Clozapine oral suspension
VERSACLOZ
Pronunciation: KLOE-za-peen (VER-sa-kloz)
“Clothes pin”
“Red as a beet” crimson color theme → anticholinergic
Blind as a bat → dilated pupils and cycloplegia (M3 antimuscarinic)
“Mad as a hatter” → BBB-crossing anticholinergic
“Dry as a bone” → risk of severe constipation (M3)
Tachycardia (M2 antimuscarinic); myocarditis risk
Neutrophil in mouth → risk of agranulocytosis
Polka dots on pink → α1 blocker → syncope if titrated too quickly (hit the floor)
What it isClozapine oral suspension (VERSACLOZ, 2013) — liquid formulation for patients who cannot reliably take tablets; same titration, ANC monitoring, and stop-start rules as every clozapine product.
Why this oneSame molecule and receptor pharmacology as the parent card — the formulation (and its label) is the difference.
What limits itClass warnings of the parent molecule apply unchanged.
FDA-approved for
- treatment-resistant schizophrenia (2013)
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Treatment-resistant schizophrenia | Adults | 12.5 mg QD or BID | 150–225 mg BID | 450 mg BID |
| Reduce risk of recurrent suicidal behavior in schizophrenia/schizoaffective disorder | Adults | 12.5 mg QD or BID | 150–225 mg BID | 450 mg BID |
Titration Increase by 25–50 mg/day to target by 2 weeks; then increases up to 100 mg once or twice weekly
Renal Dose reduction may be necessary in significant renal impairment
Hepatic Dose reduction may be necessary in significant hepatic impairment
ANC monitoring required (REMS); titrate slowly (orthostasis/seizure risk)
Instructions
- Take with or without food
- Shake suspension; administer with provided oral syringe
- On discontinuation reduce dose gradually over 1–2 weeks
- Reduce dose when restarting after interruption (e.g., >2 missed days: restart 12.5 mg QD/BID)
Available strengths
- susp 50 mg/mL
- tab 12.5, 25, 50, 100, 200 mg
- ODT 12.5, 25, 100, 150, 200 mg
Cautions
- Gastrointestinal hypomotility (constipation to ileus)
- Eosinophilia
- QT prolongation
- Metabolic changes (hyperglycemia, dyslipidemia, weight gain)
- Neuroleptic malignant syndrome
- Hepatotoxicity
- Fever
- Pulmonary embolism
- Anticholinergic toxicity
- Tardive dyskinesia
- Falls
Adverse reactions
- Sedation/somnolence
- Dizziness/vertigo
- Hypersalivation
- Tachycardia
- Hypotension/syncope
- Constipation
- Nausea
- Sweating
- Dry mouth
- Fever
- Headache
- Tremor
Pregnancy Third-trimester exposure risks neonatal extrapyramidal/withdrawal symptoms; no established major-defect risk
Lactation Present in human milk; monitor breastfed infant for sedation and neutropenia
Cost
| Strength | #/mo | generic $/unit | CostPlus | |
|---|---|---|---|---|
| 50 mg/mL | susp | per unit | not offered |
Other forms: Clozapine (CLOZARIL) · Clozapine ODT (FAZACLO)
⚠ BOXED WARNING
- Increased mortality in elderly patients with dementia-related psychosis
Classes and tags
Clinical profile
Legacy pregnancy categoryB
Defining liabilitySevere neutropenia, myocarditis, seizures and potentially fatal gastrointestinal hypomotility.
Active metabolites
Open Clozapine oral suspension in the interactive console ↗
Memory aids: interaction avatars
