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Covid-19 Primary Care Resources

Clozapine guidance for patients with Covid-19

Symptoms of Covid-19 can mimic clozapine related Adverse Drug Effects

This information is sourced from the Specialist Pharmacy Service:

For patients on clozapine with COVID-19 symptoms recommendations are:

  • Continue clozapine but take a blood sample immediately to determine WCC; neutrophil count; and clozapine plasma concentration
  • If the patient is suspected of having a serious clozapine-related ADE (adverse drug effects) then stop clozapine and investigate appropriately

Symptoms of COVID-19 can mimic clozapine related ADEs: notably, myocarditis and neutropenic sepsis:

• Myocarditis: clozapine related myocarditis is more likely to occur within the first 6 weeks of treatment. Therefore after the initial period, the likelihood of any myocarditis being clozapine related reduces

• White cell count: COVID-19 can cause a reduction in WCC but does not appear to affect neutrophil levels, whilst clozapine does. Therefore if neutrophil levels are stable, continue clozapine

See further advice: Clozapine and blood dyscrasias in patients with coronavirus (COVID-19)