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pSevere nervous system reactionvery stiffrigidmuscleshigh feversweatingconfusionfast or uneven heartbeatstremorsfeeling like you might pass out;/ppPatients who develop clozapine-induced myocarditis or cardiomyopathy should not be re-exposed to clozapinesee section 4.3 and 4.4/ppImpaired glucose tolerance and/or development or exacerbation of diabetes mellitus has been reported rarely during treatment with clozapineA mechanism for this possible association has not yet been determinedCases of severe hyperglycaemia with ketoacidosis or hyperosmolar coma have been reported very rarely in patients with no prior history of hyperglycaemiasome of which have been fatalWhen follow-up data were availablediscontinuation of clozapine resulted mostly in resolution of the impaired glucose toleranceand reinstitution of clozapine resulted in its reoccurrencePatients with an established diagnosis of diabetes mellitus who are started on atypical antipsychotics should be monitored regularly for worsening of glucose controlPatients with risk factors for diabetes mellituse.gobesityfamily history of diabeteswho are starting treatment with atypical antipsychotics should undergo fasting blood glucose testing at the beginning of treatment and periodically during treatmentPatients who develop symptoms of hyperglycaemia during treatment with atypical antipsychotics should undergo fasting blood glucose testingIn some caseshyperglycaemia has resolved when the atypical antipsychotic was discontinuedhoweversome patients required continuation of antidiabetic treatment despite discontinuation of the suspect drugThe discontinuation of clozapine should be considered in patients where active medical management of their hyperglycaemia has failed./ppSevere nervous system reactionvery stiffrigidmuscleshigh feversweatingconfusionfast or uneven heartbeatstremorsfeeling like you might pass out;/ppBecause of the possibility of additive effectscaution is essential in the concomitant administration of substances possessing anticholinergichypotensiveor respiratory depressant effects./p
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