Clonazepam
Commercial names and formulations:
Brand name: Klonopin, Ceberclon, Valpax
Formulations: Tablet, Wafer
How to store it?
Store at room temperature
What does the body do to the medication?
Can I take it with food?
Yes
How long does it take to get to the blood after I take it?
1–2 hours
How long does it take to start having a steady effect?
Unknown
Can this medication be started at a high dose or it has to be started gradually?
Gradually
How long does it stay in the body?
About 1-2 days
How is it eliminated?
Liver
What does the medication do to the body?
Type of epilepsy that helps:
Partial and Generalized Epilepsy
FDA approved for:
Lennox-Gastaut syndrome, myoclonic seizures and absence seizures
Common side effects:
• Skin: hair loss, abnormal hair growth, skin rash
• Bones: none
• Blood: anemia, decrease in white blood cells, decrease in platelets
• Liver: swelling of the liver, increase in liver enzymes
• Kidneys: none
• Stomach and intestines: weight loss, constipation, diarrhea, dry mouth, increased appetite, nausea, sore gums, dehydration
• Heart: palpitations
• Brain: abnormal eye movements, coma, difficulty speaking, “glassy-eyed” appearance, headache, slurred speech, tremor, vertigo, difficulty with memory
• Mood: excitability, irritability, aggressive behavior, agitation, nervousness, hostility, anxiety, depression
• Others: confusion, hallucinations, hysteria, increased libido, difficulty sleeping, nightmares, vivid dreams, chest congestion, shortness of breath, ankle and facial edema, muscle weakness, blurred vision
Serious side effects:
Risk of suicidal thoughts or behavior, excessive sleepiness leading to breathing difficulty
What happens if I get too much of it (intoxication)?
Symptoms may include drowsiness, confusion, coma and diminished reflexes. Could be fatal if combined with alcohol or barbiturates.
What happens if I stop it suddenly (withdrawal)?
You should not stop taking the medication suddenly. Withdrawal symptoms may include increased seizures and status epilepticus.
Who should not take this medication?
Clonazepam should be used with caution in patients with significant liver or kidney disease, acute narrow angle glaucoma, or allergies to the ingredients in the medication. Caution should be used when combined with a barbiturate.
What is the average dose and how many times a day should be given?
Children: initial 0.01-0.03 mg/kg/day (in divided doses); maintenance 0.1-0.2 mg/kg/day
Adults: initial .25 mg/day; maintenance 4-20 mg/day (in divided doses)
Does the body get used to the medication?
Yes
Medications to be careful with:
Other AEDs that can increase the blood level of clonazepam:
None anticipated
Other AEDs that can decrease the blood level of clonazepam:
None anticipated
Other drug interactions:
The actions of the benzodiazepines may be potentiated by barbiturates, narcotics, phenothiazines, monoamine oxidase inhibitors or other antidepressants.
Blood work required?
CBC and CPM?
Yes
How often?
Periodic blood counts and liver function tests are recommended.
Are medication levels in blood useful?
No
Women’s health
Affects contraceptives?
No
Affect fertility?
No
Are safe in pregnancy?
It is not recommended that pregnant women take clonazepam.
Category
Pregnancy category D
Can breastfeed?
Unknown
Affect bones (osteoporosis)?
No
Men’s health
Affects sexual performance?
No
Affects fertility?
No
Use other than epilepsy:
Panic disorder, Anxiety, non-epileptic myoclonus