How JustAnswer Works:

  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site.
    Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.

Ask Dr. Sohaib Your Own Question

Dr. Sohaib
Dr. Sohaib, Doctor
Category: Health
Satisfied Customers: 4708
Experience:  M.B;B.S ; FCPS Experienced in all Medical Specialties
Type Your Health Question Here...
Dr. Sohaib is online now
A new question is answered every 9 seconds

Can the 500mg daily dose of my 29-year-old daughters clozapine

Resolved Question:

Can the 500mg daily dose of my 29-year-old daughter's clozapine be safely increased to 600mg, on the basis of the following assay result?

CLOZAPINE 289 - UG/1 - 50-700

DIMETHYLCLOZAPINE 24- - UG/1
Submitted: 11 months ago.
Category: Health
Expert:  Dr. Sohaib replied 11 months ago.

Hello and thank you for the question Lester.

Answers given are for informational purposes only and are not meant to replace an exam by an in-person.

I am Dr. Sohaib, a practicing Internal Medicine Specialist and i will do my best to help you today.

The maximum daily dose of clozapine is 900 mg in 24 hours, but it has been seen that most of the patients get desired results at doses 400 to 600 mg per day.

Whether or not the drug dose should be increased depend upon the patient's tolerability to that particular drug, and for clozapine you must know that there are some serious side effects that need to be watched closely before making any dose increments (it reduces white cell counts as well as increases the chances of seizures).

The dose can be increased from 500 to 600 only if the patient has been taking the 500mg daily dose for over 2 weeks (which allows her system to adapt to these drugs and prevent chances of any side effects that might occur when the dose is increased).

So these are not only the assays, but also the clinical indicators as well as lab tests (like blood cbc) that should be considered before increasing drug dose.

Honestly in this case, her physician is the best judge to decide whether the dose should be increased or not, and even if this is planned, it should be done very carefully as well as under close supervision of the doctor.

You should not do this yourself. Because we all want to make sure that she remains safe and free from any serious side effects.

My goal is to provide you with Excellent Service - if satisfied with the response, Please do not forget to Rate my service as this is the only way i get credit for my time and expertise on your question.

If you feel you have gotten anything less, please reply back, I am happy to address follow-up questions.

Kindest Regards.

Dr. Sohaib, Doctor
Category: Health
Satisfied Customers: 4708
Experience: M.B;B.S ; FCPS Experienced in all Medical Specialties
Dr. Sohaib and 6 other Health Specialists are ready to help you
Customer: replied 11 months ago.

I am very happy with your answer. I will give a bonus. But first please confirm that an increase from 500mg in 24 hours to 600mg in 24 hours could reduce WBC.


 


My daughter has been on 500mg in 24 hours since 2011, could an increase still reduce WBC?


 


Expert:  Dr. Sohaib replied 11 months ago.

Thank you very much for the follow up question.

Extremely unlikely that raising the dose will affect the white cell count with in 24 hours. This may take few days to affect the white cell count.

And this is not necessary that increasing the drug dose will reduce the white cell count in all the cases.

This is experienced by few people, but due to serious nature of this side effect, it need to be monitored in all cases especially when the dose in increased.

My goal is to provide you with Excellent Service - if satisfied with the response, Please do not forget to Rate my service as this is the only way i get credit for my time and expertise on your question.

If you feel you have gotten anything less, please reply back, I am happy to address follow-up questions.

Kindest Regards.

Dr. Sohaib, Doctor
Category: Health
Satisfied Customers: 4708
Experience: M.B;B.S ; FCPS Experienced in all Medical Specialties
Dr. Sohaib and 6 other Health Specialists are ready to help you
Expert:  Dr. Sohaib replied 11 months ago.
Dear Lester,
Hope you are fine.
Is there anything else i can help you with?
I will be glad to assist.

JustAnswer in the News:

 
 
 
Ask-a-doc Web sites: If you've got a quick question, you can try to get an answer from sites that say they have various specialists on hand to give quick answers... Justanswer.com.
JustAnswer.com...has seen a spike since October in legal questions from readers about layoffs, unemployment and severance.
Web sites like justanswer.com/legal
...leave nothing to chance.
Traffic on JustAnswer rose 14 percent...and had nearly 400,000 page views in 30 days...inquiries related to stress, high blood pressure, drinking and heart pain jumped 33 percent.
Tory Johnson, GMA Workplace Contributor, discusses work-from-home jobs, such as JustAnswer in which verified Experts answer people’s questions.
I will tell you that...the things you have to go through to be an Expert are quite rigorous.
 
 
 

What Customers are Saying:

 
 
 
  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
< Last | Next >
  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
  • I thank-you so much! It really helped to have this information and confirmation. We will watch her carefully and get her in for the examination and US right away if things do not improve. God bless you as well! Claudia Albuquerque, NM
  • Outstanding response time less than 6 minutes. Answered the question professionally and with a great deal of compassion. Kevin Beaverton, OR
  • Suggested diagnosis was what I hoped and will take this info to my doctor's appointment next week.
    I feel better already! Thank you.
    Elanor Tracy, CA
  • Thank you to the Physician who answered my question today. The answer was far more informative than what I got from the Physicians I saw in person for my problem. Julie Lockesburg, AR
  • You have been more help than you know. I seriously don't know what my sisters situation would be today if you had not gone above and beyond just answering my questions. John and Stefanie Tucson, AZ
  • I have been dealing with an extremely serious health crisis for over three years, and one your physicians asked me more questions, gave me more answers and encouragement than a dozen different doctors who have been treating me!! Janet V Phoenix, AZ
 
 
 

Meet The Experts:

 
 
 
  • Nurse Milli, RN

    Nurse (RN)

    Satisfied Customers:

    4043
    20 years experience in many areas of Nursing. Both Hospital and Private Practice experience.
< Last | Next >
  • http://ww2.justanswer.com/uploads/NU/nursescare4u/2013-3-31_03429_JApic.64x64.jpg Nurse Milli, RN's Avatar

    Nurse Milli, RN

    Nurse (RN)

    Satisfied Customers:

    4043
    20 years experience in many areas of Nursing. Both Hospital and Private Practice experience.
  • http://ww2.justanswer.com/uploads/agketch/2008-7-14_184046_drketchresized.jpg Dr. Ketch's Avatar

    Dr. Ketch

    Doctor

    Satisfied Customers:

    102
    Medical Degree, Former Assistant Professor at School of Medicine at Yale University
  • http://ww2.justanswer.com/uploads/FA/FamilyPhysician/2013-8-31_191624_JA550x500Photo.64x64.jpg Family Physician's Avatar

    Family Physician

    Doctor (MD)

    Satisfied Customers:

    5622
    Emergency Medicine and Family Practice for over 26 years
  • http://ww2.justanswer.com/uploads/drphophalia/2007-08-23_095626_dr._arun_phophalia.jpg Dr. Arun Phophalia's Avatar

    Dr. Arun Phophalia

    Doctor (MD)

    Satisfied Customers:

    17025
    MBBS, MS (General Surgery), Fellowship in Sports Medicine
  • http://ww2.justanswer.com/uploads/VA/VANP/2012-6-6_235535_Skye2.64x64.jpg A. Schuyler, NP's Avatar

    A. Schuyler, NP

    Nurse Practitioner

    Satisfied Customers:

    12170
    Board Certified NP, MS, RN. Private practice & hospitalist
  • http://ww2.justanswer.com/uploads/TA/tazechip/2012-6-7_135230_drpic.64x64.png Dr. Chip's Avatar

    Dr. Chip

    Doctor (MD)

    Satisfied Customers:

    10029
    Over 20 yrs of Family Practice
  • http://ww2.justanswer.com/uploads/neurosurg/2009-10-06_120923_profile.jpg Dr. Mark's Avatar

    Dr. Mark

    Doctor (MD)

    Satisfied Customers:

    6234
    U.S. Physician/Surgeon in Neurosurgery