Are there examples of monitoring protocols or tracking log forms that could be used when starting clozapine?

The only required monitoring when starting clozapine is the monitoring of neutrophils specified by the clozapine REMS program.  See the SMI Adviser tip on blood count monitoring for clozapine.  However, it is wise to monitor for other side effects as well.  Side effect monitoring can be informed by assessment of past medical history, concurrent medications, tobacco smoking, coffee consumption, substances being used, bowel health, diet, vital signs, weight, and pertinent lab tests.  Lab tests can include neutrophil count, comprehensive metabolic panel, lipid panel, glucose or Hg1c, and a pregnancy test for women under 50. Some clinicians monitor for myocarditis using troponins, but there is not consensus about the need for this in the United States. Here is a sample monitoring log and tracking form.

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