Meds and you

Updated 11 February 2013

Clobazam

Clobazam is a long-acting tranquiliser prescribed for the treatment of moderate to severe anxiety and panic disorders, and for the treatment of certain types of epilepsy.

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Clobazam is the active ingredient of Urbanol.

General Information

Clobazam is a long-acting tranquiliser prescribed for the treatment of moderate to severe anxiety and panic disorders, and for the treatment of certain types of epilepsy. It is also prescribed as adjunctive treatment in schizophrenia and other psychotic disorders . Unlike the benzodiazepine alprazolam it does not possess any antidepressant qualities.

This benzodiazepine should in most case not be used for longer than 2-4 weeks, as tolerance and physical and psychological dependence can occur. Clobazam shares with other benzodiazepines the risk of abuse, misuse, psychological and/or physical dependence. It is not recommended that anxiety and tension related to everyday life be treated with clobazam. If prescribed for longer than 6 weeks your doctor should periodically reassess the need for clobazam.

How does clobazam work?

Clobazam has an effect on gamma-aminobutyric acid (GABA). GABA is the brain's quieting or tranquilising neurotransmitter, possessing an inhibitive effect on the transmission of nerve signals. Clobazam and other benzodiazepines enhance the effect of GABA, slowing down the transmission of nerve signals.

Fast facts

Drug schedule: Schedule 5

Available as: Clobazam is available as tablets and capsules.

What does it do? Clobazam has an anti-anxiety and anti-epileptic effect.

Overdose risk: Medium

Dependence risk: High

Is clobazam available as a generic? No

Is clobazam available on prescription only? Yes

User information

Onset of effect: Within 2-3 hours

Duration of action: Up to 12 hours

Dietary advice: Clobazam may be taken with or without food.

Stopping this medicine: Clobazam should not be stopped abruptly. Sudden discontinuation may lead to withdrawal symptoms. The dosage of Clobazam should be gradually reduced, following the advice of your doctor.

Prolonged use: Short-term therapy is advised and treatment should generally be no longer than 4 - 6 weeks, including a tapering off process. Tolerance has been noted with long term use. Do not take clobazam for longer periods unless strictly instructed by your doctor.

Special precautions

Never exceed the prescribed dose of clobazam.

Consult your doctor before using this drug if:

  • You have a known hypersensitivity to benzodiazepines
  • You have acute closed-angle glaucoma
  • You have myasthenia gravis
  • You have liver or kidney disease
  • You have a history of alcohol or substance abuse
  • You have chronic lung disease
  • You suffer from epilepsy
  • You suffer from mental illness or depression
  • You suffer from sleep apnoea.

Pregnancy: Avoid. Potential risk to the foetus has been reported. Consult your doctor before use, or if you are planning to fall pregnant.

Breastfeeding: Avoid. This medication is passed through breast milk and may affect your baby adversely. Consult your doctor before use.

Porphyria: Avoid. This medication may have serious adverse effects. Consult your doctor before use.

Infants and children: This medication is not intended for use in children. If prescribed, the dose should be calculated by your paediatrician.

Elderly: Use with caution as side effects may be emphasised. Dosage may need adjustment.

Driving and hazardous work: This medication should be avoided, as it may cause extreme sedation.

Alcohol: Clobazam's effect may intensify the effect of alcohol and vice versa. Do not consume alcohol while taking this medication, as side effects may be drastically pronounced.

Possible side effects:

Side effect

Frequency

Consult your doctor

Common

Rare

Only if severe

In all cases

Drowsiness

x

x

Loss of coordination/dizziness

x

x

Slurred speech

x

x

Change in libido

x

x

Fever/chills

x

x

Extreme fatigue

x

x

Nausea/vomiting

x

x

Rash/itching

x

x

Anger/behaviour changes

x

x

Yellow tinge: eyes/skin

x

x

Bruising/bleeding

x

x

Interactions:

Drug interactions:

Alcohol, antihistamines, antidepressants, other benzodiazepines, narcotics

Increased depression of central nervous system (CNS)

Digoxin

Increased possibility of digoxin toxicity

Disulfiram

Increased possibility of clobazam toxicity

Ketokonazole and other related antifungals

Increased possibility of clobazam toxicity

Cimetidine

Increased possibility of clobazam toxicity

Isoniazid

Increased possibility of clobazam toxicity

Oral contraceptive

Increased possibility of clobazam toxicity

Propranolol

Increased possibility of clobazam toxicity

Valproic acid

Increased possibility of clobazam toxicity

Isoniazid

Increased possibility of a clobazam toxicity

Levodopa

Decreases levodopa's anti-Parkinson effect.

Probenecid

Increased possibility of clobazam toxicity

Rifampicin

May decrease the effect of clobazam.

Theophylline

May counteract the sedative effects of clobazam.

Disease interactions

Consult your doctor before using this drug if you have acute closed-angle glaucoma, myasthenia gravis or liver or kidney disease; also chronic lung disease, epilepsy, mental illness or depression, or sleep apnoea.

Overdose action

An overdose of clobazam can be serious. Seek immediate emergency medical attention. Symptoms may include poor coordination, slow breathing, tremors, drowsiness, slurred speech, confusion, slow reflexes and loss of consciousness.

Recommended dosage

10-30 mg/day strictly as prescribed by your doctor

 

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