Clonazepam(kloe na’ ze pam)
Apo-Clonazepam (CAN), CO Clonazepam (CAN), Gen-Clonazepam (CAN), Klonopin, PMS-Clonazepam (CAN), ratio-Clonazepam (CAN), Rivotril (CAN)
PREGNANCY CATEGORY D
CONTROLLED SUBSTANCE C-IV
Drug Classes
Antiepileptic
Benzodiazepine
Therapeutic Actions
Exact mechanisms not understood; benzodiazepines potentiate the effects of GABA, an inhibitory neurotransmitter.
Indications
Used alone or as adjunct in treatment of Lennox-Gastaut syndrome (petit mal variant), akinetic and myoclonic seizures; may be useful in patients with absence (petit mal) seizures who have not responded to succinimides; up to 30% of patients show loss of anticonvulsant activity of drug, often within 3 mo of therapy (may respond to dosage adjustment)
Treatment of panic disorder with or without agoraphobia
Unlabeled uses: Periodic leg movements during sleep; hypokinetic dysarthria; acute manic episodes; multifocal tic disorders; neuralgias; adjunct in managing schizophrenia
Contraindications and Cautions
Contraindicated with hypersensitivity to benzodiazepines, psychoses, acute narrow-angle glaucoma, shock, coma, acute alcoholic intoxication with depression of vital signs; pregnancy (risk of congenital malformations, neonatal withdrawal syndrome), labor and delivery (“floppy infant” syndrome), lactation (infants become lethargic and lose weight).
Use cautiously with hepatic or renal impairment, debilitation; elderly patients.
Available Forms
Tablets—0.5, 1, 2 mg; orally disintegrating tablets—0.125, 0.25, 0.5, 1, 2 mg
Dosages
Individualize dosage; increase dosage gradually to avoid adverse effects; drug is available only in oral dosage forms.
Adults
Seizure disorders: Initial dose should not exceed 1.5 mg/day PO divided into three doses; increase in increments of 0.5–1 mg PO every 3 days until seizures are adequately controlled or until side effects preclude
further increases. Maximum recommended dosage is 20 mg/day.
Panic disorders: Initial dose 0.25 mg PO bid; gradually increase to a target dose of 1 mg/day. Do not exceed 4 mg/day.
Pediatric patients at least 10 yr or 30 kg
Initially, 0.01–0.03 mg/kg/day PO; do not exceed 0.05 mg/kg/day PO, given in two or three doses. Increase dosage by not more than 0.25–0.5 mg every third day until a daily maintenance dose of 0.1–0.2 mg/kg has been reached, unless seizures are controlled by lower dosage or side effects preclude increases. Whenever possible, divide daily dose into three equal doses, or give largest dose at bedtime.
Stay updated, free articles. Join our Telegram channel
Full access? Get Clinical Tree
