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Updated 11 February 2013

Clonazepam

Clonazepam is prescribed to manage and prevent seizures in epilepsy.

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Clonazepam is the active ingredient of Rivotril.

General Information

Clonazepam is prescribed to manage and prevent seizures in epilepsy. Its efficacy may however wane with long-term use and clonazepam is generally less effective for chronic use. It is often combined with other anti-epileptic drugs to add to its efficacy.

For clonazepam to be effective it has to be taken regularly. Take your doses regularly and try not to miss any.

Because clonazepam is a benzodiazepine drug it is also effective in treating panic attacks, anxiety and insomnia.

How does clonazepam work?

Clonazepam has an effect on gamma-aminobutyric acid (GABA). GABA is the brain's quieting or tranquilising neurotransmitter, possessing and inhibitive effect on the transmission of nerve signals. Clonazepam enhances the effect of GABA, thus slowing down the transmission of nerve signals responsible for triggering seizures.

Fast facts

Drug schedule: Schedule 5

Available as: Clonazepam is available as tablets, drops and injection.

What does it do? Clonazepam prevents and treats convulsions and reduces anxiety.

Overdose risk: Medium

Dependence risk: Medium

Is clonazepam available as a generic? No

Is clonazepam available on prescription only? Yes

User information

Onset of effect: Within 2 hours

Duration of action: Up to 24 hours

Stopping this medicine: Clonazepam should not be stopped abruptly. Sudden discontinuation may cause a return of symptoms and may lead to withdrawal symptoms. The dosage of clonazepam should be gradually reduced according to the advice of your doctor.

Prolonged use: Clonazepam's efficacy may wane with long-term use. A short course is generally prescribed.

Special precautions

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 a chronic lung disease
  • You have had a stroke or other brain disease
  • You have a mental illness or suffer from 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 cause serious adverse effects. Consult your doctor before use.

Infants and children: This medication is not often used in young children.

Elderly: Caution is advised in the elderly, as adverse effects may be more likely and severe.

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

Alcohol: Avoid concomitant use of alcohol with this medication, as it may increase the sedative effects of clonazepam.

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 clonazepam toxicity

Ketoconazole and other related antifungals

Increased possibility of clonazepam toxicity

Cimetidine

Increased possibility of clonazepam toxicity

Isoniazid

Increased possibility of clonazepam toxicity

Oral contraceptive

Increased possibility of clonazepam toxicity

Propranolol

Increased possibility of clonazepam toxicity

Valproic acid

Increased possibility of clonazepam toxicity

Isoniazid

Increased possibility of a clonazepam toxicity

Levodopa

Decreases levodopa's anti-Parkinson effect.

Probenecid

Increased possibility of clonazepam toxicity

Rifampicin

May decrease the effect of clonazepam.

Theophylline

May counteract the sedative effects of clonazepam.

Disease interactions

Consult your doctor before using this drug if you have acute closed-angle glaucoma, myasthenia gravis, liver or kidney disease, a history of alcohol or substance abuse, a chronic lung disease, a mental illness or depression, or if you suffer from sleep apnoea.

Overdose action

A small overdose is no cause for concern. In case of intentional large overdose seek emergency medical attention. Symptoms may include confusion, drowsiness, slower breathing and loss of consciousness.

Recommended dosage

Adults: 1-8 mg per day

Children: 0.05-0.3 mg/kg/day as prescribed by your paediatrician

 
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