Clonazepam side effects klonopin drug information

By | 26.06.2018

clonazepam side effects klonopin drug information

Keep the medication in a place where others cannot get to it. Like all benzodiazepines, clonazepam is a GABA-positive allosteric modulator. The initial dose for adults with panic disorder is 0. Over time, the patient's body tends to build tolerance to clonazepam. Antiepileptic drugs AEDs , including Klonopin, increase the risk of suicidal thoughts or behavior in patients taking these drugs for any indication. Klonopin, a benzodiazepine, is available as scored tablets with a K-shaped perforation containing 0. This is not a complete list of side effects and others may occur. Benzodiazepine Addiction, Overdose, Withdrawal, Side effects and Recovery (benzos e.g. Xanax, Klonopin, Rivotril, Clonazepam, Ativan etc.)

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Clonazepam side effects klonopin drug information 985
Clonazepam overdose uptodate medical free In three studies in rivotril clonazepam dosage color images clonazepam was administered orally to pregnant rabbits klonopin doses of 0. Ethosuximide Effects Phensuximide information Gabapentinoids: Biotransformation occurs mainly by reduction of klonopin 7-nitro group drug the 4-amino derivative. Ask rrug healthcare provider if you are not sure if clonazepam have any of the problems listed above. To view content dgug and attributions, please refer effects our editorial policy. What happens if Side miss a dose Klonopin, Klonopin Wafer? Consistent Side use will almost certainly give rise to a degree of information dependence a point at which the drug reacts as if it requires Klonopin to function normally clonazepam without it will often begin to experience withdrawal symptoms.
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The adverse experiences for Klonopin are provided separately for patients with seizure disorders and with panic disorder. The most frequently occurring side effects of Klonopin are referable to CNS depression. Others, listed by system, including those identified during postapproval use of Klonopin are:. Hair loss, hirsutism , skin rash, ankle and facial edema. Anorexia , coated tongue, constipation, diarrhea, dry mouth , encopresis , gastritis , increased appetite, nausea, sore gums.

Dysuria , enuresis , nocturia , urinary retention. Anemia , leukopenia , thrombocytopenia , eosinophilia. Hepatomegaly , transient elevations of serum transaminases and alkaline phosphatase. Dehydration, general deterioration, fever, lymphadenopathy , weight loss or gain. Confusion, depression, amnesia , hysteria, increased libido , insomnia, psychosis the behavior effects are more likely to occur in patients with a history of psychiatric disturbances.

The following paradoxical reactions have been observed: Chest congestion , rhinorrhea , shortness of breath, hypersecretion in upper respiratory passages. Adverse events during exposure to Klonopin were obtained by spontaneous report and recorded by clinical investigators using terminology of their own choosing. Consequently, it is not possible to provide a meaningful estimate of the proportion of individuals experiencing adverse events without first grouping similar types of events into a smaller number of standardized event categories.

In the tables and tabulations that follow, CIGY dictionary terminology has been used to classify reported adverse events, except in certain cases in which redundant terms were collapsed into more meaningful terms, as noted below. The stated frequencies of adverse events represent the proportion of individuals who experienced, at least once, a treatment-emergent adverse event of the type listed.

An event was considered treatment-emergent if it occurred for the first time or worsened while receiving therapy following baseline evaluation. Table 3 enumerates the incidence, rounded to the nearest percent, of treatment-emergent adverse events that occurred during acute therapy of panic disorder from a pool of two 6- to 9-week trials.

The prescriber should be aware that the figures in Table 3 cannot be used to predict the incidence of side effects in the course of usual medical practice where patient characteristics and other factors differ from those that prevailed in the clinical trials. Similarly, the cited frequencies cannot be compared with figures obtained from other clinical investigations involving different treatments, uses and investigators. The cited figures, however, do provide the prescribing physician with some basis for estimating the relative contribution of drug and nondrug factors to the side effect incidence in the population studied.

While these findings are noteworthy, Hamilton Depression Rating Scale HAM-D data collected in these trials revealed a larger decline in HAM-D scores in the clonazepam group than the placebo group suggesting that clonazepamtreated patients were not experiencing a worsening or emergence of clinical depression. Following is a list of modified CIGY terms that reflect treatment-emergent adverse events reported by patients treated with Klonopin at multiple doses during clinical trials.

All reported events are included except those already listed in Table 3 or elsewhere in labeling, those events for which a drug cause was remote, those event terms which were so general as to be uninformative, and events reported only once and which did not have a substantial probability of being acutely life-threatening. The effectiveness of Klonopin in long-term use, that is, for more than 9 weeks, has not been systematically studied in controlled clinical trials.

Clonazepam is available as a tablet. The tablets should be administered with water by swallowing the tablet whole. The use of multiple anticonvulsants may result in an increase of CNS depressant adverse effects. This should be considered before adding Klonopin to an existing anticonvulsant regimen. The initial dose for adults with seizure disorders should not exceed 1.

Dosage may be increased in increments of 0. Maintenance dosage must be individualized for each patient depending upon response. Maximum recommended daily dose is 20 mg. Klonopin is administered orally. In order to minimize drowsiness, the initial dose for infants and children up to 10 years of age or 30 kg of body weight should be between 0. Dosage should be increased by no more than 0. Whenever possible, the daily dose should be divided into three equal doses.

If doses are not equally divided, the largest dose should be given before retiring. There is no clinical trial experience with Klonopin in seizure disorder patients 65 years of age and older. The initial dose for adults with panic disorder is 0. To reduce the inconvenience of somnolence , administration of one dose at bedtime may be desirable. Treatment should be discontinued gradually, with a decrease of 0. There is no body of evidence available to answer the question of how long the patient treated with clonazepam should remain on it.

Therefore, the physician who elects to use Klonopin for extended periods should periodically reevaluate the long-term usefulness of the drug for the individual patient. There is no clinical trial experience with Klonopin in panic disorder patients under 18 years of age. There is no clinical trial experience with Klonopin in panic disorder patients 65 years of age and older.

Klonopin tablets are available as scored tablets with a K-shaped perforation - 0. The adverse experiences for Klonopin are provided separately for patients with seizure disorders and with panic disorder. The most frequently occurring side effects of Klonopin are referable to CNS depression. Others, listed by system, including those identified during postapproval use of Klonopin are:.

Hair loss, hirsutism , skin rash, ankle and facial edema. Anorexia , coated tongue, constipation, diarrhea, dry mouth , encopresis , gastritis , increased appetite, nausea, sore gums. Dysuria , enuresis , nocturia , urinary retention. Anemia , leukopenia , thrombocytopenia , eosinophilia. Hepatomegaly , transient elevations of serum transaminases and alkaline phosphatase. Dehydration, general deterioration, fever, lymphadenopathy , weight loss or gain.

Confusion, depression, amnesia , hysteria, increased libido , insomnia, psychosis the behavior effects are more likely to occur in patients with a history of psychiatric disturbances. The following paradoxical reactions have been observed: Chest congestion , rhinorrhea , shortness of breath, hypersecretion in upper respiratory passages. Adverse events during exposure to Klonopin were obtained by spontaneous report and recorded by clinical investigators using terminology of their own choosing.

Consequently, it is not possible to provide a meaningful estimate of the proportion of individuals experiencing adverse events without first grouping similar types of events into a smaller number of standardized event categories. In the tables and tabulations that follow, CIGY dictionary terminology has been used to classify reported adverse events, except in certain cases in which redundant terms were collapsed into more meaningful terms, as noted below.

The stated frequencies of adverse events represent the proportion of individuals who experienced, at least once, a treatment-emergent adverse event of the type listed. An event was considered treatment-emergent if it occurred for the first time or worsened while receiving therapy following baseline evaluation. Table 3 enumerates the incidence, rounded to the nearest percent, of treatment-emergent adverse events that occurred during acute therapy of panic disorder from a pool of two 6- to 9-week trials.

The prescriber should be aware that the figures in Table 3 cannot be used to predict the incidence of side effects in the course of usual medical practice where patient characteristics and other factors differ from those that prevailed in the clinical trials. Similarly, the cited frequencies cannot be compared with figures obtained from other clinical investigations involving different treatments, uses and investigators. The cited figures, however, do provide the prescribing physician with some basis for estimating the relative contribution of drug and nondrug factors to the side effect incidence in the population studied.

While these findings are noteworthy, Hamilton Depression Rating Scale HAM-D data collected in these trials revealed a larger decline in HAM-D scores in the clonazepam group than the placebo group suggesting that clonazepamtreated patients were not experiencing a worsening or emergence of clinical depression. Following is a list of modified CIGY terms that reflect treatment-emergent adverse events reported by patients treated with Klonopin at multiple doses during clinical trials.

All reported events are included except those already listed in Table 3 or elsewhere in labeling, those events for which a drug cause was remote, those event terms which were so general as to be uninformative, and events reported only once and which did not have a substantial probability of being acutely life-threatening.

It is important to emphasize that, although the events occurred during treatment with Klonopin, they were not necessarily caused by it. Events are further categorized by body system and listed in order of decreasing frequency. Body as a Whole: Central and Peripheral Nervous System Disorders: Hearing and Vestibular Disorders: Metabolic and Nutritional Disorders: Skin and Appendages Disorders: The concomitant use of benzodiazepines and opioids increases the risk of respiratory depression because of actions at different receptor sites in the CNS that control respiration.

When benzodiazepines and opioids are combined, the potential for benzodiazepines to significantly worsen opioid -related respiratory depression exists. Limit dosage and duration of concomitant use of benzodiazepines and opioids, and follow patients closely for respiratory depression and sedation. Clonazepam does not appear to alter the pharmacokinetics of carbamazepine or phenobarbital. Clonazepam has the potential to influence concentrations of phenytoin.

Monitoring of phenytoin concentration is recommended when clonazepam is co-administrated with phenytoin. The effect of clonazepam on the metabolism of other drugs has not been investigated. Literature reports suggest that ranitidine , an agent that decreases stomach acidity, does not greatly alter clonazepam pharmacokinetics. Although clinical studies have not been performed, based on the involvement of the cytochrome P 3A family in clonazepam metabolism, inhibitors of this enzyme system, notably oral antifungal agents e.

The CNS-depressant action of the benzodiazepine class of drugs may be potentiated by alcohol, narcotics, barbiturates, nonbarbiturate hypnotics, antianxiety agents, the phenothiazines, thioxanthene and butyrophenone classes of antipsychotic agents, monoamine oxidase inhibitors and the tricyclic antidepressants , and by other anticonvulsant drugs.

Withdrawal symptoms , similar in character to those noted with barbiturates and alcohol e. The more severe withdrawal symptoms have usually been limited to those patients who received excessive doses over an extended period of time. Generally milder withdrawal symptoms e. Addiction- prone individuals such as drug addicts or alcoholics should be under careful surveillance when receiving clonazepam or other psychotropic agents because of the predisposition of such patients to habituation and dependence.

Following the short-term treatment of patients with panic disorder in Studies 1 and 2 see Clinical Trials , patients were gradually withdrawn during a 7-week downward-titration discontinuance period. Overall, the discontinuance period was associated with good tolerability and a very modest clinical deterioration, without evidence of a significant rebound phenomenon.

However, there are not sufficient data from adequate and well-controlled long-term clonazepam studies in patients with panic disorder to accurately estimate the risks of withdrawal symptoms and dependence that may be associated with such use. Concomitant use of benzodiazepines , including Klonopin, and opioids may result in profound sedation, respiratory depression , coma, and death. Because of these risks, reserve concomitant prescribing of benzodiazepines and opioids for use in patients for whom alternative treatment options are inadequate.

Observational studies have demonstrated that concomitant use of opioid analgesics and benzodiazepines increases the risk of drug-related mortality compared to use of opioids alone. If a decision is made to prescribe Klonopin concomitantly with opioids, prescribe the lowest effective dosages and minimum durations of concomitant use, and follow patients closely for signs and symptoms of respiratory depression and sedation.

Since Klonopin produces CNS depression, patients receiving this drug should be cautioned against engaging in hazardous occupations requiring mental alertness, such as operating machinery or driving a motor vehicle. Antiepileptic drugs AEDs , including Klonopin, increase the risk of suicidal thoughts or behavior in patients taking these drugs for any indication. Pooled analyses of placebo-controlled clinical trials mono- and adjunctive therapy of 11 different AEDs showed that patients randomized to one of the AEDs had approximately twice the risk adjusted Relative Risk 1.

In these trials, which had a median treatment duration of 12 weeks, the estimated incidence rate of suicidal behavior or ideation among 27, AED-treated patients was 0. There were four suicides in drug-treated patients in the trials and none in placebo-treated patients, but the number is too small to allow any conclusion about drug effect on suicide. The increased risk of suicidal thoughts or behavior with AEDs was observed as early as one week after starting drug treatment with AEDs and persisted for the duration of treatment assessed.

Because most trials included in the analysis did not extend beyond 24 weeks, the risk of suicidal thoughts or behavior beyond 24 weeks could not be assessed. The risk of suicidal thoughts or behavior was generally consistent among drugs in the data analyzed. The finding of increased risk with AEDs of varying mechanisms of action and across a range of indications suggests that the risk applies to all AEDs used for any indication.

The risk did not vary substantially by age 5 years in the clinical trials analyzed. The relative risk for suicidal thoughts or behavior was higher in clinical trials for epilepsy than in clinical trials for psychiatric or other conditions, but the absolute risk differences were similar for the epilepsy and psychiatric indications. Anyone considering prescribing Klonopin or any other AED must balance the risk of suicidal thoughts or behavior with the risk of untreated illness.

Epilepsy and many other illnesses for which AEDs are prescribed are themselves associated with morbidity and mortality and with an increased risk of suicidal thoughts and behavior. Should suicidal thoughts and behavior emerge during treatment, the prescriber needs to consider whether the emergence of these symptoms in any given patient may be related to the illness being treated.

Patients, their caregivers, and families should be informed that AEDs increase the risk of suicidal thoughts and behavior and should be advised of the need to be alert for the emergence or worsening of the signs and symptoms of depression, any unusual changes in mood or behavior, or the emergence of suicidal thoughts, behavior, or thoughts about self-harm. Behaviors of concern should be reported immediately to healthcare providers. Withdrawal symptoms of the barbiturate type have occurred after the discontinuation of benzodiazepines see Drug Abuse And Dependence.

When used in patients in whom several different types of seizure disorders coexist, Klonopin may increase the incidence or precipitate the onset of generalized tonic-clonic seizures grand mal. This may require the addition of appropriate anticonvulsants or an increase in their dosages. The concomitant use of valproic acid and Klonopin may produce absence status. In some cases, dosage adjustment may reestablish efficacy. Periodic blood counts and liver function tests are advisable during long-term therapy with Klonopin.

Physical And Psychological Dependence. Paradoxical reactions are more likely to occur in children and in the elderly. The abrupt withdrawal of Klonopin, particularly in those patients on long-term, high-dose therapy, may precipitate status epilepticus. Therefore, when discontinuing Klonopin, gradual withdrawal is essential.

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2 thoughts on “Clonazepam side effects klonopin drug information

  1. Gubei

    Hello I have been on klonoin 0.50 and an antidepressant for 17 years it saved me from my panic attacks. A year ago I lost my husband tragicially he was only 38 and recently the antidepressants stopped working and I have just upped the klonopin to 1.5 mg to stop the attacks. I have tried 4 different antidepressants and they have done nothing but give me horrible side effects. Although klonopin is addicting it also has given me my life and help me get through the roughest time of my life.

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