Clonazepam Tablet
Clonazepam
2mg
Albion Laboratories Ltd.
| Pack size | |
|---|---|
| Retail Price | 6.00 |
Indications
Panic disorder, Epilepsy, Tardive dyskinesia, Restless leg syndrome, Rapid eye movement, Burning mouth syndrome
Panic disorder, with or without agoraphobia.
Epilepsy and other seizure disorders including status epilepticus. As an adjunct or refractory cases in the management of myoclonic and akinetic seizures, petit mal variant (Lennox-Gastaut syndrome) and infantile spasm.
In patients with absence seizures (petit mal) who have failed to respond to succinimides, clonazepam may be useful.
Clonazepam is may also an option for treating tardive dyskinesia, restless leg syndrome, rapid eye movement and burning mouth syndrome.
Adult Dose
Oral
Epilepsy
Adult: Initially, 1 mg given at night for 4 days, gradually increased over 2-4 weeks.
Maintenance: 4-8 mg/day. Max: 20 mg/day.
Panic disorder
Adult: Initially, 0.25 mg bid, increased after 3 days up to 1 mg/day.
Max: 4 mg/day.
Intravenous
Emergency management of status epilepticus
Adult: 1 mg by slow IV inj over at least 2 min or by infusion, repeated if necessary.
Max: 20 mg.
Child Dose
Oral
Epilepsy
Child: <10 yr or <30 kg: Initially, 0.01-0.03 mg/kg/day but not to exceed 0.05 mg/kg/day given in 2 or 3 divided doses.
May be increased by no more than 0.25-0.5 mg every 3rd day until seizure control is achieved.
Maintenance: 0.1-0.2 mg/kg/day divided 3 times daily. Max: 0.2 mg/kg/day.
>10 years or >30 kg
1.5 mg/day PO divided 8 hourly; increase by 0.5-1 mg every 3rd day until desired effect achieved; not to exceed 20 mg/day
Maintenance: 2-8 mg PO; not to exceed 20 mg/day
Intravenous
Emergency management of status epilepticus
Child: 500 mcg by slow IV inj or by infusion.
Elderly Dose
Oral
Epilepsy
Elderly: Initially, 0.5 mg once daily at night for 4 nights, dose to be increased over 2–4 weeks, usual dose 4–8 mg daily, adjusted according to response, dose usually taken at night;
May be given in 3–4 divided doses if necessary
Hepatic Dose
Hepatic impairment: Dosage adjustment may be needed.
Administration
May be taken with or without food.
Contra Indications
Patients who are hypersensitive to other benzodiazepines, this drug, or to any ingredient in the
formulation.
Severe respiratory insufficiency
Severe hepatic impairment as benzodiazepines, may precipitate hepatic encephalopathy.
Sleep apnea syndrome
Myasthenia gravis
Narrow angle glaucoma
Precautions
Concomitant use of benzodiazepines and opioids may result in profound sedation, respiratory depression, coma, and death. Reserve concomitant prescribing of these drugs for patients for whom alternative treatment options are inadequate. Limit dosages and durations to the minimum required. Follow patients for signs and symptoms of respiratory depression and sedation.
The use of benzodiazepines, including Clonazepam, exposes users to risks of abuse, misuse, and addiction, which can lead to overdose or death. Abuse and misuse of benzodiazepines commonly involve concomitant use of other medications, alcohol, and/or illicit substances, which is associated with an increased frequency of serious adverse outcomes. Before prescribing Clonazepam and throughout treatment, assess each patient’s risk for abuse, misuse, and addiction.
The continued use of benzodiazepines, including Clonazepam, may lead to clinically significant physical dependence. The risks of dependence and withdrawal increase with longer treatment duration and higher daily dose.
Abrupt discontinuation or rapid dosage reduction of Clonazepam after continued use may precipitate acute withdrawal reactions, which can be life-threatening.
To reduce the risk of withdrawal reactions, use a gradual taper to discontinue Clonazepam or reduce the dosage
Use caution in COPD, sleep apnea, renal/hepatic disease, open-angle glaucoma (questionable), depression, suicidal ideation
Not recommended in patients with depressed neuroses, psychotic reactions, severe respiratory depression, myasthenia gravis (allowable in limited circumstances), acute alcohol intoxication
Anterograde amnesia reported benzodiazepine use
May cause CNS depression and impairs ability to perform hazardous tasks
Hyperactive or aggressive behavior reported with benzodiazepines in pediatric/adolescent patients and in psychiatric patients
Increased risk of suicidal thoughts/behavior reported with antiepileptic agents; monitor patient for suicidal behavi
Pregnancy-Lactation
Not Classi
Pregnancy
There are no adequate and well-controlled studies of Klonopin in pregnant women; available human data on risk of teratogenicity are inconclusive; there is insufficient evidence in humans to assess effect of benzodiazepine exposure during pregnancy on neurodevelopment; administration of benzodiazepines immediately prior to or during childbirth can result in a syndrome of hypothermia, hypotonia, respiratory depression, and difficulty feeding; in addition, infants born to mothers who have taken benzodiazepines during later stages of pregnancy can develop dependence, and subsequently withdrawal, during the postnatal period
Data for other benzodiazepines suggest possibility of adverse developmental effects (long-term effects on neurobehavioral and immunological function) in animals following prenatal exposure to benzodiazepines
Lactation
Effects on breastfed infant and on milk production are unknown; developmental and health benefits of breastfeeding should be considered along with mother's clinical need for therapy and any potential adverse effects on breastfed infant from drug or from underlying maternal condition
Interactions
Additive depressant effect w/ TCAs, MAOIs, sedative and hypnotics, barbiturates, anxiolytics, antipsychotics, and opiate agonists.
May increase serum phenytoin levels.
Contraindicated (0)
Serious (32)
apalutamide
benzhydrocodone/acetaminophen
buprenorphine subdermal implant
buprenorphine transdermal
buprenorphine, long-acting injection
calcium/magnesium/potassium/sodium oxybates
carbamazepine
conivaptan
fentanyl
fentanyl intranasal
fentanyl iontophoretic transdermal system
fentanyl transdermal
fentanyl transmucosal
fexinidazole
hydrocodone
idelalisib
ivosidenib
lonafarnib
methohexital
metoclopramide intranasal
oliceridine
olopatadine intranasal
opicapone
remifentanil
selinexor
sodium oxybate
sufentanil SL
thalidomide
tolcapone
tucatinib
valerian
zuranolone
Adverse Effects
>10%
Somnolence (37%)
1-10%
Abnormal coordination (5-10%),Ataxia (5-10%),Depression (5-10%),Dizziness (5-10%),Fatigue (5-10%),Memory impairment (5-10%),Upper respiratory infection (5-10%),Confusion (1-5%),Dysarthria (1-5%),Rhinitis (1-5%),Coughing (1-5%),Urinary frequency (1-5%),Impotence (1-5%),Decreased libido (1-5%)
Frequency Not Defined
Increased salivation,Worsening tonic-clonic seizures
Potentially Fatal: Salivary or bronchial hypersecretion leading to respiratory problems (children). May produce diminished reflexes or coma. Rarely, blood dyscrasias.
Mechanism of Action
Clonazepam reduces the nerve transmission in the motor cortex which suppresses the spike and wave discharge in absence seizures. Its mechanism is believed to be related to its ability to enhance the activity of GABA. Clinically, it improves focal epilepsy and generalised seizures.
Note
Clonazepam 2mg Tablet manufactured by Albion Laboratories Ltd.. Its generic name is Clonazepam.