Standard Health Pals Formulary
Clozapine 200 mg Tablet
Coverage Level – 100%
Copay – $0
Limitations – No more than 30 days’ supply
Restrictions – Health Pals Mail Order Pharmacy Network
Comments – This drug is generic for “Clozaril”. This is a REMS (Risk Evaluation and Mitigation Strategies) medication that requires frequent blood tests. Your prescriber may decide that if you have neutropenia you may not be able to take this medication. The Clozapine REMS will obtain information about your prescriptions, in addition to your prescriber’s officer and the dispensing pharmacy. Click the logo below to learn more about Clozapine REMS.