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. This syndrome can develop between 3 days to 3 weeks after birth and can have a duration of up to several months. The United States FDA must certify that any generic drug approved by them is bioequivalent to the original patented drug. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. Chemically, clonazepam is 5- 2-chlorophenyl -1,3-dihydronitro-2 H -1,4- benzodiazepinone. Health Information A-Z Our index of medical information authored by professionals Community Join the discussion in our forums Medicine directory Drug treatments, dosage instructions and side effects Medical Professionals Information for medical professionals Symptom Checker Assess your symptoms online with our free symptom checker. 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 Google Drive app is dying -- time to update (CNET News)
It can make your condition worse. For people with liver disease: If you have liver problems, your body may not be able to clear this drug well. This can cause the drug to build up in your body. This puts you at a higher risk for side effects. Clonazepam is a category D pregnancy drug. That means two things:. This drug should be used only if the potential benefit justifies the potential risk to the fetus. Call your doctor right away if you become pregnant while taking this drug.
For women who are breastfeeding: Clonazepam passes into breast milk and causes side effects in a child who is breastfed. Talk to your doctor if you breastfeed your child. You may need to decide whether to stop breastfeeding or stop taking this medication. The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly.
As a result, more of a drug stays in your body for a longer time. This raises your risk of side effects. This dosage information is for clonazepam oral tablet. All possible dosages and drug forms may not be included here. Your dosage, drug form, and how often you take the drug will depend on:. Your doctor may start you on a lowered dose or a different dosing schedule.
This can help keep levels of this drug from building up too much in your body. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. Always speak with your doctor or pharmacist about dosages that are right for you. Clonazepam oral tablet is used for short-term treatment. If you stop taking it suddenly, you may have symptoms of withdrawal. These include irritability, trouble sleeping, and anxiety. If you take too much: You could have dangerous levels of the drug in your body.
Symptoms of an overdose of this drug can include:. If your symptoms are severe, call or go to the nearest emergency room right away. What to do if you miss a dose: Take your dose as soon as you remember. But if you remember just a few hours before your next scheduled dose, take only one dose. Never try to catch up by taking two doses at once. This could result in dangerous side effects. How to tell if the drug is working: You should have fewer panic attacks or seizures.
A prescription for this medication is refillable. However, clonazepam is a schedule IV controlled substance. Therefore, your prescription for this drug may be refilled no more than five times. Also, you can only get refills for six months after the date your doctor wrote the original prescription. You and your doctor should monitor certain health issues.
This can help make sure you stay safe while you take this drug. Many insurance companies require a prior authorization for this drug. This means your doctor will need to get approval from your insurance company before your insurance company will pay for the prescription. There are other drugs available to treat your condition. Some may be better suited for you than others. Talk to your doctor about other drug options that may work for you.
Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication.
The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses. Alprazolam is an oral prescription drug used to treat anxiety disorders and panic disorder.
Learn about side effects, warnings, dosage, and more. Several types of drugs can help relieve anxiety alongside therapy. Learn what drugs are available and how they work. Clonazepam and Xanax are medications used mainly to treat anxiety disorders. See how they compare. Anxiolytics are used to prevent and treat symptoms of acute anxiety related to many conditions.
Clonazepam, like other benzodiazepines, may impair a person's ability to drive or operate machinery. The central nervous system depressing effects of the drug can be intensified by alcohol consumption, and therefore alcohol should be avoided while taking this medication. Benzodiazepines have been shown to cause dependence. Patients dependent on clonazepam should be slowly titrated off under the supervision of a qualified healthcare professional to reduce the intensity of withdrawal or rebound symptoms.
Benzodiazepines such as clonazepam can be very effective in controlling status epilepticus , but, when used for longer periods of time, some potentially serious side-effects may develop, such as interference with cognitive functions and behavior. Physiological dependence was demonstrated by flumazenil -precipitated withdrawal. A recurrence of symptoms of the underlying disease should be separated from withdrawal symptoms. Like all benzodiazepines, clonazepam is a GABA-positive allosteric modulator.
High dosage and long-term use increase the risk and severity of dependence and withdrawal symptoms. Withdrawal seizures and psychosis can occur in severe cases of withdrawal, and anxiety and insomnia can occur in less severe cases of withdrawal. A gradual reduction in dosage reduces the severity of the benzodiazepine withdrawal syndrome. Due to the risks of tolerance and withdrawal seizures, clonazepam is generally not recommended for the long-term management of epilepsies.
Increasing the dose can overcome the effects of tolerance, but tolerance to the higher dose may occur and adverse effects may intensify. The mechanism of tolerance includes receptor desensitization, down regulation, receptor decoupling, and alterations in subunit composition and in gene transcription coding. Tolerance to the anticonvulsant effects of clonazepam occurs in both animals and humans.
In humans, tolerance to the anticonvulsant effects of clonazepam occurs frequently. The degree of tolerance is more pronounced with clonazepam than with chlordiazepoxide. Abrupt or over-rapid withdrawal from clonazepam may result in the development of the benzodiazepine withdrawal syndrome, causing psychosis characterised by dysphoric manifestations, irritability, aggressiveness, anxiety, and hallucinations.
Anti-epileptic drugs, benzodiazepines such as clonazepam in particular, should be reduced in dose slowly and gradually when discontinuing the drug to mitigate withdrawal effects. Coma can be cyclic, with the individual alternating from a comatose state to a hyper-alert state of consciousness, which occurred in a 4-year-old boy who suffered an overdose of clonazepam. Overdose symptoms may include extreme drowsiness, confusion, muscle weakness, and fainting. Clonazepam and 7-aminoclonazepam may be quantified in plasma , serum or whole blood in order to monitor compliance in those receiving the drug therapeutically.
Results from such tests can be used to confirm the diagnosis in potential poisoning victims or to assist in the forensic investigation in a case of fatal overdosage. Both the parent drug and 7-aminoclonazepam are unstable in biofluids, and therefore specimens should be preserved with sodium fluoride, stored at the lowest possible temperature and analyzed quickly to minimize losses.
The elderly metabolize benzodiazepines more slowly than younger individuals and are also more sensitive to the effects of benzodiazepines, even at similar blood plasma levels. Doses for the elderly are recommended to be about half of that given to younger adults and are to be administered for no longer than two weeks. Long-acting benzodiazepines such as clonazepam are not generally recommended for the elderly due the risk of drug accumulation.
The elderly are especially susceptible to increased risk of harm from motor impairments and drug accumulation side effects. Benzodiazepines also require special precaution if used by individuals that may be pregnant, alcohol- or drug-dependent, or may have comorbid psychiatric disorders. Clonazepam is not recommended for use in those under Use in very young children may be especially hazardous. Of anticonvulsant drugs, behavioural disturbances occur most frequently with clonazepam and phenobarbital.
Doses higher than 0. Clonazepam may aggravate hepatic porphyria. Clonazepam is not recommended for patients with chronic schizophrenia. A double-blinded, placebo-controlled study found clonazepam increases violent behavior in individuals with chronic schizophrenia. Clonazepam has similar effectiveness to other benzodiazepines at often a lower dose. Clonazepam decreases the levels of carbamazepine ,   and, likewise, clonazepam's level is reduced by carbamazepine.
Azole antifungals, such as ketoconazole , may inhibit the metabolism of clonazepam. Combined use of clonazepam with certain antidepressants , antiepileptics , such as phenobarbital , phenytoin and carbamazepine , sedative antihistamines , opiates , antipsychotics , nonbenzodiazepine hypnotics like zolpidem and alcohol may result in enhanced sedative effects. There is some medical evidence of various malformations, e. The data are also inconclusive on whether benzodiazepines such as clonazepam cause developmental deficits or decreases in IQ in the developing fetus when taken by the mother during pregnancy.
Clonazepam, when used late in pregnancy, may result in the development of a severe benzodiazepine withdrawal syndrome in the neonate. Withdrawal symptoms from benzodiazepines in the neonate may include hypotonia , apnoeic spells, cyanosis and impaired metabolic responses to cold stress. The safety profile of clonazepam during pregnancy is less clear than that of other benzodiazepines, and if benzodiazepines are indicated during pregnancy, chlordiazepoxide and diazepam may be a safer choice.
The use of clonazepam during pregnancy should only occur if the clinical benefits are believed to outweigh the clinical risks to the fetus. Caution is also required if clonazepam is used during breastfeeding. Possible adverse effects of use of benzodiazepines such as clonazepam during pregnancy include: Neonatal withdrawal syndrome associated with benzodiazepines include hypertonia , hyperreflexia , restlessness , irritability , abnormal sleep patterns, inconsolable crying, tremors or jerking of the extremities, bradycardia , cyanosis , suckling difficulties, apnea , risk of aspiration of feeds, diarrhea and vomiting, and growth retardation.
This syndrome can develop between 3 days to 3 weeks after birth and can have a duration of up to several months. The pathway by which clonazepam is metabolized is usually impaired in newborns. If clonazepam is used during pregnancy or breast feeding , it is recommended that serum levels of clonazepam are monitored and that signs of central nervous system depression and apnea are also checked for. In many cases, non-pharmacological treatments, such as relaxation therapy, psychotherapy and avoidance of caffeine , can be an effective and safer alternative to the use of benzodiazepines for anxiety in pregnant women.
Clonazepam acts by binding to the benzodiazepine site of the GABA receptors, which enhances the electric effect of GABA binding on neurons, resulting in an increased influx of chloride ions into the neurons. This further results in an inhibition of synaptic transmission across the central nervous system. Benzodiazepines do not have any effect on the levels of GABA in the brain. Clonazepam does, however, affect glutamate decarboxylase activity. It differs from other anticonvulsant drugs it was compared to in a study.
Benzodiazepines, including clonazepam, bind to mouse glial cell membranes with high affinity. This has been conjectured as a mechanism for high-dose effects on seizures in the study. Clonazepam is a chlorinated derivative of nitrazepam  and therefore a chloro-nitro benzodiazepine. Clonazepam is lipid-soluble, rapidly crosses the blood—brain barrier , and penetrates the placenta.
It is extensively metabolised into pharmacologically inactive metabolites. Clonazepam is metabolized extensively via nitroreduction by cytochrome P enzymes, including CYP3A4. Erythromycin , clarithromycin , ritonavir , itraconazole , ketoconazole , nefazodone , cimetidine , and grapefruit juice are inhibitors of CYP3A4 and can affect the metabolism of benzodiazepines. In some individuals, however, peak blood concentrations were reached at 4—8 hours. Clonazepam passes rapidly into the central nervous system, with levels in the brain corresponding with levels of unbound clonazepam in the blood serum.
Plasma levels of clonazepam can vary as much as tenfold between different patients. Clonazepam is largely bound to plasma proteins. It is effective for 6—8 hours in children, and 6—12 in adults. A US government study of emergency department ED visits found that sedative-hypnotics were the most frequently implicated pharmaceutical drug in ED visits, with benzodiazepines accounting for the majority of these. Clonazepam was the second most frequently implicated benzodiazepine in ED visits.
Alcohol alone was responsible for over twice as many ED visits than clonazepam in the same study. The study examined the number of times the non-medical use of certain drugs was implicated in an ED visit. The criteria for non-medical use in this study were purposefully broad, and include, for example, drug abuse , accidental or intentional overdose , or adverse reactions resulting from legitimate use of the medication.
Clonazepam was approved in the United States as a generic drug in and is now manufactured and marketed by several companies. Clonazepam is available as tablets and orally disintegrating tablets wafers an oral solution drops , and as a solution for injection or intravenous infusion. From Wikipedia, the free encyclopedia. Not to be confused with clozapine , clonazolam , or clorazolam.