Zapenia | Clozapine 100 | ePharma
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Zapenia 100mg Tablet 10pcs

Generic: Clozapine

Type: Tablet

Pack Size: 10 Pcs

Clozapine is an atypical antipsychotic drug, distinguishing itself from traditional antipsychotics by its unique interaction with dopamine receptors. It affects dopamine-mediated behaviors differently compared to other typical antipsychotic drugs. Clozapine binds to D1, D2, D3, and D5 dopamine receptors, with a particularly strong affinity for the D4 receptor. This pattern of activity is thought to primarily affect limbic dopamine receptors, which may explain Clozapine’s minimal extrapyramidal side effects. Additionally, Clozapine acts as an antagonist at adrenergic, cholinergic, histaminergic, and serotonergic receptors.


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✅ Description:

Pack Image of Zapenia 100 mg Tablet
Zapenia is indicated for the treatment of:Schizophrenia in patients who do not respond to or cannot tolerate conventional antipsychotic medications.Psychosis associated with Parkinson's disease.

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✔️ Uses of Zapenia 100

Treatment of Schizophrenia

✔️ How does Zapenia 100 work?

Zapenia 100 Tablet works by blocking the effects of chemical receptors in the brain, such as dopamine and serotonin, thereby helping in improving mood, behavior, and thoughts. 

✔️ Dosage & Administration: Schizophrenia:
  • For adults over 16 years: Start with 12.5 mg once or twice on the first day (elderly patients should begin with 12.5 mg once).
  • On the second day, increase the dose to 25-50 mg (elderly patients should use 25-37.5 mg).
  • Gradually increase the dose by 25-50 mg daily (elderly patients should have increments of 25 mg daily) over 14-21 days, with a maximum dose of 300 mg daily in divided doses (larger dose taken at night, up to 200 mg daily may be taken as a single dose at bedtime). The dose can be further increased in steps of 50-100 mg once or twice weekly, with the usual dose range being 200-450 mg daily (maximum 900 mg daily).
✔️ Dosage & Administration: Psychosis in Parkinson's Disease

For adults over 16 years: Start with 12.5 mg at bedtime, then increase by 12.5 mg as needed, up to twice weekly. The usual dose is 25-37.5 mg at bedtime, with a maximum daily dose of 50 mg. In exceptional cases, the dose may be further increased to 100 mg daily in 1-2 divided doses.

✔️ Overdose Effects
  • Symptoms of overdose include altered consciousness (e.g., drowsiness, delirium, coma), tachycardia, hypotension, respiratory depression, hypersalivation, and possibly seizures.
  • Fatal overdoses typically occur with doses above 2500 mg.
  • Treatment includes airway management, oxygenation, activated charcoal, and cardiac monitoring. Avoid epinephrine and quinidine.
  • No specific antidote for Zapenia is available, and certain interventions such as forced diuresis or dialysis are unlikely to be beneficial.
✔️ Side Effects

Common side effects include:

  • Constipation
  • Mild dizziness or lightheadedness
  • Drowsiness
  • Mild headache
  • Increased salivation
  • Nausea or vomiting
  • Unusual weight gain
    Less common side effects include:
  • Abdominal discomfort or heartburn
  • Dry mouth
✔️ Interaction
  • The use of Zapenia with myelosuppressants may worsen myelosuppression.
  • It can interact with other CNS-active drugs and alcohol.
  • Combining Zapenia with benzodiazepines or other psychotropics may lead to orthostatic hypotension.
  • Zapenia is highly protein-bound and may be displaced by other protein-bound drugs, or it may displace other drugs (e.g., warfarin, digoxin).
  • Cimetidine can decrease Zapenia plasma levels.
  • Concomitant use of Carbamazepine is not recommended, as discontinuation of Carbamazepine may increase Zapenia levels.
  • Reduced dosages of Zapenia should be used with fluvoxamine, paroxetine, or sertraline.
  • Hypotensive drugs may be more effective when used with Zapenia.
  • Adrenaline should be avoided due to its potential reversal by Zapenia’s alpha-adrenergic blocking properties.
  • When used with drugs metabolized by cytochrome P450 2D6, such as phenothiazines, antidepressants, and antiarrhythmics, the dose of Zapenia or the other drugs may need adjustment.
✔️ Contraindications
  • Severe heart conditions (e.g., myocarditis)
  • Renal impairment (avoid if creatinine clearance is below 10 ml/min)
  • History of neutropenia or agranulocytosis
  • Bone-marrow disorders
  • Paralytic ileus
  • Alcoholic and toxic psychoses
  • History of circulatory collapse, drug intoxication, or coma
  • Severe CNS depression
  • Uncontrolled epilepsy
  • Breastfeeding
✔️ Pregnancy & Lactation
  • There are no adequate studies on the effects of Clozapine in pregnant women. Animal studies show no significant fetal harm, but it should only be used during pregnancy if the benefits outweigh the risks.
  • Clozapine is excreted in breast milk, so breastfeeding is not recommended for women taking Clozapine.
✔️ Precautions & Warnings
  • Do not abruptly stop taking this medication; taper off over 1-2 weeks.
  • If abrupt discontinuation is necessary due to conditions like leukopenia, myocarditis, or cardiomyopathy, closely monitor for psychosis and cholinergic rebound symptoms.
  • Elderly patients may be more prone to adverse effects such as agranulocytosis and tardive dyskinesia.
  • WBC monitoring is essential, especially during the first 6 months of treatment, and thereafter if levels are maintained within a safe range.
  • Cognitive or motor impairment may occur, leading to sedation and impaired performance in tasks requiring alertness.
  • Use cautiously in patients with a history of seizures, or those at risk, including those with brain damage, alcoholism, or concurrent medications lowering the seizure threshold.
  • Can cause hyperglycemia, including severe cases of ketoacidosis and death in diabetes or glucose regulation disorders.
  • May cause orthostatic hypotension and tachycardia, requiring caution in patients with cardiovascular conditions.
  • Risk of myocarditis, pericarditis, and cardiomyopathy, particularly within the first month of treatment. Fatalities related to myocarditis have been reported.
  • Monitor for thromboembolism, including pulmonary embolism or stroke, especially in older patients.
✔️ Storage Conditions

Store below 30°C, away from light, and out of the reach of children.

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