Blood level monitoring for toxicity for clozapine, other antipsychotics
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Blood level monitoring for toxicity for clozapine, other antipsychotics Monitoring of blood clozapine levels for toxicity is now advised in certain clinical situations, according to a drug safety update from the Medicines and Healthcare products Regulatory Agency (MHRA) in the UK, released on 26 August 2020. Clinical situations where monitoring of blood clozapine levels for toxicity is advised include when: a patient has pneumonia or other serious infection; a patient stops smoking or switches to an e-cigarette; or concomitant medicines may interact to increase blood clozapine levels. Monitoring of blood clozapine levels is also advised when toxicity is suspected or reduced clozapine metabolism is suspected. Such blood clozapine level monitoring should be carried out in addition to monitoring required to manage the risk of agranulocytosis. For other antipsychotics, where assays and reference values are available, blood level monitoring for toxicity may be helpful in certain clinical situations, for example when concomitant medicines may interact to increase antipsychotic drug levels or when toxicity is suspected. This new monitoring advice from the MHRA follows a request to take action in two Coroner’s reports. In the reports, the patients’ deaths were determined to have been partly caused by clozapine toxicity or amisulpride toxicity, respectively. These reports raised concerns regarding the need for monitoring of clozapine and antipsychotic blood levels. Medicines and Healthcare products Regulatory Agency (UK). Clozapine and other antipsychotics: monitoring blood concentrations for toxicity. Internet Document : 26 Aug 803500221 2020. Available from: URL: https://www.gov.uk/drug-safety-update/clozapine-and-other-antipsychotics-monitoring-blood-concentrations-for-toxicity
0114-9954/20/1820-0001/$14.95 Adis © 2020 Springer Nature Switzerland AG. All rights reserved
Reactions 5 Sep 2020 No. 1820
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