Show More Show Less. Talk to your healthcare provider about the best way to feed your baby if you take clonazepam. Clonazepam was initially patented in and went on sale in the United States in For more information, call Actavis at 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.
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.
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Boll Soc Ital Biol Sper. Acta Physiol Pharmacol Bulg. Acta Neurologica Scandinavica Supplementum. Archived from the original on 16 March Retrieved 9 February Cloxazolam Flutazolam Haloxazolam Mexazolam Oxazolam. Do not give this medicine to a child without medical advice. Clonazepam is not approved to treat panic disorder in anyone younger than 18 years old. Take clonazepam exactly as prescribed by your doctor. Follow all directions on your prescription label.
Your doctor may occasionally change your dose to make sure you get the best results. Do not use this medicine in larger or smaller amounts or for longer than recommended. Never share this medicine with another person, especially someone with a history of drug abuse or addiction. Misuse of habit-forming medicine can cause addiction, overdose, or death. Selling or giving away this medicine is against the law.
Clonazepam should be used for only a short time. Do not take this medication for longer than 9 weeks without your doctor's advice. Do not stop using clonazepam suddenly or you could have unpleasant withdrawal symptoms, including a seizure convulsions. Ask your doctor how to safely stop using this medicine. Call your doctor if this medicine seems to stop working as well in treating your seizures or anxiety symptoms. Seizures are often treated with a combination of drugs.
Use all medications as directed by your doctor. Read the medication guide or patient instructions provided with each medication. Do not change your doses or medication schedule without your doctor's advice. Keep track of the amount of medicine used from each new bottle. Clonazepam is a drug of abuse and you should be aware if anyone is using your medicine improperly or without a prescription.
Dosage Information in more detail. Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose. Clonazepam may impair your thinking or reactions. Avoid driving or operating machinery until you know how this medicine will affect you. Dizziness or severe drowsiness can cause falls or other accidents.
Get emergency medical help if you have signs of an allergic reaction to clonazepam: Report any new or worsening symptoms to your doctor, such as: The sedative effects of clonazepam may last longer in older adults. Accidental falls are common in elderly patients who take benzodiazepines. Use caution to avoid falling or accidental injury while you are taking clonazepam. This is not a complete list of side effects and others may occur.
Call your doctor for medical advice about side effects. Side effects in more detail. Up to 10 years of age or 30 kg of body weight: See adult dosing Comments: