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Clozapine agranulocytosis — GPhC CRA MCQ

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HardAdverse Drug Reactions and SafetyClozapine agranulocytosisGPhC CRA

A patient taking clozapine 350mg daily reports fever, sore throat and mouth ulcers. He missed his last scheduled blood test and asks for chlorhexidine mouthwash. What is the most appropriate action?

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Correct answer: C — Refer urgently for full blood count and clozapine service advice

Clozapine can cause agranulocytosis, and fever or sore throat must be treated as urgent until neutropenia is excluded. Missing blood monitoring increases concern and the clozapine monitoring service or prescriber should be contacted urgently. Symptomatic mouthwash alone would be unsafe. Clozapine dose changes should not be made without specialist input.

Reference: BNF; Clozapine monitoring service guidance