Alternative Routes of Administration of Clozapine - PubMed

Affiliations

• PMID: 35113345
• DOI: 10.1007/s40263-022-00900-w

Review

Alternative Routes of Administration of Clozapine

Siobhan Gee et al. CNS Drugs. 2022 Feb.

Abstract

Clozapine is the only antipsychotic with proven effectiveness in treatment-resistant schizophrenia. It is usually administered using commercially available oral tablets, but not all patients are willing or able to take medicines in this way. Orodispersible clozapine tablets are available from several manufacturers and may be useful where swallowing solid dosage forms is difficult, or as an aid to observe compliance. Liquid formulations of clozapine can be prepared extemporaneously or purchased commercially, but most preparations are suspensions (clozapine is poorly soluble) and patients may find them unpalatable. The administration of clozapine (suspension or crushed tablets) via enteral feeding tubes (predominantly nasogastric) has been reported both in medically unwell patients and in patients refusing clozapine. Enteral administration is likely to be superseded by intramuscular clozapine, which has recently been re-introduced and is being widely used in some countries. Successful use of this formulation in enforced treatment strategies has been described by several authors with good long-term outcomes when switched to oral treatment. Intramuscular clozapine has also been used in physically ill patients who are unable to take any form of enteral medication. Other methods of delivery (transdermal, nasal) are not yet commercially available, but offer promise of further treatment options for this group of seriously ill patients.

Similar articles

• Evaluation of bioequivalence between clozapine suspension and tablet formulations : a multiple-dose, fed and fasted study.

  Glue P, Gale C, Menkes DB, Hung N. Glue P, et al. Clin Drug Investig. 2012 Nov;32(11):723-7. doi: 10.1007/s40261-012-0004-6. Clin Drug Investig. 2012. PMID: 23018283 Clinical Trial.

• Treatment of Refractory Schizophrenia With Clozapine in a Patient With Wolff-Parkinson-White Syndrome.

  Cintrón Pastrana MA, Quintana Aviles E. Cintrón Pastrana MA, et al. J Clin Psychopharmacol. 2022 Jan-Feb 01;42(1):95-96. doi: 10.1097/JCP.0000000000001494. J Clin Psychopharmacol. 2022. PMID: 34928564 No abstract available.

• Effects on monotherapy and reduction of antipsychotic drugs by clozapine therapy in Japanese patients with treatment-resistant schizophrenia.

  Akamine Y, Kikuchi Y, Miura M. Akamine Y, et al. J Clin Pharm Ther. 2021 Oct;46(5):1312-1318. doi: 10.1111/jcpt.13432. Epub 2021 May 7. J Clin Pharm Ther. 2021. PMID: 33959995

• [Cost-effectiveness analysis of schizophrenic patient care settings: impact of an atypical antipsychotic under long-acting injection formulation].

  Llorca PM, Miadi-Fargier H, Lançon C, Jasso Mosqueda G, Casadebaig F, Philippe A, Guillon P, Mehnert A, Omnès LF, Chicoye A, Durand-Zaleski I. Llorca PM, et al. Encephale. 2005 Mar-Apr;31(2):235-46. doi: 10.1016/s0013-7006(05)82390-5. Encephale. 2005. PMID: 15959450 Review. French.

• Advances in atypical antipsychotics for the treatment of schizophrenia: new formulations and new agents.

  Kelleher JP, Centorrino F, Albert MJ, Baldessarini RJ. Kelleher JP, et al. CNS Drugs. 2002;16(4):249-61. doi: 10.2165/00023210-200216040-00004. CNS Drugs. 2002. PMID: 11945108 Review.

Cited by

• Quantification of Microsphere Drug Release by Fluorescence Imaging with the FRET System.

  Chen Y, Lu H, He Q, Yang J, Lu H, Han J, Zhu Y, Hu P. Chen Y, et al. Pharmaceutics. 2024 Jul 31;16(8):1019. doi: 10.3390/pharmaceutics16081019. Pharmaceutics. 2024. PMID: 39204364 Free PMC article.

• Development of Lyophilised Eudragit^® Retard Nanoparticles for the Sustained Release of Clozapine via Intranasal Administration.

  Lombardo R, Ruponen M, Rautio J, Ghelardini C, Di Cesare Mannelli L, Calosi L, Bani D, Lampinen R, Kanninen KM, Koivisto AM, Penttilä E, Löppönen H, Pignatello R. Lombardo R, et al. Pharmaceutics. 2023 May 21;15(5):1554. doi: 10.3390/pharmaceutics15051554. Pharmaceutics. 2023. PMID: 37242796 Free PMC article.

References

Publication types

MeSH terms

Substances

LinkOut - more resources

• Full Text Sources

  • Springer