Clozapine REMS Certification UPDATED ACTUAL Questions
and CORRECT Answers
1. What are box warnings for clozapine? Neutropenia
Orthostatic Hypotension
Bradycardia
Syncope
Seizure
Myocarditis
Cardiomyopathy
2. What group is clozapine not FDA approved Increased mortality in elderly patients with
for? dementia related psychosis
3. What should the ANC be before starting 1500 for general population
clozapine medication? 1000 for BEN (benign ethnic neutropenia)
4. What is considered neutropenia? Neutropenia = ANC < 500
(Absolute neutrophil count)
5. What are symptoms of severe neutrope- Fever
nia/infection? Lethargy
Weakness
Sore throat
6. T/F: Risk of neutropenia is greatest from False; risk is greatest during first 18
years 1-2 of treatment. months
7. T/F: Risk of neutropenia is not dose depen- True
dent.
8. For which conditions is clozapine contraindi- Photosensitivity
cated? Vasculitis
Erythema multiforme
1/8
, Clozapine REMS Certification UPDATED ACTUAL Questions
and CORRECT Answers
Stevens Johnsons syndrome
Hx of hypersensitivity to clozapine
9. What is the starting dose for clozapine? 12.5mg either qd or BID
10. Your patient taking clozapine starts show- If patients are showing symptoms of car-
ing lowered heart rate, dizziness, and chest diac complications, discontinue and ob-
pain. What do you do? tain labs
11. What is the method of increasing the cloza- Increase in increments of 25-50mg/day.
pine dose?
12. What is the clozapine target dose by the end 300mg to 450mg/day (in divided doses)
of 2 weeks?
13. What is the max daily dose of clozapine? 900mg/day
14. Weekly ANC monitoring for the first First 6 months
months, then every weeks.
Then every 2 weeks
15. T/F: If ANC is greater than or equal to 1500 True
for the first year, monitoring can be reduced
o every 4 weeks.
16. How is ANC calculated? Total WBC count x Total percentage of neu-
trophils obtained from differential
17. A patient taking clozapine presents with an - Continue treatment
ANC of 1300, what do you do? - Monitor ANC 3x/week
^ Protocol for mild neutropenia
(100-1499)
18.
2/8
and CORRECT Answers
1. What are box warnings for clozapine? Neutropenia
Orthostatic Hypotension
Bradycardia
Syncope
Seizure
Myocarditis
Cardiomyopathy
2. What group is clozapine not FDA approved Increased mortality in elderly patients with
for? dementia related psychosis
3. What should the ANC be before starting 1500 for general population
clozapine medication? 1000 for BEN (benign ethnic neutropenia)
4. What is considered neutropenia? Neutropenia = ANC < 500
(Absolute neutrophil count)
5. What are symptoms of severe neutrope- Fever
nia/infection? Lethargy
Weakness
Sore throat
6. T/F: Risk of neutropenia is greatest from False; risk is greatest during first 18
years 1-2 of treatment. months
7. T/F: Risk of neutropenia is not dose depen- True
dent.
8. For which conditions is clozapine contraindi- Photosensitivity
cated? Vasculitis
Erythema multiforme
1/8
, Clozapine REMS Certification UPDATED ACTUAL Questions
and CORRECT Answers
Stevens Johnsons syndrome
Hx of hypersensitivity to clozapine
9. What is the starting dose for clozapine? 12.5mg either qd or BID
10. Your patient taking clozapine starts show- If patients are showing symptoms of car-
ing lowered heart rate, dizziness, and chest diac complications, discontinue and ob-
pain. What do you do? tain labs
11. What is the method of increasing the cloza- Increase in increments of 25-50mg/day.
pine dose?
12. What is the clozapine target dose by the end 300mg to 450mg/day (in divided doses)
of 2 weeks?
13. What is the max daily dose of clozapine? 900mg/day
14. Weekly ANC monitoring for the first First 6 months
months, then every weeks.
Then every 2 weeks
15. T/F: If ANC is greater than or equal to 1500 True
for the first year, monitoring can be reduced
o every 4 weeks.
16. How is ANC calculated? Total WBC count x Total percentage of neu-
trophils obtained from differential
17. A patient taking clozapine presents with an - Continue treatment
ANC of 1300, what do you do? - Monitor ANC 3x/week
^ Protocol for mild neutropenia
(100-1499)
18.
2/8
