Class: Benzodiazepine. C-IV
Dosage Forms. Tablet: 0.5 mg, 1 mg, 2 mg; Tablet, Disintegrating: 0.125 mg, 0.25 mg, 0.5 mg, 1 mg, 2 mg
Common FDA Label Indication, Dosing, and Titration.
1. Panic disorder: 0.25 mg po bid, may titrate by 0.125-0.25 mg po bid every 3 d to a max total daily dose of 1-4 mg (divided into 2-3 daily doses)
2. Seizure: Adults, 0.5 mg po tid, may titrate by 0.125-0.25 mg po bid every 3 d to a max of 1-4 mg/d (divided into 2-3 daily doses); Children up to 10 y or up to 30 kg, 0.01-0.03 mg/kg/d po divided into 2-3 daily doses, may titrate by 0.25-0.5 mg po every 3 d to max of 0.1-0.2 mg/kg/d (divided into 3 daily doses)
1. Restless legs syndrome: 0.5-2 mg po qhs
MOA. Enhances the postsynaptic effect of the inhibitory neurotransmitter, gamma-aminobutyric acid (GABA)
Drug Characteristics: Clonazepam
Medication Safety Issues: Clonazepam
Drug Interactions: Clonazepam
Adverse Reactions: Clonazepam
Efficacy Monitoring Parameters. Reduction of anxiety symptoms or seizures.
Toxicity Monitoring Parameters. Seek medical attention if severe drowsiness, slow or rapid heartbeat or skipped beats, thoughts of suicide.
Key Patient Counseling Points. May cause drowsiness; avoid driving or other tasks requiring motor coordination. Allow orally disintegrating tablet to dissolve on your tongue. Avoid alcohol.
Clinical Pearls. Consider dose reductions of benzodiazepine in hepatic impairment. Use caution in elderly, appear more sensitive to the effects; dose reductions of 50% have been recommended. Use CNS depressants with caution, may have additive effects. Avoid abrupt discontinuation after chronic use, may cause seizures. Medication guide required when dispensing.