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Clozapine (Clozaril)

Antipsychoticprescriptionoral · predicted

Dibenzodiazepine atypical antipsychotic, gold standard for treatment-resistant schizophrenia. Unique D4 > D2 affinity with broad 5-HT2A, H1, M1, alpha-1 antagonism. Only antipsychotic proven to reduce suicidality in schizophrenia. Requires mandatory blood monitoring (REMS program) due to risk of agranulocytosis (~1%). Also causes significant metabolic effects, sedation, sialorrhea, and seizure risk at high doses. CYP1A2 metabolism (smoking effect).

Projected serum levels — 100 mg, twice daily

Clozapine (Clozaril)
Clozapine (Clozaril) modeled serum levels, 100 mg twice daily over 15 days Population-based pharmacokinetic estimate. Steady state reached after approximately 1 days. 0 25 50 75 100 Day 0 Day 4 Day 7 Day 11 Day 15 Time on a regular schedule ≈ steady state · day 1
Clozapine (Clozaril) modeled serum levels with a loading dose of 148 mg, then 100 mg twice daily The first dose is larger so levels approach steady state faster. 0 25 50 75 100 Day 0 Day 4 Day 7 Day 11 Day 15 Time on a regular schedule

Maintenance schedule: 100 mg twice daily (oral).

Loading schedule: 148 mg on day 1, then 100 mg twice daily — reaching therapeutic levels sooner.

Modeled steady state after ~1 days: peak ≈ 57.1 mg, trough ≈ 23.2 mg body load. Population-based estimate over 15 days for a 100 mg dose at a 70 kg reference body mass — the interactive app scales curves to your doses, timing, and body mass.

Key facts

Category
Antipsychotic
Route modeled
Oral
Model confidence
predicted
Half-life
12 h
Common dose
100 mg
Suggested maximum
900 mg/day
Reference dose range
50–900 mg (single dose)
Suggested cadence
twice daily
Validated against
100 mg oral — Cmax 0.27 mg/L at 2.5 h

Documented interactions

  • danger
    1P-LSD (1-Propionyl-LSD) + Clozapine (Clozaril) Serotonin risk

    1P-LSD (1-Propionyl-LSD) and Clozapine (Clozaril) both have serotonergic activity. Risk of serotonin syndrome (hyperthermia, rigidity, autonomic instability, altered mental status).

  • danger
    25I-NBOMe + Clozapine (Clozaril) Serotonin risk

    25I-NBOMe and Clozapine (Clozaril) both have serotonergic activity. Risk of serotonin syndrome (hyperthermia, rigidity, autonomic instability, altered mental status).

  • danger
    2C-I (2,5-Dimethoxy-4-iodophenethylamine) + Clozapine (Clozaril) Serotonin risk

    2C-I (2,5-Dimethoxy-4-iodophenethylamine) and Clozapine (Clozaril) both have serotonergic activity. Risk of serotonin syndrome (hyperthermia, rigidity, autonomic instability, altered mental status).

  • danger
    2C-B (4-Bromo-2,5-dimethoxyphenethylamine) + Clozapine (Clozaril) Serotonin risk

    2C-B (4-Bromo-2,5-dimethoxyphenethylamine) and Clozapine (Clozaril) both have serotonergic activity. Risk of serotonin syndrome (hyperthermia, rigidity, autonomic instability, altered mental status).

  • danger
    3-MeO-PCP (3-Methoxyphencyclidine) + Clozapine (Clozaril) Serotonin risk

    3-MeO-PCP (3-Methoxyphencyclidine) and Clozapine (Clozaril) both have serotonergic activity. Risk of serotonin syndrome (hyperthermia, rigidity, autonomic instability, altered mental status).

  • danger
    4-AcO-DMT (Psilacetin) + Clozapine (Clozaril) Serotonin risk

    4-AcO-DMT (Psilacetin) and Clozapine (Clozaril) both have serotonergic activity. Risk of serotonin syndrome (hyperthermia, rigidity, autonomic instability, altered mental status).

Serum checks 187 modeled interaction pairings for clozapine (clozaril) across your whole stack — absorption conflicts, enzyme inhibition, and nutrient depletion included.

Research behind this entry

  1. Effectiveness of clozapine versus olanzapine, quetiapine, and risperidone in patients with chronic schizophrenia who did not respond to prior atypical antipsychotic treatment (CATIE Phase 2) McEvoy JP et al. · American Journal of Psychiatry, 2006 DOI

    Landmark NIMH CATIE phase 2 trial demonstrating clozapine superiority over other atypicals in treatment-resistant schizophrenia, with significantly longer time to discontinuation and greater PANSS improvement.

  2. Clozapine for the treatment-resistant schizophrenic: a double-blind comparison with chlorpromazine Kane J et al. · Archives of General Psychiatry, 1988 DOI

    Pivotal RCT that established clozapine as effective for treatment-resistant schizophrenia: 30% of clozapine patients responded versus 4% on chlorpromazine, leading to FDA approval with blood monitoring requirement.

2 published studies referenced in the app, each with a plain-language summary.