Clients taking which of the following medications need close monitoring of their cardiac status

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Page 2

Clozapine monitoring in clinical practice

InvestigationsBaselineFurther testing frequency*Yearly*
WBC count, DC, ANC×Weekly for 18 weeks†, fortnightly up to one year, and then monthly
FBC××
Urea and electrolytes××
LFT××
Lipids×3 monthly for first year×
FBG‡×1 month, every 4–6 months
ECG×After dose changes×
Physical examination×Weekly during titration†×
BP, postural drop×Acute monitoring. Frequently during dose titration†×
Pulse×Acute monitoring. Frequently during dose titration†, definitely in the first 1–2 months×
Temperature×Acute monitoring. Frequently during dose titration†
Weight×Frequently during first 3 months, every 3 months for first year×
BMI×1, 3, 4–6 monthly×
Waist circumference×1, 3, 4–6 monthly×
Cardiovascular monitoring××
Smoking status×Regularly at follow-up
Review of co-prescribed medications×Regularly for drug interactions, as additional medications are prescribed
Serum clozapineAs necessary. 3 monthly, if dose is 600 mg or more×
ProlactinNot specifically needed for clozapine, consider when relevant
EEGWhen relevant