Zodiac

Indications

Clonazepam is used to control several types of epilepsy (seizures), including absence seizures and myoclonic jerks. It is also used for panic disorder, with or without fear of open or crowded places. Doctors may use it for other conditions, such as some movement or sleep disorders, as prescribed. It is a controlled medicine and should only be used with a prescription.

How It Works

Clonazepam is a benzodiazepine. It boosts the effect of GABA, a natural chemical that calms nerve activity in the brain. This helps prevent seizures and reduces panic and anxiety.

Dosage and Administration

Doses are set by the doctor and depend on the condition. Treatment usually starts with a low dose, for example 0.25 mg to 0.5 mg once or twice a day in adults, and is raised slowly over several weeks until it works. Older people often need lower doses. Children: as prescribed by weight. Take it at the same times each day and never take more than prescribed. Do not stop suddenly; the doctor will lower the dose slowly.

Interactions

Alcohol, opioid painkillers and cough medicines, sleeping tablets, other sedatives, sedating antihistamines, some antidepressants and antipsychotics can cause dangerous drowsiness and slow breathing when taken with Clonazepam. Other epilepsy medicines such as Carbamazepine, Phenytoin and Phenobarbital can lower its level, and it may change their levels. Using it with Sodium Valproate may rarely cause a type of prolonged absence seizure. Tell your doctor about all medicines you take.

Contraindications

• Allergy to Clonazepam or other benzodiazepines.
• Severe breathing problems or sleep apnoea (stopping breathing during sleep).
• Severe liver disease.
• Myasthenia gravis (a muscle weakness disease).
• Coma, or current alcohol or drug intoxication.

Side Effects

Common: drowsiness, tiredness, dizziness, poor coordination, unsteady walking, and problems with memory and concentration. Children may have increased saliva or become restless or irritable.

Get urgent medical help if you have:

• Slow, shallow or difficult breathing, or extreme sleepiness that is hard to wake from.
• New or worse low mood, agitation, aggression or thoughts of harming yourself.
• More frequent or longer seizures.
• Swelling of the face or throat, or a severe rash.
• Yellow skin or eyes, or unusual bruising.

Pregnancy and Lactation

Talk to your doctor before planning a pregnancy. Clonazepam may affect the unborn baby, and use near delivery can make the newborn floppy, sleepy or have withdrawal symptoms. If you have epilepsy, do not stop it on your own if you become pregnant, as seizures are also risky; see your doctor quickly. It passes into breast milk and can make the baby sleepy, so breastfeeding is usually not advised while taking it.

Precautions and Warnings

Clonazepam can cause dependence, especially with high doses or long use. Stopping suddenly can cause withdrawal symptoms such as anxiety, sleep problems and seizures. Do not drink alcohol. Do not drive or operate machinery if you feel drowsy. Use with care in older people (risk of falls), and in people with lung, liver or kidney disease, depression, or a past history of alcohol or drug misuse. Keep it safely stored and never share it.

Overdose

Too much can cause deep sleepiness, confusion, slurred speech, poor balance, slow breathing and coma. The danger is much greater when taken with alcohol or opioids. This is an emergency; seek medical help at once.

Therapeutic Class

Benzodiazepine (antiepileptic and anti-panic medicine).

Storage

Store below 30°C in a dry place, away from light, in a safe place out of the reach of children.