Please be careful with the clozaril. If you feel anything weird with your heart or blood pressure it needs checked out. Like I said, my pdoc is very adamant that the "major" interaction is a big deal. But I'm not on abilify so maybe it's different. I know she will not do "major" interactions I think ever but maybe that's because my history with meds is so bad. I don't think that's the reason but I've never asked specifically I guess. Just maybe have a low threshold for concern maybe?
If your pdoc didn't want you to bother him you wouldn't have his contact information. They know when they give that out which patients are going to need to use it. I do think that he should be more responsive or tell you to contact him another way (when my pdoc was getting chemotherapy and radiation I knew that she wasn't going to be answering emails as often and that I needed to call her secretary). But trying to get help for yourself using information he gave you is definitely not nagging. If you looked up his information yourself and kept calling him THAT would be a problem but you didn't so you are fine and are just doubting yourself.
Like others have said when he is being willing to keep you out of the hospital when even you feel you need to be there (and I thought he's always said that was when he would send you?) I think you need to be ready to decide to go in anyway if you need to. Ultimately only you can decide when this is necessary; he isn't in your head. So if you feel in danger you need to go and let the hospital figure out whether you should stay.
I hope the clozaril works for you. Just please be careful with it. It apparently is a drug that you only get one chance; if you stop it it's unlikely to work a 2nd time (from anecdotal reading) and so I think you have to have the support in place to make sure it works the first time.
Also please be careful with that starting dose. I thought 20 sounded high so I looked it up and this is what I found:
Quote:
Required Laboratory Testing Prior to Initiation and During Therapy
Prior to initiating treatment with CLOZARIL, obtain a complete blood count (CBC) with differential. The absolute neutrophil count (ANC) must be greater than or equal to 2000/mm³and the WBC must be greater than or equal to 3500 mm³in order to initiate treatment. To continue treatment, the ANC and WBC must be monitored regularly [see WARNINGS AND PRECAUTIONS].
Dosing Information
The starting dose is 12.5 mg once daily or twice daily. The total daily dose can be increased in increments of 25 mg to 50 mg per day, if well-tolerated, to achieve a target dose of 300 mg to 450 mg per day (administered in divided doses) by the end of 2 weeks. Subsequently, the dose can be increased once weekly or twice weekly, in increments of up to 100 mg. The maximum dose is 900 mg per day. To minimize the risk of orthostatic hypotension, bradycardia, and syncope, it is necessary to use this low starting dose, gradual titration schedule, and divided dosages [see WARNINGS AND PRECAUTIONS].
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