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GenC^N

Gen-Gozapmc ACCESS NetWork

Monitoring With Confidence

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HEMATOLOGICAL MONITORING GUIDELINES'

Status    Action

GREEN STATUS WBC > 3.5xlOVL ANC a 2.0x10*/L	Continue clozapine treatment CBC and differential lab work once weekly, every 2 weeks or every 4 weeks. Pharmacy continues to dispense clozapine once weekty, every 2 weeks or every 4 weeks.
CLINICAL SAFETY ALERT: YELLOW STATUS	Continue clozapine treatment.
Low Values:	CBC and differential lab work x 2Aveek.
WBC 3.5x10*/L -2.0xl0*/L	Evaluate for fiu like complaints, fever.
ANC 2.0xl0*A- -1.5xlO*A Falling Values: WBC Fallł 3.0xl0»/L Measured in the last 4 weeks reaching a value < 4.0xlO^i/L ANC Fali > 1.5x 10»A Measured in the last 4 weeks reaching a value < 2.5x10*/L Physlcal Symptoms: Flu-like complaints or other symptoms which might suggest infection.	signs and symptoms of infection.
CLINICAL SAFETY ALERT: RED STATUS	Repeat CBC and differential within 24hrs to confirm results.
WBC < 2.0x10^ł/L	Pharmacy contact physician for dispensing direction.
ANC < 1.5xlO*/L	Results confirmed = STOP clozapine treatment CBC and differential continue weekly x 4 weeks. Evaluate for fiu like complaints, fever, signs and symptoms of infection. CLOZAPINE TX MUST NOT BE RESUMED: PAT1ENT NON-RECHALLENGEABLE
•Notę:	Protective isolation is recommended, if evidence of infection
WBC <1.0 xlO*/L	develops, appropriate cultures and antibiotic regime should
ANC < 0.5 x 10^ł/L	be performed.

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GEN-CLOZAPINE

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