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  • Clonazepam tablets; dosage, overdose, side effects – And medicine

    Description
    Clonazepam is a benzodiazepine, which is used in the treatment of panic disorders and seizure disorders.
    Mode of action
    Clonazepam binds with the benzodiazepine site of GABA (gamma-amino butyric acid) receptor and potentiates the efficacy of GABA, resulting in a greater entry of chloride ion and the cell gains more negative charge which causes the reduction of neural excitability.
    Pharmacokinetics
    Clonazepam is rapidly and completely absorbed after oral administration. The absolute bioavailability of Clonazepam is about 90%. Maximum peak plasma concentrations are achieved within 1 to 4 hours after oral administration. Clonazepam is approximately 85% bound to plasma proteins. Clonazepam is highly metabolized by the kidneys, with less than 2% unchanged Clonazepam being excreted in the urine.
    Composition
    Clonazepam 0.5 mg Tablet: Each tablet contains Clonazepam BP
    0.5 mg.
    Clonazepam 2 mg Tablet: Each tablet contains Clonazepam BP
    2 mg.
    Clonazepam 10 ml Drops: Each 5 ml contains Clonazepam BP
    12.5 mg.
    Indications
    Seizure disorders: Partial seizures, generalized seizures; Panic disorders; Drug induced dyskinesia; Choreiform movement; Fulgurant pain.
    Dosage & administration Seizure Disorders:
    Adults: The initial dose for adults with seizure disorders should not exceed 1.5 mg/day divided into three doses. Dosage may be increased in increments of 0.5 to 1 mg every 3 days until seizures are adequately controlled or until side effects preclude any further increase. Maintenance dosage must be individualized for each patient depending upon response.
    Paediatric patients: Clonazepam is administered orally. In order to minimize drowsiness, the initial dose for infants and children (upto 10 years of age or 30 kg of body weight) should be between 0.01 and 0.03 mg/kg/day, but not to exceed 0.05 mg/kg/day given two or three divided doses. Dosage should be increased by not more than 0.25 to 0.5 mg every third day until a daily maintenance dose of 0.1 to 0.2 mg/kg of body weight has been reached, unless seizures are controlled or side effects preclude further increase.
    Geriatric patients: In general, elderly patients should be started
    on low doses of Clonazepam and observed closely.
    Panic disorders:
    Adults: The initial dose for adults with panic disorder is 0.25 mg
    b.i.d. An increase to the target dose for most patients of 1
    mg/day may be made after 3 days. In case of discontinuation,
    dose should be reduced gradually.
    Paediatric patients: There is no clinical trial experience with
    Clonazepam in panic disorder patients under 18 years of age.
    Drug induced dyskinesia:
    1 to 3 mg in divided doses.
    Choreiform movement
    3.5 to 5.5 mg in divided doses and gradually dose may be
    increased (if required).
    Fulgurant pain:
    4 to 8 mg in divided doses.
    Contraindications
    Patients with hypersensitivity to benzodiazepines, acute pulmonary insufficiency, respiratory depression, significant liver dysfunction and acute narrow-angle glaucoma.
    Side effects
    CNS depression, coma, diplopia, dysarthria, headache, weakness, nystagmus, tremors, vertigo and respiratory depression may occur. Confusion, depression, amnesia, hallucinations, hysteria, suicidal tendency are rare forms of psychiatric side effects. Rhinorrhoea, salivation, increased respiratory secretions; palpitations, dysuria, enuresis, nocturia and urinary retention have been recorded. Oedema, hair loss, skin rash, hirsutism, anorexia, coated tongue, nausea, vomiting, constipation or diarrhoea may occur. Muscle weakness, pain, fever, lymphadenopathy, anemia, leucopenia and thrombocytopenia.
    Use in pregnancy & lactation
    The effects of clonazepam on pregnancy and nursing infants have not been clearly established.
    Precautions
    Patients using clonazepam should be cautioned against hazardous occupation requiring mental alertness. Concomitant use of alcohol and other CNS depressants potentiates the depressant activity of clonazepam. Abrupt discontinuation may produce withdrawal symptoms. Simultaneous use of sodium valproate and clonazepam may produce absence status. Liver function and blood cell counts should be done. Rapjd withdrawal may lead to status epilepticus. if liver/renal dysfunction exists then dose should be reduced. Respiratory depression may occur. This should be used with caution in patients with chronic respiratory disease. Patients should be informed regarding development of dependence while using clonazepam.
    Drug interactions
    All patients receiving clonazepam must be under surveillance for drug abuse. The use of CNS depressants may potentiate the depressant action of clonazepam. Potentially hazardous interactions will take place when used with other antiepileptic agent.
    Over dosage
    The symptoms of overdosage or intoxication vary greatly from person to person depending on age, body weight and “individual response. They range from tiredness and light-headedness to ataxia, drowsiness, deep sleep and even coma with respiratory depression and circulatory collapse.
    Storage
    Store in a cool and dry place, protected from light.
    Packaging
    Clonazepam 0.5 mg Tabtet: Each carton contains 10×5. tablets in
    blister pack.
    Clonazepam 2 mg Tablet: Each carton contains 10×3 tablets in blister
    pack.
    Clonazepam 10 ml Drops: Each carton contains a bott

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