Clonazepam

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Clonazepam uses


Pharmacological action

Clonazepam is an antiepileptic drugs from the group of benzodiazepine derivatives. This medication has a pronounced anticonvulsant and central muscle relaxant, anxiolytic, sedative and hypnotic effects.

Clonazepam strengthens the inhibitory effect of GABA on the transmission of nerve impulses.

Anxiolytic effects of this drug is due to the influence on the amygdaloid complex of the limbic system and appears in reducing the emotional stress, reduce anxiety, fear, anxiety.

The sedation effects is due to the influence on the reticular formation of the brainstem and nonspecific thalamic nucleus and manifests a decrease in neurotic symptoms.

Anticonvulsant effect is realized by increasing presynaptic inhibition.

The central muscle relaxant effect is due to inhibition of spinal polysynaptic afferent inhibitory ways (to a lesser extent and monosynaptic).

It is possibly and direct inhibition of motor nerves and muscle function.

Pharmacokinetics

For oral administration of Clonazepam its bioavailability is more than 90%. The plasma protein binding is more than 80%. Vd is 3.2 L / kg. T1/2 is 23 hours. This drug is excreted mainly as metabolites.

Why is Clonazepam prescribed?

As the medication of I row - epilepsy : typical absence seizures (petit mal), atypical absence seizures (Lennox-Gastaut syndrome), nodding spasm, atonic seizures (a syndrome of "falling" or "drop-attacks").

As the medication of II row - infantile spasms (West syndrome).

As the medication of III row - tonic-clonic seizures (grand mal), simple and complex partial seizures and secondary generalized tonic-clonic seizures.

Status epilepticus (IV injections).

Somnambulism, muscular hypertonicity, insomnia (especially in patients with organic brain damage), psychomotor agitation, alcohol withdrawal syndrome (acute agitation, tremor, threatening or acute delirium tremens and hallucinations), panic disorder.

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Dosage and administration

Dosing regimen of Clonazepam is individual. For oral administration for adults the recommended initial dose is not more than 1 mg / day. The maintenance dose is 4-8 mg / day.

For infants and children aged 1-5 years, the initial dose should not exceed 250 micrograms / day, for children aged 5-12 years - 500 mcg / day. Supporting daily doses for children under 1 year are 0.5-1 mg, 1-5 years - 1-3 mg, 5-12 years - 3-6 mg.

For elderly patients the recommended starting dose is not exceeding 500 micrograms.

The daily dose should be divided into 3-4 equal doses. Maintenance doses prescribed in 2-3 weeks of treatment.

IV (slowly) for adults - 1 mg, for children under the age of 12 years - 500 mcg.

Clonazepam side effects, adverse reactions

CNS: early treatment - severe lethargy, fatigue, drowsiness, weakness, dizziness, stupor, headache; rarely - confusion, ataxia. When used in high doses, especially in long-term treatment - violation of articulation, diplopia, nystagmus, paradoxical reactions ; anterograde amnesia. Rarely - hyperergic reactions, muscle weakness - depression. With long-term treatment of some forms of epilepsy may increase the frequency of seizures.

Digestive system: rarely - dry mouth, nausea, diarrhea, heartburn, nausea, vomiting, decreased appetite, constipation or diarrhea, liver damage, elevated liver transaminases and alkaline phosphatase, jaundice. In infants and young children may increase salivation.

Cardiovascular system: decreased blood pressure, tachycardia.

Endocrine: changes in libido, dysmenorrhea, reversible premature sexual development in children (part-time early puberty).

Respiratory system: with / in the introduction possible respiratory depression, particularly after treatment with other medicines that cause respiratory depression; in infants and young children it is possible bronchial hypersecretion.

Hematopoietic system: leukopenia, neutropenia, agranulocytosis, anemia, and thrombocytopenia.

Urinary system: urinary incontinence, urinary retention, impaired renal function.

Allergic reactions: hives, skin rash, itching, extremely rare - anaphylactic shock.

Dermatological reactions: transient alopecia, discoloration.

Other: addiction, drug dependence, with a sharp decrease in dose or cessation of reception - a withdrawal syndrome.

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Clonazepam contraindications

Inhibition of the respiratory center, severe COPD (the progression of the degree of respiratory failure), acute respiratory failure, myasthenia gravis, coma, shock, angle-closure glaucoma (acute attack or predisposition), acute alcohol intoxication with the weakening of the vital functions, acute poisoning with narcotic analgesics and hypnotics, severe depression (suicidal tendencies may occur), pregnancy, lactation, hypersensitivity to Clonazepam.

Using during pregnancy and breastfeeding

Clonazepam is contraindicated for use during pregnancy and lactation. This medication crosses the placental barrier. Clonazepam may be excreted in breast milk.

Category effects on the fetus by FDA - D.

Special instructions

With caution used in patients with ataxia, severe liver disease, severe chronic respiratory failure, especially in the acute stage of deterioration, with episodes of sleep apnea.

With careful use in elderly patients because they may be slowed by removal of Clonazepam and reduced tolerance, especially in the presence of cardio-pulmonary insufficiency.

With prolonged use of this drug it may develop drug dependence. With a sharp lifting of Clonazepam after long-term treatment it may been developed the withdrawal syndrome.

In long-term use of Clonazepam in children should be kept in mind the possibility of side effects on physical and mental development, which may not manifest for years.

During the period of treatment avoid to drink alcohol.

During the period of treatment is observed slowing of psychomotor responses. It is necessary to take into account persons engaged in potentially hazardous activities that require attention and quickness of psychomotor reactions.

Clonazepam drug interactions

Simultaneous administration of Clonazepam with:

  • drugs providing a depressing effect on the CNS, ethanol, ethanol containing drugs may increase the CNS depressant effects.
  • Clonazepam enhances the action of muscle relaxants, with valproate sodium reducing sodium valproate and the provocation of seizures.
  • described the case to reduce the concentration of desipramine in plasma in 2 times and its increase after withdrawal of Clonazepam.
  • carbamazepine which causes the induction of microsomal liver enzymes may increase metabolism and the resulting decrease in concentration of Clonazepam in plasma.
  • caffeine may reduce sedative and anxiolytic effects of Clonazepam, with lamotrigine - may decrease the concentration of Clonazepam in plasma, with lithium carbonate - the development of neurotoxicity.
  • primidone increases its concentration in blood plasma, with tiapride - possibly the development of NMS.
  • toremifene it is possible significant reduction in AUC and T1/2 of toremifene in connection with the induction of liver enzymes under the influence of Clonazepam which leads to faster metabolism of toremifene.
  • may increase the concentration of phenytoin in blood plasma and the development of toxic reactions, its reduction or absence of these changes.
  • cimetidine increases the side effects of the CNS, however, the frequency of seizures in some patients decreased. There was described a case of headache with localization in the occipital region, while the application with phenelzine.

    Clonazepam in case of emergency / overdose

    Symptoms: CNS depression of varying severity (from lethargy to coma): severe drowsiness, prolonged confusion, depression of reflexes, coma, possible respiratory depression.

    Treatment: induction of vomiting and the prescription of activated charcoal (if the patient is conscious), gastric lavage through a tube (if patient is unconscious), symptomatic therapy, monitoring of vital functions (breathing, pulse, blood pressure), in intravenous fluids (to increase urine output), if necessary, mechanical ventilation. As a specific antidote may be used benzodiazepine receptor antagonist flumazenil (in hospital), however, flumazenil is not indicated for use in patients with epilepsy (likely provocation of epileptic seizures).

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    Clonazepam pharmaceutical active ingredients containing related brand and generic drugs:

    Active ingredient is the part of the drug or medicine which is biologically active. This portion of the drug is responsible for the main action of the drug which is intended to cure or reduce the symptom or disease. The other portions of the drug which are inactive are called excipients; there role is to act as vehicle or binder. In contrast to active ingredient, the inactive ingredient's role is not significant in the cure or treatment of the disease. There can be one or more active ingredients in a drug.


    Clonazepam available forms, composition, doses:

    Form of the medicine is the form in which the medicine is marketed in the market, for example, a medicine X can be in the form of capsule or the form of chewable tablet or the form of tablet. Sometimes same medicine can be available as injection form. Each medicine cannot be in all forms but can be marketed in 1, 2, or 3 forms which the pharmaceutical company decided based on various background research results.
    Composition is the list of ingredients which combinedly form a medicine. Both active ingredients and inactive ingredients form the composition. The active ingredient gives the desired therapeutic effect whereas the inactive ingredient helps in making the medicine stable.
    Doses are various strengths of the medicine like 10mg, 20mg, 30mg and so on. Each medicine comes in various doses which is decided by the manufacturer, that is, pharmaceutical company. The dose is decided on the severity of the symptom or disease.

    Price
    Apo-Clonazepam 0.5 mg Tablet0.12 USD
    Apo-Clonazepam 2 mg Tablet0.21 USD
    ClonazePAM ODT 0.125 mg Dispersible Tablet1.17 USD
    ClonazePAM ODT 0.25 mg Dispersible Tablet1.22 USD
    ClonazePAM ODT 0.5 mg Dispersible Tablet1.18 USD
    ClonazePAM ODT 1 mg Dispersible Tablet1.1 USD
    ClonazePAM ODT 2 mg Dispersible Tablet1.67 USD
    Clonazepam 0.5 mg tablet0.61 USD
    Clonazepam 1 mg tablet0.63 USD
    Clonazepam 2 mg tablet0.81 USD
    Co Clonazepam 0.5 mg Tablet0.12 USD
    Co Clonazepam 1 mg Tablet0.19 USD
    Co Clonazepam 2 mg Tablet0.21 USD
    Klonopin 0.5 mg tablet1.91 USD
    Klonopin 1 mg tablet2.17 USD
    Klonopin 2 mg tablet2.85 USD
    Mylan-Clonazepam 0.5 mg Tablet0.12 USD
    Mylan-Clonazepam 2 mg Tablet0.21 USD
    Novo-Clonazepam 0.5 mg Tablet0.12 USD
    Novo-Clonazepam 2 mg Tablet0.21 USD
    Phl-Clonazepam 0.5 mg Tablet0.12 USD
    Phl-Clonazepam 1 mg Tablet0.19 USD
    Phl-Clonazepam 2 mg Tablet0.21 USD
    Phl-Clonazepam-R 0.5 mg Tablet0.12 USD
    Pms-Clonazepam 0.25 mg Tablet0.07 USD
    Pms-Clonazepam 0.5 mg Tablet0.12 USD
    Pms-Clonazepam 1 mg Tablet0.19 USD
    Pms-Clonazepam 2 mg Tablet0.21 USD
    Pms-Clonazepam-R 0.5 mg Tablet0.12 USD
    Ratio-Clonazepam 0.5 mg Tablet0.12 USD
    Ratio-Clonazepam 2 mg Tablet0.21 USD
    Rivotril 0.5 mg Tablet0.22 USD
    Rivotril 2 mg Tablet0.38 USD
    Sandoz Clonazepam 0.5 mg Tablet0.12 USD
    Sandoz Clonazepam 1 mg Tablet0.19 USD
    Sandoz Clonazepam 2 mg Tablet0.21 USD
    Tablets, Film-Coated; Oral; Clonazepam 0.5 mg
    Tablets, Film-Coated; Oral; Clonazepam 2 mg
    Tablets, Orally Disintegrating; Oral; Clonazepam 0.125 mg
    Tablets, Orally Disintegrating; Oral; Clonazepam 0.25 mg
    Tablets, Orally Disintegrating; Oral; Clonazepam 0.5 mg
    Tablets, Orally Disintegrating; Oral; Clonazepam 1 mg
    Tablets, Orally Disintegrating; Oral; Clonazepam 2 mg
    Tablets; Oral; Clonazepam 0.5 mg
    Tablets; Oral; Clonazepam 1 mg
    Tablets; Oral; Clonazepam 2 mg
    Tablets; Orally Disintegrating; Oral; Clonazepam 0.125 mg
    Tablets; Orally Disintegrating; Oral; Clonazepam 0.25 mg
    Tablets; Orally Disintegrating; Oral; Clonazepam 0.5 mg
    Tablets; Orally Disintegrating; Oral; Clonazepam 1 mg
    Tablets; Orally Disintegrating; Oral; Clonazepam 2 mg

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    Clonazepam destination | category:

    Destination is defined as the organism to which the drug or medicine is targeted. For most of the drugs what we discuss, human is the drug destination.
    Drug category can be defined as major classification of the drug. For example, an antihistaminic or an antipyretic or anti anginal or pain killer, anti-inflammatory or so.


    Clonazepam Anatomical Therapeutic Chemical codes:

    A medicine is classified depending on the organ or system it acts [Anatomical], based on what result it gives on what disease, symptom [Therapeutical], based on chemical composition [Chemical]. It is called as ATC code. The code is based on Active ingredients of the medicine. A medicine can have different codes as sometimes it acts on different organs for different indications. Same way, different brands with same active ingredients and same indications can have same ATC code.


    Clonazepam pharmaceutical companies:

    Pharmaceutical companies are drug manufacturing companies that help in complete development of the drug from the background research to formation, clinical trials, release of the drug into the market and marketing of the drug.
    Researchers are the persons who are responsible for the scientific research and is responsible for all the background clinical trials that resulted in the development of the drug.


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    References

    1. Dailymed."CLONAZEPAM TABLET [MAJOR PHARMACEUTICALS]". https://dailymed.nlm.nih.gov/dailym... (accessed August 28, 2018).
    2. Dailymed."CLONAZEPAM: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailym... (accessed August 28, 2018).
    3. "clonazepam". https://pubchem.ncbi.nlm.nih.gov/co... (accessed August 28, 2018).

    Frequently asked Questions

    Can i drive or operate heavy machine after consuming Clonazepam?

    Depending on the reaction of the Clonazepam after taken, if you are feeling dizziness, drowsiness or any weakness as a reaction on your body, Then consider Clonazepam not safe to drive or operate heavy machine after consumption. Meaning that, do not drive or operate heavy duty machines after taking the capsule if the capsule has a strange reaction on your body like dizziness, drowsiness. As prescribed by a pharmacist, it is dangerous to take alcohol while taking medicines as it exposed patients to drowsiness and health risk. Please take note of such effect most especially when taking Primosa capsule. It's advisable to consult your doctor on time for a proper recommendation and medical consultations.

    Is Clonazepam addictive or habit forming?

    Medicines are not designed with the mind of creating an addiction or abuse on the health of the users. Addictive Medicine is categorically called Controlled substances by the government. For instance, Schedule H or X in India and schedule II-V in the US are controlled substances.

    Please consult the medicine instruction manual on how to use and ensure it is not a controlled substance.In conclusion, self medication is a killer to your health. Consult your doctor for a proper prescription, recommendation, and guidiance.

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    Review

    sdrugs.com conducted a study on Clonazepam, and the result of the survey is set out below. It is noteworthy that the product of the survey is based on the perception and impressions of the visitors of the website as well as the views of Clonazepam consumers. We, as a result of this, advice that you do not base your therapeutic or medical decisions on this result, but rather consult your certified medical experts for their recommendations.

    Visitor reports

    Visitor reported useful

    No survey data has been collected yet

    One visitor reported side effects

    Did you get side effects while taking the Clonazepam drug, or were there no side effects?
    According to the survey conducted by website sdrugs.com users, the below-mentioned percentages indicate the number of people experiencing the side effects and the number of people not experiencing the side effects when taking Clonazepam medicine. Every drug produces minimal side effects, and they are negligible most times, when compared to the desired effect [use] of the medicine. Side effects depend on the dose you are taking, any drug interactions that happen when you are on other medications, if the patient is sensitive, and other associated conditions. If you cannot tolerate the side effects, consult your doctor immediately, so he can either adjust the dose or change the medication.
    Visitors%
    No side effects1
    100.0%

    One visitor reported price estimates

    What is your opinion about drug cost? Did you feel the cost is apt, or did you feel it is expensive?
    The report given by the sdrugs.com website users shows the following figures about several people who felt the medicine Clonazepam is expensive, and the medicine is not expensive. The results are mixed. The perception of the cost of the medicine to be expensive or not depends on the brand name of the medicine, country, and place where it is sold, and the affordability of the patient. You can choose a generic drug in the place of the branded drug to save the cost. The efficiency of the medicine will not vary if it is generic or a branded one.
    Visitors%
    Not expensive1
    100.0%

    One visitor reported frequency of use

    How often in a day do you take the medicine?
    Are you taking the Clonazepam drug as prescribed by the doctor?

    Few medications can be taken Twice in a day more than prescribed when the doctor's advice mentions the medicine can be taken according to frequency or severity of symptoms. Most times, be very careful and clear about the number of times you are taking the medication. The report of sdrugs.com website users about the frequency of taking the drug Clonazepam is mentioned below.
    Visitors%
    Twice in a day1
    100.0%

    Six visitors reported doses

    What is the dose of Clonazepam drug you are taking?
    According to the survey conducted among sdrugs.com website users, the maximum number of people are using the following dose 1-5mg. Few medications come in only one or two doses. Few are specific for adult dose and child dose. The dose of the medicine given to the patient depends on the severity of the symptom/disease. There can be dose adjustments made by the doctor, based on the progression of the disease. Follow-up is important.
    Visitors%
    1-5mg6
    100.0%

    Visitor reported time for results

    No survey data has been collected yet

    One visitor reported administration

    The drugs are administered in various routes, like oral or injection form. They are administered before food or after food. How are you taking Clonazepam drug, before food or after food?
    Click here to find out how other users of our website are taking it. For any doubts or queries on how and when the medicine is administered, contact your health care provider immediately.
    Visitors%
    After food1
    100.0%

    Three visitors reported age

    Visitors%
    46-601
    33.3%
    30-451
    33.3%
    6-151
    33.3%

    Visitor reviews


    There are no reviews yet. Be the first to write one!


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    The information was verified by Dr. Arunabha Ray, MD Pharmacology

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