What medication requires Risk Evaluation and Mitigation Strategy (REMS) monitoring?

Clozapine is the medication that requires Risk Evaluation and Mitigation Strategy (REMS) monitoring. This requirement is in place primarily due to the risk of agranulocytosis, a potentially life-threatening side effect marked by a significant decrease in white blood cell counts, which can lead to severe infections.

To mitigate this risk, a specific patient monitoring program must be followed. Patients on clozapine are required to have regular blood tests to monitor their white blood cell counts, particularly the absolute neutrophil count (ANC). Depending on the latest ANC results, prescribing physicians and pharmacists are informed about the appropriate course of action regarding clozapine therapy.

The REMS for clozapine ensures that both healthcare providers and patients are aware of the risks involved with the medication, and provides a framework for safe usage. The requirement for these monitoring protocols is a direct response to the serious risks associated with clozapine, which sets it apart from other antipsychotics listed in the options.

Other medications listed do not have the same level of risk concerning blood dyscrasias necessitating a formal REMS program with mandatory monitoring. As a result, they do not require the same structured oversight as clozapine.