Clonazepam: Uses, Dosage and Side effects

Overview

What is Clonazepam?

Clonazepam is a prescription drug to treat seizure disorders in children and adults. It is also used to manage panic disorders in adults. It is an active drug that belongs to the drug class known as benzodiazepines.

Seizure disorders are when the brain cells have sudden uncontrolled electrical activity in the brain cells leading to behavioral changes and abrupt body movements. Panic disorders are characterized by abrupt, severe dread and discomfort.

Clonazepam is the generic form of the drug, i.e., it contains the same ingredients as the trade-name drug. Clonazepam is also available in its trade name form as Klonopin, Ceberclon, and Rivotril. Clonazepam drugs might be prescribed alone or with other medications to treat medical conditions.

In 1997, the FDA (The Food and drug administration, United States) approved Clonazepam as a generic drug¹Overview| Researched based study from Sciencedirect.com

Working of Clonazepam

• Clonazepam increases the activity of the GABA (gamma-aminobutyric acid) compound.
• GABA is the brain’s chemical messenger. It helps the nervous system calm down by controlling the nerve cell’s over activity in cases of fear, stress, and anxiety.
• A person taking Clonazepam medication will have more GABA in the body and thus help them have fewer seizures and panic attacks ²Overview| Researched based study from Nlm.nih.gov

Uses

Uses of Clonazepam

Clonazepam is used for the following conditions:

• Seizure disorders in children, adults, and infants
• It is also used for akinetic seizures, myoclonic seizures, Lennox-Gastaut syndrome, and Petit mal seizures.
• Management of Panic disorders with or without agoraphobia (fear of situation where escape might not be possible)
• The doctor might also prescribe Clonazepam for other non-approved conditions ⁴Uses| Researched based study from Nlm.nih.gov

Dosage

Dosage of Clonazepam

One must take Clonazepam oral tablets as prescribed by the physician. However, some of the commonly prescribed doses are mentioned:

Panic disorder dosage

Adults (18 years to 64 years)

• Starting dose- 0.25 mg twice daily
• Gradually increased dose-0.5 mg twice daily after three days
• Maximum dose- 4mg daily

Dose reduction when trying to stop the medication

• Dose reduction- 0.125 mg every three days

Older adults (65 years and above)

• Depending on the medical condition, the doctors may start the medication at a lowered dose.

Seizure disorder dosage

Adult (18 years to 64 years)

• Starting dose- 0.5 mg thrice daily
• Gradually increase dose-0.5 to 1 mg every three days until the seizure is controlled.
• Maximum dose- 20 mg daily in divided dose

Adolescent (11 to 17 years)

• Starting dose- 0.5 mg thrice daily
• Gradually increase dose-0.5 to 1 mg every three days until the seizure is controlled.
• Maximum dose- 20 mg daily in divided dose

Children (below ten years /weight 30 kg or less)

• Starting dose- 0.01to 0.03 (mg/kg body weight) daily
• Gradually increased dose-0.25 to 0.5 mg every three days until the seizure are controlled
• Maximum amount- 0.1 to 0.2 (mg/kg body weight) daily in divided dose

Older adults (65 years and above)

• Depending on the medical condition, the doctors may start the medication at a lowered dose ³Dosage| Researched based study from Nlm.nih.gov

Side effects

Side effects of Clonazepam

Common side effects

• Headache
• Sleepiness
• Lightheadedness
• Tiredness
• Depression
• Walking and coordination problem
• Memory problem
• Weight changes (gain or loss)

Serious side effects

• Slow breathing rate
• Severe depression with suicidal thoughts
• Worsening seizure disorder symptoms
• Blood clotting problem
• Difficulty in urinating
• Low blood pressure
• Vision problem
• Irregular or painful periods
• Chest pain
• Irregular heartbeat
• Loss of consciousness and faint
• Addiction
• Itching
• Hives
• Skin rash
• Swelling in the lips, tongue, throat, and mouth
• Difficult breathing ⁵Side effects| Researched based study from Nlm.nih.gov

Formulations

Formulation of Clonazepam

Clonazepam is available in two forms:

• Oral tablets that one can swallow in the strength 0.5 milligram(mg), 1 mg, 2 mg
• Oral disintegrating tablets that quickly dissolve in the mouth-in the strength 0.125 mg,0.25 mg,0.5 mg,1 mg, 2 mg

Klonopin (trade name) is available in Oral tablets form in the strength of 0.5 mg, 1 mg, 2 mg ⁵Formulations| Researched based study from Nlm.nih.gov

How to use Clonazepam?

• A doctor prescribes Clonazepam tablet dosage depending on factors such as the person’s age, the severity of the medical condition, and other medications already in use.
• A doctor starts with a lower dose and then gradually adjusts it to the amount suitable for the patient. While stopping the medication, the doctor slowly lowers the dose over time before discontinuing it to avoid withdrawal symptoms such as vomiting, sweating, diarrhea, tremor, and stomach pain.

Taking Clonazepam tablets

• One can swallow the Clonazepam oral tablet with plain water
• Clonazepam oral disintegrating tablets dissolve quickly in the tongue. Take the tablets with a dry hand as the tablet melts once moist.
• Take Clonazepam oral disintegrating tablets ten minutes after eating or drinking something. Also, wait ten minutes for the tablet to completely dissolve before eating.

Overdose

Overdose toxicity

One must not consume Clonazepam tablets more than the proposed dose as it can lead to serious life-threatening side effects.

Some of the symptoms of an overdose are as follows:

• Confusion
• Decreased breathing
• Hypotension (Low blood pressure)
• Sleepiness
• Coordination problem
• Slowed reflexes
• Coma
• Death(in rare case)

However, in case of accidental intake of Clonazepam overdose, one must immediately dial the emergency medical number based on the geographical location or rush to the nearest emergency medical room ⁶Overdose| Researched based study from Nlm.nih.gov

Precautions

Precautions & Warnings

• The pregnant woman must avoid using Clonazepam as some scientific information suggests it harms the growing fetus.
• Nursing mothers must also avoid taking Clonazepam as it can pass to the breast milk and increase the side effect in the child.
• People who drink alcohol must avoid drinking while taking Clonazepam, as taking both together might increase the side effect of the drug.

Warnings

Misuse and addiction

• Misuse is taking Clonazepam differently and not following as prescribed
• Addiction is when a person uses it despite its harmful effects. However, misuse and addiction can lead to overdose and death.

Dependence on the drug

• Dependence is the use of drugs to function the body as usual⁷Precautions| Researched based study from Nlm.nih.gov

Contraindications

Contraindications

Before taking Clonazepam, one must inform the doctor about the medical condition and any history of taking other benzodiazepines. The precise information enables the doctor to discuss the possible risk and the benefits of taking the medication for the disease.

Medical conditions that can bother are as follows:

• Bipolar disorder(mental disorder that causes a change in mood)
• Parkinson’s disease (brain disorder)
• Myasthenia gravis( an ailment that causes muscle weakness)
• History of seizure
• Suicidal thoughts
• Breathing problem
• Pregnant or trying to conceive

Who should avoid Clonazepam

• Pregnant woman
• People allergic to Clonazepam or any ingredient of the drug
• With blood disorders such as porphyria
• One with kidney disease
• People with liver disease
• One with glaucoma (eye disease) ⁸Contraindications| Researched based study from Nlm.nih.gov

Interactions

Interactions of Clonazepam

Clonazepam can interact with several drugs and herbs.

The list of some of the medicines that can interact is as follows:

• Fentanyl, Hydromorphone (opioids )
• Cetirizine ,Chlorpheniramine (antiallergic drug)
• Clozapine, Risperidone (an antipsychotic drug )
• Buspirone (anxiety drug)
• Zolpidem (insomnia drugs)
• Fluconazole(antifungal drug)
• Propantheline(a drug to treat ulcers)
• Serious interaction results into coma and death with other opioid drugs such as morphine and tramadol ⁷Interactions| Researched based study from Nlm.nih.gov

Some herbs that can interact with Clonazepam are as follows:

• Chamomile (herb)
• Cannabis (plant)
• Kava (shrub)
• Valerian (plant) ⁹Interactions| Researched based study from Researchgate.net

Cost & Storage

Cost & storage of Clonazepam

• The cost of Clonazepam might vary depending on various factors such as geographical location, insurance coverage, and the health store in use.
• One can avail of financial assistance for Clonazepam tablets from two websites viz; Needy Meds and Medicine assistance tools. The websites also enable one to find low-cost health stores and necessary educational resources.

Storage of Clonazepam

• Store Clonazepam at room temperatures between 15 to 30 degrees centigrade
• Keep in a tightly closed container away from the direct sunlight
• Also, keep out of reach of children and young pets

Disposal

• Dispose of unused medicine in thrash or a sealed bag to prevent accidental overdose or death of animals or pets.
• Throw the medication whose expiry date has crossed

Takeaway

Key Takeaways

• Clonazepam is a medication to treat seizure and panic disorders
• Most people who take Clonazepam may have few or more side effects. Any side effects that persist must be informed to the health care provider.
• Clonazepam’s sudden discontinuation can lead to withdrawal symptoms, so one must follow the discontinuation process as the doctor advises