Published: 9 April 2020

Medicines

Clozapine monitoring during COVID19 Alert Level 4 - Current requirements

Blood monitoring is a mandatory requirement for patients taking clozapine to manage their risk of experiencing agranulocytosis. This information is provided while national guidance is being developed by the National Health Coordination Centre (NHCC). Current requirements, detailed below, allow some flexibility with blood testing to avoid patients abruptly stopping clozapine treatment.

We encourage patients to continue to have their regular blood tests whenever possible. Patients should also continue to take their clozapine treatment as prescribed.

Access to blood tests
Delaying blood tests
Monitor for infection and other adverse effects
More information

Access to blood tests

Under COVID-19 Alert Level 4, some patients may find it difficult to get a blood test because:

  • they are in isolation
  • their test centre is temporarily closed
  • their method of transport to the test centre is unavailable
  • their home test visit has been delayed.

Also, in areas with high community transmission, patients may have concerns about their safety when leaving home to visit a test centre.

Delaying blood tests

If a patient’s registered physician wishes to delay blood testing for a patient and ensure continued supply of clozapine, they must:

  • discuss with the patient the benefits and risks of delayed blood testing and seek informed consent, as this is an unapproved use (required under the Code of Health and Disability Services Consumers' Rights)
  • take the individual patient’s circumstances into account, such as time on treatment,
  • notify the appropriate clozapine monitoring database that the blood test is to be delayed.

Following these steps will allow the patient to continue to access clozapine (Clozaril and Clopine) for an additional 14 days for patients on monthly monitoring and an extra 2 days for patients on weekly monitoring.

Monitor for infection and other adverse effects

Closely monitor patients taking clozapine for signs of infection as an urgent blood test will be required. Patients should also be closely monitored for other clozapine adverse effects. Due to the COVID-19 lock down, patients may have changed their diet and activity levels and be more susceptible to constipation. They may also have changed their smoking habits, affecting plasma clozapine levels.

Report clozapine adverse effects to the Centre for Adverse Reactions Monitoring.

More information

See the clozapine data sheets for prescribing information.

See the CareLink Plus (Clozaril® Patient Monitoring Service) website

See the ClopineCentral website

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