Zapenia 100mg Tablet (Box)

✔️ Dosage & Administration of Zapenia 100

For Schizophrenia (Adults 16+):

• Day 1: Start with 12.5 mg once or twice (elderly: 12.5 mg once).
• Day 2: Increase to 25–50 mg/day (elderly: 25–37.5 mg).

Gradually increase by 25–50 mg/day (maximum 25 mg/day in the elderly) over 2–3 weeks up to 300 mg/day in divided doses (larger dose at night).

• Maintenance dose: typically 200–450 mg/day; maximum: 900 mg/day.

For Parkinson’s Disease Psychosis:

• Start with 12.5 mg at bedtime; titrate in 12.5 mg increments up to twice a week.
• Usual dose: 25–37.5 mg at bedtime; maximum: 50 mg/day.

In rare cases, the dose can be increased weekly to a maximum of 100 mg/day.

Use only as directed by a registered physician.

✔️ Overdose Effects of Zapenia 100

Symptoms include:

• Altered consciousness (drowsiness to coma)
• Low blood pressure, fast heart rate
• Respiratory depression, excessive salivation
• Seizures, cardiac issues, aspiration pneumonia

Management:

• Ensure airway and breathing.
• Activated charcoal may help; gastric lavage/emesis is not preferred.
• Supportive care with continuous monitoring.
• Avoid adrenaline, quinidine, and procainamide.
• No specific antidote; dialysis is likely ineffective.

✔️ Side Effects

Common: Drowsiness, dizziness, constipation, hypersalivation, headache, nausea, weight gain
Less common: Heartburn, dry mouth, abdominal discomfort

✔️ Drug Interactions

• Hematologic risk: Use with other myelosuppressants may enhance bone marrow suppression.
• CNS depressants/alcohol: May increase sedation.
• Benzodiazepines/psychotropics: Heighten risk of orthostatic hypotension.
• Protein-bound drugs (e.g., warfarin, digoxin): Risk of displacement and altered plasma levels.
• CYP450 interactions:
• Inhibitors (e.g., fluvoxamine, paroxetine): Lower Zapenia dose required.
• Inducers (e.g., carbamazepine): Avoid co-administration; stopping carbamazepine may raise Zapenia levels.
• Avoid adrenaline due to paradoxical hypotensive effects.

✔️ Zapenia is not recommended in patients with:

• Severe heart disease (e.g., myocarditis)
• Significant renal impairment (creatinine clearance <10 ml/min)
• History of neutropenia, agranulocytosis, or bone marrow disorders
• Paralytic ileus
• Psychoses due to alcohol or toxins
• CNS depression, coma, or epilepsy not under control
• Breastfeeding

✔️ Use in Pregnancy & Lactation

• No well-controlled studies in humans. Animal data do not show harmful fetal effects.
• May be used during pregnancy if needed.
• Clozapine is excreted in breast milk; nursing is not recommended.

✔️ Precautions & Warnings

• Do not discontinue abruptly unless medically required; taper off over 1–2 weeks.
• Monitor for cholinergic rebound (e.g., vomiting, diarrhea) after sudden stop.
• High risk of agranulocytosis:
• Weekly WBC/ANC monitoring for 6 months, then biweekly if stable.
• Continue monitoring for 4 weeks after stopping.
• Caution in the elderly and those with hepatic issues, diabetes, cardiovascular disease, or seizure risk.
• May cause metabolic disturbances (e.g., hyperglycemia, weight gain), sedation, orthostatic hypotension, and cardiomyopathy or myocarditis.
• Avoid in patients with urinary retention, glaucoma, or GI obstruction.

✔️ Storage Conditions

Store below 30°C. Keep away from light and out of children's reach.