily blood count. Suspend treatment definitively. Manage signs of infection. Monitor until one month after WBC and/or Neutrophils normalize. SEVERE < 2000 <1000 Daily blood count. Suspend treatment definitively. Manage signs of infection. Monitor through Hematology Services. AGRANULOCYTOSIS <500 Daily blood count. Suspend treatment definitively. Referral to Hematology Services and possible administration of colony stimulating factors.

* The established procedure is adopted with just one altered parameter.