title: Evaluation of an interchangeability switch in patients treated with clozapine: A retrospective review.
abstract: OBJECTIVE
  To report the findings of a switch from brand-name to generic clozapine in a Canadian outpatient population.
  
  
  METHODS
  The medical records of 58 outpatients diagnosed with schizophrenia and other psychotic disorders and stabilized on brand-name clozapine therapy were reviewed retrospectively. Patients were switched from brand-name to generic clozapine on their next dispensing supply after September 29, 2003. Data regarding clozapine dose regimens, physicians' visits, hospitalizations, and adverse events were collected from the patients' charts for the 6 months preceding and the 6 months after the switch from brand-name to generic clozapine. Relevant measurement changes in those data associated with the switch are evaluated.
  
  
  RESULTS
  No significant changes in dose, number of physician's visits, or hospitalization rates were observed as a consequence of the switch from brand-name to generic clozapine. In addition, there were no reported increases in the frequency of the most common adverse events, including decreases in white blood cell counts. None of the patients received a "nonrechallengeable" status, and no discontinuation of clozapine therapy occurred for any reason (toxicity or treatment failure) in the 6 months after the formulation switch.
  
  
  CONCLUSIONS
  In the current outpatient population, retrospective evaluation of the conversion from brand-name clozapine to the first generic alternative available on the Canadian market did not reveal any significant treatment changes.
authors.affiliation: Faculty of Pharmacy, University of Manitoba, Winnipeg, Manitoba, Canada. alessise@ms.umanitoba.ca
authors.forename: Silvia
authors.initials: S
authors.lastname: Alessi-Severini
authors.forename: Patricia L
authors.initials: PL
authors.lastname: Honcharik
authors.forename: Karleen D
authors.initials: KD
authors.lastname: Simpson
authors.forename: Michael K
authors.initials: MK
authors.lastname: Eleff
authors.forename: David M
authors.initials: DM
authors.lastname: Collins
mesh_terms: D000328:Adult; D000368:Aged; D000380:Agranulocytosis / Q000139:chemically induced / Q000453:epidemiology; D000553:Ambulatory Care / Q000706:statistics & numerical data; D002170:Canada; D003024:Clozapine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D016568:Drugs, Generic / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007880:Legislation, Drug; D008297:Male; D008875:Middle Aged; D011618:Psychotic Disorders / Q000188:drug therapy* / Q000523:psychology; D012189:Retrospective Studies; D012559:Schizophrenia / Q000188:drug therapy; D012565:Schizophrenic Psychology; D016896:Treatment Outcome
chemical_list: D016568:Drugs, Generic; D003024:Clozapine