目的严重感染或炎症与血清氯氮平浓度升高有关，有时与氯氮平毒性有关。方法这两个病例描述了中国患者（病例1：一名57岁的女性不吸烟者患有严重皮炎，病例2：一名47岁的男性不吸烟者患有流感和继发感染）。结果在这两种情况下，药物相互作用概率量表确定了可能的药物相互作用的存在。在这两种情况下，氯氮平和总氯氮平浓度与剂量比遵循时间模式（正常-高-正常），与高峰炎症期间氯氮平代谢的抑制一致。在第一种情况下,总氯氮平浓度与剂量比(8例无/低炎症:中位数为3.10,2例炎症峰值:中位数为3.90)提供了显著差异(P=0.044).第二个病人,由于较小的样本量和降低的统计能力（4没有感染：中位数为1.59，2在高峰感染：3.46），增加没有达到显著性(P=0.13).在第一种情况下,基线氯氮平浓度与剂量比中位数从2.00增加1.45倍,达到2.89的峰值.为了弥补氯氮平代谢的抑制作用，剂量校正因子为0.69(1/1.45)或剂量减少约三分之一.在第二种情况下，基线氯氮平浓度与剂量比中位数从1.15增加到2.94,增加了2.56倍.结论这提供了0.40（1/2.56）或大约一半剂量的剂量校正因子，与高加索人严重呼吸道感染的已发表病例相似。
Objective Serious infections or inflammations have been associated with serum clozapine concentration increases and sometimes with clozapine toxicity. Method These two cases describe Chinese patients (Case 1: a 57-year-old female nonsmoker with severe dermatitis and Case 2: a 47-year-old male nonsmoker with influenza and secondary infection). Results In both cases, the Drug Interaction Probability Scale established the presence of a probable drug-drug interaction. In both cases, the clozapine and the total clozapine concentration-to-dose ratios followed a temporal pattern (normal-high-normal), consistent with an inhibition of clozapine metabolism during peak inflammation. In the first case, the total clozapine concentration-to-dose ratio (8 with no/low inflammation: median of 3.10 and 2 at peak inflammation: median of 3.90) provided a significant difference (P = 0.044). In the second patient, because of the smaller sample size and reduced statistical power (4 with no infection: a median of 1.59 and 2 at peak infection: 3.46), the increase did not reach significance (P = 0.13). In the first case, the median baseline clozapine concentration-to-dose ratio increased by a factor of 1.45 from 2.00 to a peak of 2.89. To compensate for the inhibition of clozapine metabolism, the dose correction factor was 0.69 (1/1.45) or a decrease in dose of approximately one-third. In the second case, the median baseline clozapine concentration-to-dose ratio increased by a factor of 2.56 from 1.15 to a peak of 2.94. Conclusion This provided a dose correction factor of 0.40 (1/2.56) or approximately half the dose, similar to published cases in Caucasians with serious respiratory infections.
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