CLONAZEPAM

Benzodiazepine with antiepileptic activity

Dosage Forms

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Tablet

2 mg

Uses

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  • Treatment of all forms of epilepsy

Dose and Duration

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Treatment of epilepsy
Adult and child above 12 years:1 mg (0.5 mg in elderly) once a day at night for 4 nights, increased according to response over 2–4 weeks to usual maintenance dose of 4–8 mg at night. If necessary, give in 3–4 divided doses
Child 5-12 years: 0.5 mg increased as above to the usual maintenance dose of 3–6 mg
Child 1-5 years:0.25 mg increased as above to the usual maintenance dose of 1–3 mg
Child up to 1 year: 0.25 mg increased as above to usual maintenance dose of 0.5–1 mg

Contraindications

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  • Respiratory depression
  • Acute pulmonary insufficiency
  • Sleep apnoea syndrome
  • Marked neuromuscular respiratory weakness including myasthenia gravis
  • Coma
  • Current alcohol or drug abuse
  • Severe hepatic insufficiency

Side Effects

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  • Drowsiness, fatigue, dizziness, poor concentration, restlessness
  • Ataxia, muscle hypotonia, co-ordination disturbances
  • Confusion, amnesia
  • Dependence
  • Salivary or bronchial hypersecretion in infants and small children
  • Nystagmus

Interactions

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  • Clozapine (serious adverse events)
  • Sodium oxybate (effects of sodium oxybate enhanced)

Pregnancy

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  • Can be used

Breastfeeding

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  • Can be used

⚠️ Caution

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  • Patients may need to be maintained on a specific brand or generic product
  • Use the lowest effective dose for the shortest needed time
  • The effect of clonazepam may decrease significantly after weeks or months of continued therapy
  • Avoid use in hepatic failure due to risk of coma
  • Use lower doses in renal impairment because patients have increased cerebral sensitivity
  • ARisk of neonatal withdrawal symptoms when used during pregnancy. Only use if there is a clear indication such as seizure control. High doses taken during late pregnancy may cause neonatal hypothermia, hypotonia, and respiratory depression