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Missing a dose of Clozapine... zyprexa?


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So I totally missed getting my med box today. I went at 8 am but it was not ready. They said to come back at 4 pm. I lost track of time. 

I have old Seroquel XR and abilify and lamictal to take tonight but no Clozapine or drool pill. And I'm not sure if old pills work even. 

Do I take a zyprexa zydis? I'm afraid I'll lose my mind completely with husband being sick. I can't be missing meds. 

Any advice? My pharmacy and clinic are closed. 

 

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The only thing that I can think of is going to the ER, explaining that you are currently taking Clozapine (even showing them your pill bottle) and ran out and have no pills for tonight.  They may be able to get you pills to tie you over, until you can reach the clinic.

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11 hours ago, netsavy006 said:

The only thing that I can think of is going to the ER, explaining that you are currently taking Clozapine (even showing them your pill bottle) and ran out and have no pills for tonight.  They may be able to get you pills to tie you over, until you can reach the clinic.

Thanks for the idea! I have no pill bottle though because I don’t manage my own meds. And I made it through the night. I am going to the clinic this morning. I’m thinking about asking to change my med box pick up day to Thursdays so it’s easier for them. 

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2 hours ago, cakepop said:

I don’t think missing one night is gonna hurt anything. You said the Clozapine doesn’t seem to be helping anyway?

I know if you miss so many nights in a row of clozapine you have to start over at the smallest dose and build back up again. So that is bad. That is one reason why you don’t want to be skipping doses. Plus I’m going through a hard time right now and AAP’s are the only meds that really help me. 

And clozapine does seem to be doing something helping a little bit. I just think the dose needs to be higher and I need to get off another AAP. But my pdoc is moving super slow to avoid any episodes that would send me IP. So I may seem impatient but it is doing something good for me. Just not fast enough. I need to give it time. So I apologize if I get impatient. It must sound annoying to you and others maybe too. I’ll try harder to shut up about it. Because I do need to be more patient.

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2 minutes ago, Butterflykisses said:

The first time I was on clozapine and got up to 500mg, I would sometimes miss a dose. It was fine. I didn't have any problems. I just took it the next scheduled dose. You should be fine. :)

Thanks butterfly! That’s good to know. I will take my next dose then tonight. 

Quick question, did you take all 500 mg at bedtime? Or split dose?

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4 minutes ago, Wonderful.Cheese said:

Thanks butterfly! That’s good to know. I will take my next dose then tonight. 

Quick question, did you take all 500 mg at bedtime? Or split dose?

I took 200mg in the morning and 300mg at bedtime

It's interesting because when I went up very slowly on clozapine I didn't have a huge issue with sedation. I hope its that way this time.

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1 minute ago, Butterflykisses said:

I took 200mg in the morning and 300mg at bedtime

It's interesting because when I went up very slowly on clozapine I didn't have a huge issue with sedation. I hope its that way this time.

I hope so too. I really hope you have better luck going up slowly with clozapine this time butterfly. You had good luck with going slow before so I really sincerely hope it is the same experience as the last time you went up slowly. Maybe going up that fast the last time was just too much for you or anyone to handle. Good luck and keep us posted.

I think I need a morning dose. I will ask my pdoc. But I don’t see her for like over two weeks. 

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2 minutes ago, Wonderful.Cheese said:

I hope so too. I really hope you have better luck going up slowly with clozapine this time butterfly. You had good luck with going slow before so I really sincerely hope it is the same experience as the last time you went up slowly. Maybe going up that fast the last time was just too much for you or anyone to handle. Good luck and keep us posted.

I think I need a morning dose. I will ask my pdoc. But I don’t see her for like over two weeks. 

I hope so too. I am scared but hopeful. I wasn't hospitalized once when I was on clozapine. I've been hospitalized 3 times since coming off of it in September. It stinks because I was at the point where I only had to get blood work once a month, but now since starting all over I have to go once a week again. The only reason I went off of it was because I thought it was causing stomach issues, when in reality it was the lithium I was toxic on. Bummer. 

I hope you find a good dose. Clozapine is full of promises for those of us who are treatment resistant. I have been on mostly all AAP's and AP's and none have worked.

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2 hours ago, Butterflykisses said:

I hope so too. I am scared but hopeful. I wasn't hospitalized once when I was on clozapine. I've been hospitalized 3 times since coming off of it in September. It stinks because I was at the point where I only had to get blood work once a month, but now since starting all over I have to go once a week again. The only reason I went off of it was because I thought it was causing stomach issues, when in reality it was the lithium I was toxic on. Bummer. 

I hope you find a good dose. Clozapine is full of promises for those of us who are treatment resistant. I have been on mostly all AAP's and AP's and none have worked.

Darn. It must be hard to go back to weekly blood lab after being on monthly ones. I’m stilll weekly too. I have a while yet to get to every other week still I think. I’d have to check to be sure. Even that will be nice. The lab ladies know me now.  Lol

 

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1 hour ago, cakepop said:

Don’t forget to pick your dose up today though! Yeah some of these meds you have to start over after a few days missing it. I know Lamictal is one such med.

Cheese, I know I sound bitchy in my posts but I actually worry a lot about people. I just have no filter sometimes and it gets me into trouble. I do hope the higher Clozapine dose will help you once you get there ? 

Yes thanks! I just picked up my dose this morning! So I got my morning meds taken a bit late but that’s ok. 

Thank you. I understand now better that you are coming from a place of worry. Believe me, I snap at my husband all the time when I’m super anxious. I don’t know why that is but I do it when worried or anxious. Ugh.

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Clozapine and olanzapine are structurally and pharmacologically very similar. They also closely relate to quetiapine and loxapine as well. This is something you should talk to your pdoc about because if this happens again, it would be good to have the comfort of knowing you have a backup. Based on what I know as an amateur, I would think that if you run out of clozapine, olanzapine would be a reasonable substitute perhaps once, maybe twice in an emergency situation.

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