closin 50mg tablet - Clozapine (50mg) medicine

Alkepin ODT 50mg Tablet (Clozapine): Comprehensive Medicine Guide

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🏭 S P Pharma 📦 Varies by brand 💊 Allopathy 📅 Updated: Oct 16, 2026
📋 Prescription Required 💊 Generic Available
Medically Reviewed
11 min read
Evidence: High
Reviewed by
SaathiMed Expert Panel | Oct 16, 2026
🩺
Medically Fact-Checked & Clinically Verified by SaathiMed Clinical Review Board
Clinical Reference Standards: CDSCO (Central Drugs Standard Control Organisation), Indian Pharmacopoeia (IP) & WHO | Last Updated: September 2026

When to Call Your Doctor IMMEDIATELY

  • Fever, sore throat, or mouth ulcers (signs of infection)
  • Chest pain, shortness of breath, or palpitations
  • Severe abdominal pain, vomiting, or inability to pass stool
  • Seizures or loss of consciousness
  • High fever with muscle rigidity and confusion
  • Involuntary movements of the face, tongue, or limbs
  • Yellowing of skin or eyes
  • Severe dizziness or fainting

If experiencing severe symptoms, call emergency services immediately.

What is closin 50mg tablet used for?

This medicine is an atypical antipsychotic used to treat schizophrenia in patients who have not responded to other treatments. It requires regular blood tests due to the risk of severe neutropenia.

  • Generic Name: Clozapine
  • Manufacturer: S P Pharma
  • Form: Allopathy
  • Pregnancy Category: Consult doctor
  • Prescription Required: Yes

🇮🇳 closin 50mg tablet के बारे में (Hindi Summary)

उपयोग: यह दवा क्लोज़ापिन नामक सक्रिय तत्व से बनी है और मुख्य रूप से सिज़ोफ्रेनिया के इलाज के लिए उपयोग की जाती है, खासकर उन रोगियों में जो अन्य एंटीसाइकोटिक दवाओं से ठीक नहीं हुए हैं। यह मतिभ्रम, भ्रम और सोच में गड़बड़ी को कम करने में मदद करती है। इस दवा का उपयोग केवल डॉक्टर की सलाह पर ही करें और नियमित रक्त परीक्षण करवाते रहें।

साइड इफेक्ट्स: आम दुष्प्रभावों में नींद आना, चक्कर आना, मुँह में लार बढ़ना, तेज़ धड़कन, कब्ज़ और वजन बढ़ना शामिल हैं। गंभीर दुष्प्रभावों में गंभीर न्यूट्रोपेनिया (श्वेत रक्त कोशिकाओं की कमी), मायोकार्डिटिस (हृदय की मांसपेशियों में सूजन), दौरे और गंभीर कब्ज़ शामिल हैं। कोई भी असामान्य लक्षण दिखने पर तुरंत डॉक्टर से संपर्क करें।

सुरक्षा सलाह: इस दवा से गंभीर रक्त विकार हो सकता है, इसलिए नियमित रक्त परीक्षण अनिवार्य है। रक्त परीक्षण के अपॉइंटमेंट न छोड़ें। शराब और अन्य नींद लाने वाली दवाओं से बचें। जब तक आपको पता न चले कि यह दवा आप पर कैसा असर करती है, तब तक वाहन न चलाएँ। बुखार, गले में खराश, मुँह के छाले या संक्रमण के कोई भी लक्षण दिखने पर तुरंत डॉक्टर को बताएं। इस दवा को अचानक बंद न करें।

💡 Did You Know? The first generic medicine was introduced in India in 1970 after the Patents Act was amended.

💊 closin 50mg tablet Uses & Benefits

  • [{"condition":"Schizophrenia","description":"This medicine is used to treat schizophrenia in patients who have not responded to other antipsychotic medications or who cannot tolerate them.
  • It helps reduce hallucinations, delusions, and disorganized thinking.","evidence":"Well-established"},{"condition":"Reduction of suicidal behavior in schizophrenia","description":"This medicine has been shown to reduce the risk of recurrent suicidal behavior in patients with schizophrenia or schizoaffective disorder.","evidence":"Well-established"}]

Off-label uses: [{"condition":"Treatment-resistant bipolar disorder","description":"Sometimes prescribed off-label for bipolar disorder when other treatments have failed.","evidence":"Limited"},{"condition":"Severe borderline personality disorder","description":"May be used off-label in some cases to reduce self-harm and aggression.","evidence":"Limited"}]

Primary treatment for: Schizophrenia

Also treats: Schizoaffective disorder, Bipolar disorder (off-label), Severe borderline personality disorder (off-label)

📋 Drug Information

Generic Name(s)Clozapine
Brand NameAlkepin ODT 12.5mg Tablet
ManufacturerS P Pharma
Packaging / FormVaries by brand (Allopathy)
Therapeutic ClassNEURO CNS
Action ClassAtypical Antipsychotics
Route of AdministrationOral
StorageStore at room temperature between 15°C and 30°C (59°F to 86°F). Protect from moisture and light. Keep in the original container.
Shelf Life24 months from the date of manufacture.
WHO GuidelineNot established from the available information.
ICMR GuidelineNot established from the available information.

👨‍⚕️ Doctor's Practical Tips

Evidence-based practical advice from experienced clinicians

1
Regular blood tests are mandatory to monitor for severe neutropenia; do not skip any appointments.
2
Take this medicine at the same time each day to maintain steady blood levels.
3
Report any signs of infection such as fever, sore throat, or mouth ulcers immediately.
4
Avoid alcohol and other central nervous system depressants while taking this medicine.
5
Do not drive or operate heavy machinery until you know how this medicine affects you.
6
Do not stop this medicine abruptly; always consult your doctor before making changes.
7
Maintain a healthy diet and exercise regularly to manage weight gain and metabolic effects.

🔍 Is This Medicine Right for Your Symptom?

Educational reference. Always consult a doctor for diagnosis.

✅
Hallucinations
This medicine is commonly prescribed for this.
Likely Use
✅
Delusions
This medicine is commonly prescribed for this.
Likely Use
✅
Suicidal thoughts
This medicine may reduce suicidal behavior in schizophrenia.
Likely Use
❌
Fever
This medicine is not a primary fever reducer and may cause fever as a side effect.
Not Primary

🔬 How This Medicine Works (Pharmacology)

Pharmacokinetics

AbsorptionThis medicine is well absorbed from the gastrointestinal tract after oral administration. The orally disintegrating tablet formulation is designed to dissolve rapidly in the mouth, which may enhance absorption. Food does not significantly affect the extent of absorption.
DistributionThis medicine is widely distributed throughout the body. It crosses the blood-brain barrier and reaches the central nervous system. It also crosses the placenta and is excreted in breast milk.
Protein BindingApproximately 95% of this medicine is bound to plasma proteins.
MetabolismThis medicine is extensively metabolized in the liver, primarily by the cytochrome P450 enzymes CYP1A2, CYP3A4, and CYP2D6. The main metabolite is norclozapine, which is pharmacologically active but less potent than the parent drug.
Half-LifeThe elimination half-life of this medicine is approximately 8 to 12 hours on average, but it can vary widely among individuals.
ExcretionThis medicine and its metabolites are primarily excreted in the urine (about 50%) and feces (about 30%).
BioavailabilityThe oral bioavailability of this medicine is approximately 27% to 50% due to first-pass metabolism.
Onset of ActionThe onset of antipsychotic effects may take several days to weeks. Sedative effects may be noticed within a few hours after the first dose.
Peak Plasma TimePeak plasma concentrations are reached approximately 1.5 to 2.5 hours after oral administration.
Duration of ActionThe antipsychotic effect is continuous with regular dosing. The sedative effect may last for several hours after each dose.

How It Works

This medicine works by blocking dopamine receptors, particularly D2 receptors, in the brain. It also has strong antagonistic effects on serotonin 5-HT2A receptors, and it affects several other neurotransmitter systems including histamine, acetylcholine, and norepinephrine. This broad receptor profile is thought to contribute to its effectiveness in treatment-resistant schizophrenia and its unique side effect profile.

Mechanism Steps

1
D2 receptor blockade: This medicine binds to and blocks dopamine D2 receptors in the mesolimbic pathway, which helps reduce positive symptoms of schizophrenia such as hallucinations and delusions.
2
5-HT2A receptor antagonism: It strongly blocks serotonin 5-HT2A receptors, which contributes to its efficacy and may reduce the risk of extrapyramidal symptoms.
3
Histamine H1 blockade: Blockade of histamine H1 receptors causes sedation and weight gain.
4
Muscarinic acetylcholine blockade: Blockade of muscarinic receptors leads to anticholinergic effects such as dry mouth, constipation, and blurred vision.
5
Alpha-adrenergic blockade: Blockade of alpha-adrenergic receptors can cause orthostatic hypotension and tachycardia.

💡 How to Take closin 50mg tablet

Strength: 50 mg orally disintegrating tablet

1Remove the orally disintegrating tablet from the blister pack with dry hands.
2Place the tablet on your tongue and allow it to dissolve completely.
3Do not chew or swallow the tablet whole; let it disintegrate.
4You may take it with or without food, but be consistent.
5Take at the same times each day to maintain steady levels.
6Do not stop taking this medicine abruptly without consulting your doctor.

Dosage Information

Adult DosageThe dose of this medicine must be individualized by a qualified clinician based on indication, age, weight, renal and hepatic function, and clinical response. For schizophrenia, the usual starting dose is 12.5 mg once or twice daily, gradually increased to a target dose of 300 to 450 mg per day, divided into multiple doses. The maximum recommended dose is 900 mg per day. Dose adjustments are made slowly to minimize side effects. Regular blood tests are required.
Pediatric DosagePediatric dosing is not established from available information. Consult a pediatrician.
Elderly DosageElderly patients may be more sensitive to the effects of this medicine. Start with a lower dose and titrate slowly. Monitor for orthostatic hypotension, sedation, and anticholinergic effects.
Renal ImpairmentNo specific dose adjustment is provided in the labeling for renal impairment. However, use with caution in patients with severe renal impairment. Consult a clinician for individualized dosing.
Hepatic ImpairmentUse with caution in patients with hepatic impairment. Dose reduction may be necessary. Monitor liver function tests regularly.
Maximum Daily Dose900 mg per day

Dosage Timeline

🌅 Morning ❌ ☀️ Afternoon ❌ 🌆 Evening ❌ 🌙 Night ❌

🍽️ Food Timing Guide

With or without food
Take consistently
Food does not significantly affect absorption, but consistency helps maintain steady levels.
Grapefruit
Avoid
May increase clozapine levels by inhibiting CYP3A4.
Caffeine
Limit
May increase clozapine levels and cause excessive stimulation.

⏰ What to Do If You Miss a Dose

📌 Less than half the dosing interval has passed
→ Take the missed dose as soon as you remember.
💡 Continue with the regular schedule.
📌 More than half the dosing interval has passed
→ Skip the missed dose.
💡 Do not double dose to catch up.
📌 You miss more than one dose
→ Contact your doctor for guidance.
💡 Do not restart without medical advice.

⚠️ Side Effects of closin 50mg tablet

✅ Common Side Effects

Drowsiness (Very common (>10%))
Avoid driving or operating machinery until you know how this medicine affects you. If drowsiness is severe, consult your doctor.
Increased salivation (Very common (>10%))
This usually improves over time. If it becomes bothersome, talk to your doctor about management options.
Tachycardia (Common (1-10%))
Report persistent rapid heartbeat to your doctor. Avoid caffeine and other stimulants.
Constipation (Very common (>10%))
Increase fiber and fluid intake. If constipation persists or becomes severe, contact your doctor.
Weight gain (Very common (>10%))
Monitor your weight regularly. Follow a healthy diet and exercise as tolerated. Discuss with your doctor if weight gain is significant.
Dizziness (Common (1-10%))
Rise slowly from sitting or lying positions to avoid falls. If dizziness persists, consult your doctor.

🚨 Serious Side Effects

Severe neutropenia (Uncommon (0.1-1%))
Seek immediate medical attention if you develop fever, sore throat, mouth ulcers, or other signs of infection. Regular blood tests are essential.
Myocarditis (Rare (<0.1%))
Seek immediate medical attention if you experience chest pain, shortness of breath, palpitations, or fatigue.
Seizures (Uncommon (0.1-1%))
Seek immediate medical attention if you have a seizure. Do not drive or operate machinery if you have a history of seizures.
Severe constipation leading to bowel obstruction (Rare (<0.1%))
Seek immediate medical attention if you have severe abdominal pain, vomiting, or inability to pass stool.
Neuroleptic malignant syndrome (Rare (<0.1%))
Seek immediate medical attention if you develop high fever, muscle rigidity, confusion, or autonomic instability.

⚠️ Rare Side Effects

Tardive dyskinesia
Report any involuntary movements of the face, tongue, or limbs to your doctor immediately.
Pancreatitis
Seek immediate medical attention if you experience severe abdominal pain radiating to the back, with nausea and vomiting.
Cardiomyopathy
Report symptoms of heart failure such as shortness of breath, swelling of legs, or fatigue to your doctor.

Consult your doctor if you experience any unusual symptoms.

🔬 Drug Interactions

Drug Severity Effect
Fluvoxamine Major
Ciprofloxacin Major
Carbamazepine Major
Benzodiazepines Major
Lithium Major
Anticholinergics Moderate
Antihypertensives Moderate
CNS depressants Moderate
Grapefruit juice Minor
Caffeine Minor

🚨 Major Interactions

  • Clozapine and other antipsychotics
  • CYP1A2 inhibitors (e.g., fluvoxamine, ciprofloxacin)
  • CYP1A2 inducers (e.g., smoking, carbamazepine)
  • Benzodiazepines
  • Lithium

⚡ Moderate Interactions

  • Anticholinergic drugs
  • Antihypertensive drugs
  • CNS depressants

🍷 Alcohol Interaction

Alcohol should be avoided while taking this medicine because it can increase sedation, dizziness, and the risk of orthostatic hypotension. It may also worsen the cognitive and motor impairments caused by this medicine.

🔎 Check Your Other Medicines

Educational tool. Always confirm with your doctor or pharmacist.

🛡️ Safety & Warnings

🚫 Contraindications

["Hypersensitivity to clozapine or any component of the formulation","History of severe neutropenia or agranulocytosis induced by clozapine","Uncontrolled epilepsy","Severe cardiac disorders (e.g., myocarditis, cardiomyopathy)","Paralytic ileus","Concurrent use with other drugs that cause bone marrow suppression"]

⚠️ Warnings & Precautions

["Severe neutropenia: Regular blood tests are mandatory. Report any signs of infection immediately.","Myocarditis: Can occur early in treatment. Report chest pain, shortness of breath, or palpitations.","Seizures: May lower seizure threshold. Use with caution in patients with a history of seizures.","Orthostatic hypotension: May cause dizziness and falls. Rise slowly from sitting or lying positions.","Anticholinergic effects: May cause constipation, dry mouth, and urinary retention. Monitor and manage symptomatically.","Metabolic effects: May cause weight gain, hyperglycemia, and dyslipidemia. Monitor regularly.","Neuroleptic malignant syndrome: A rare but potentially fatal reaction. Seek immediate medical attention if symptoms occur.","Tardive dyskinesia: May develop with long-term use. Report any involuntary movements.","Withdrawal: Do not stop abruptly; taper gradually under medical supervision."]

🤱 Lactation Safety

This medicine is excreted in breast milk and may cause serious adverse effects in the nursing infant. Breastfeeding is not recommended while taking this medicine.

💊 Overdose Management

Overdose of this medicine can cause severe sedation, tachycardia, hypotension, seizures, and cardiac arrhythmias. There is no specific antidote. Treatment is supportive and symptomatic, including airway management, monitoring of vital signs, and management of seizures and arrhythmias. Contact a poison control center or emergency services immediately.

⏰ Missed Dose

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not double the dose to catch up. If you miss more than one dose, contact your doctor for guidance.

Additional Safety Advice

General Safety

This medicine can cause a serious blood disorder called neutropenia, so regular blood tests are mandatory. Do not skip any blood test appointments. Avoid alcohol and other central nervous system depressants while taking this medicine. Do not drive or operate heavy machinery until you know how this medicine affects you. Inform your doctor if you experience fever, sore throat, mouth ulcers, or any signs of infection. Do not stop this medicine abruptly without medical supervision, as this can cause withdrawal symptoms or relapse. Keep all follow-up appointments and report any new or worsening symptoms.

👴 Special Considerations for Elderly

💡 For Patients Above 65

Elderly patients are at increased risk of orthostatic hypotension, sedation, anticholinergic effects, and falls. Start with a lower dose and titrate slowly. Monitor blood pressure, heart rate, and mental status closely. This medicine is not approved for dementia-related psychosis and may increase mortality in such patients.

🤰 Pregnancy Planning (TTC)

If you are planning to become pregnant, discuss with your doctor before conception. This medicine should be used during pregnancy only if the potential benefit justifies the potential risk. It may cause neonatal withdrawal symptoms if used near term. Effective contraception is recommended during treatment.

🏥 Post-Surgery Considerations

Inform your surgeon and anesthesiologist that you are taking this medicine. It may interact with anesthetic agents and increase the risk of hypotension, sedation, and cardiac complications. Your doctor may recommend temporary dose adjustments or monitoring during the perioperative period.

🦷 Dental Procedures

Inform your dentist that you are taking this medicine. It can cause dry mouth, which may increase the risk of dental caries and gum disease. Maintain good oral hygiene and stay hydrated. It may also interact with sedatives used during dental procedures.

💚 Lifestyle Tips for Better Results

🏃
Maintain a healthy weight through diet and exercise.
🥗
Engage in regular low-impact exercise like walking or swimming.
😴
Practice good sleep hygiene to manage sedation.
💧
Avoid alcohol and recreational drugs.
🧘
Stay hydrated and eat a high-fiber diet to prevent constipation.
🌞
Attend all scheduled blood tests and follow-up appointments.

🏋️ Exercise Considerations

This medicine can cause drowsiness, dizziness, and orthostatic hypotension, which may increase the risk of falls during exercise. Start with low-impact activities and avoid strenuous exercise until you know how the medicine affects you. Stay hydrated and rise slowly from sitting or lying positions.

🥗 Diet Recommendations

Include plenty of fiber-rich foods to prevent constipation.
Limit caffeine and avoid grapefruit juice.
Choose a balanced diet to manage weight and metabolic effects.
Stay well hydrated throughout the day.
Reduce intake of processed and high-sugar foods.

💼 Impact on Daily Work & Life

This medicine can cause significant drowsiness, dizziness, and difficulty concentrating, especially during the initial weeks of treatment. It is advisable to avoid driving or operating heavy machinery until you know how it affects you. Discuss with your employer if you need temporary adjustments to your work schedule or duties.

🛑 When to Stop This Medicine

Do not stop this medicine without consulting your doctor. Abrupt discontinuation can cause withdrawal symptoms such as nausea, vomiting, insomnia, and rapid relapse of psychotic symptoms. Your doctor will gradually taper the dose if discontinuation is necessary.

📅 Long-Term Use Effects

Long-term use of this medicine may lead to weight gain, metabolic syndrome, tardive dyskinesia, and other chronic side effects. Regular monitoring of blood counts, cardiac function, liver function, and metabolic parameters is essential. The dose should be periodically reviewed and adjusted to the lowest effective level.

🌿 Non-Medicine Approaches

These can complement medicine but do not replace prescribed treatment.

Cognitive behavioral therapy (CBT)

Can complement medication in managing psychotic symptoms and improving coping skills.

Evidence: Well-established
Family therapy

Helps families support the patient and reduce relapse risk.

Evidence: Well-established
Supported employment

Helps patients return to work and improve quality of life.

Evidence: Well-established

💉 Vaccination Considerations

💉 If You're Getting Vaccinated

There are no specific vaccine interactions with this medicine. However, because it can cause neutropenia, live vaccines should be avoided during periods of severe immunosuppression. Consult your doctor before receiving any vaccinations.

📦 Storage Guide

✅ DO

Store at room temperature (15-30°C)

❌ DON'T

Do not refrigerate unless specified

✅ DO

Keep in original container

❌ DON'T

Do not transfer to unmarked containers

✅ DO

Keep away from direct sunlight

❌ DON'T

Do not store in bathroom cabinet

✅ DO

Keep out of reach of children

❌ DON'T

Do not use after expiry date

✈️ Traveling with This Medicine

When traveling, carry this medicine in its original packaging with a copy of your prescription. Keep it in your carry-on luggage to avoid loss. Store at room temperature and protect from moisture. If crossing time zones, adjust dosing times gradually in consultation with your doctor. Carry enough supply for the entire trip plus extra in case of delays. Check local customs regulations for controlled substances.

💰 Cost Analysis & Savings

👥 Real Patient Stories

Educational, anonymized scenarios. Individual results may vary.

👤 A 35-year-old man with treatment-resistant schizophrenia
After trying multiple antipsychotics without adequate relief, he was started on this medicine. Over several weeks, his hallucinations decreased significantly, and he was able to return to part-time work. He experienced increased salivation and drowsiness initially, but these improved. He diligently attended his weekly blood tests.
💡 Lesson: Consistent monitoring and gradual dose adjustment are key to safely benefiting from this medicine.
👤 A 50-year-old woman with schizoaffective disorder and recurrent suicidal thoughts
She had a history of multiple hospitalizations for suicidal ideation. After starting this medicine, her suicidal thoughts reduced markedly, and she was able to engage in therapy. She required close monitoring for metabolic side effects and attended regular follow-ups.
💡 Lesson: This medicine can be life-changing for some patients but requires commitment to monitoring and lifestyle adjustments.

💬 Questions Patients Often Ask

Q: How long does it take to work?

A: The antipsychotic effects may take several days to weeks to become noticeable. Sedative effects may occur within a few hours after the first dose.

Q: What should I do if I miss a dose?

A: If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not double the dose.

Q: Can I stop taking this medicine if I feel better?

A: No, do not stop this medicine abruptly. Always consult your doctor before making any changes, as stopping suddenly can cause withdrawal symptoms or relapse.

Q: What are the serious side effects I should watch for?

A: Seek immediate medical attention if you experience fever, sore throat, mouth ulcers, chest pain, shortness of breath, palpitations, seizures, severe abdominal pain, or involuntary movements.

🤔 Common Patient Concerns

💭 These are the concerns patients most commonly raise

  • Can I take this medicine long-term?
  • Will it affect my kidney function?
  • Can I drive after taking this medicine?
  • Does it interact with my blood pressure medicine?
  • What if I miss a dose?
  • Can I drink alcohol while taking this?
  • How often do I need blood tests?
  • Will I gain weight on this medicine?

🔄 Substitutes for closin 50mg tablet

View All

Alternative brands with exact same active ingredient:

Medical Note: Always consult your doctor before switching medications.

🛑 Myths vs. Facts

  • Myth: This medicine is a first-line treatment for schizophrenia.
    Fact: This medicine is usually reserved for patients who have not responded to other antipsychotic medications due to its serious side effect profile.
  • Myth: You can stop taking this medicine once you feel better.
    Fact: This medicine should not be stopped abruptly. Always consult your doctor before making any changes.
  • Myth: This medicine is safe to take without blood tests.
    Fact: Regular blood tests are mandatory to monitor for severe neutropenia and other serious side effects.

🔄 Alternative Options

Generic Alternatives

  • Clozapine 50 mg orally disintegrating tablet

Brand Alternatives

  • Alkepin ODT 50 mg tablet

📊 Comparison with Similar Medicines

[{"medicine":"Clozapine","class":"Atypical antipsychotic","primary_use":"Treatment-resistant schizophrenia","key_side_effects":"Severe neutropenia, myocarditis, seizures, weight gain"},{"medicine":"Olanzapine","class":"Atypical antipsychotic","primary_use":"Schizophrenia, bipolar disorder","key_side_effects":"Weight gain, metabolic syndrome, sedation"},{"medicine":"Risperidone","class":"Atypical antipsychotic","primary_use":"Schizophrenia, bipolar mania","key_side_effects":"Extrapyramidal symptoms, hyperprolactinemia"}]

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