CLONAZEPAM

Indications & Dose:

 All forms of epilepsy  

• BY MOUTH

Child 1–11 months: Initially 250 micrograms once daily for 4 nights, dose to be increased over 2–4 weeks, usual dose 0.5–1 mg daily, dose to be taken at night; may be given in 3 divided doses if necessary.

Child 1–4 years: Initially 250 micrograms once daily for 4 nights, dose to be increased over 2–4 weeks, usual dose 1–3 mg daily, dose to be taken at night; may be given in 3 divided doses if necessary.

Child 5–11 years: Initially 500 micrograms once daily for 4 nights, dose to be increased over 2–4 weeks, usual dose 3–6 mg daily, dose to be taken at night; may be given in 3 divided doses if necessary

Child 12–17 years: Initially 1 mg once daily for 4 nights, dose to be increased over 2–4 weeks, usual dose 4–8 mg daily, dose usually taken at night; may be given in 3–4 divided doses if necessary

All forms of epilepsy

Myoclonus

•   BY MOUTH

Adult: Initially 1 mg once daily for 4 nights, dose to be increased over 2–4 weeks, usual dose 4–8 mg daily, adjusted according to response, dose usually taken at night; may be given in 3–4 divided doses if necessary

Elderly: Initially 500 micrograms once daily for 4 nights, dose to be increased over 2–4 weeks, usual dose 4–8 mg daily, adjusted according to response, dose usually taken at night; may be given in 3–4 divided doses if necessary Panic disorders (with or without agoraphobia) resistant to antidepressant therapy

•  BY MOUTH

Adult: 1–2 mg daily 

Contraindications:

Severe liver disease, acute narrow-angle glaucoma

Side Effects:

Cautions:

Precautions:

COPD, impaired renal function, abrupt discontinuation (may precipitate withdrawal), status epilepticus, elderly 

Interaction:

Drugs

Disulfiram: Increased serum clonazepam concentrations

Valproic acid: Increased occurrence of absence seizures 

Warnings:

Adverse Effects:

Lactations:

Episodes of prolonged apnea in the newborn, apparently related to clonazepam, have been reported; excreted into breast milk; monitor closely for CNS depression or apnea in nursing infant 

Special Precautions:

Counselling:

Side Effects Or Adverse Reactions:

CNS: Ataxia, behavioral changes; confusion, dizziness, drowsiness, headache, insomnia, slurred speech, suicidal tendencies, tremor

CV: Bradycardia, hypotension, palpitations

EENT: Abnormal eye movements, blurred vision, diplopia, nystagmus

GI: Anorexia, constipation, diarrhea, gastritis, nausea, polyphagia, sore gums, xerostomia

GU: Dysuria, enuresis, nocturia, urinary retention

HEME: Anemia, eosinophilia, leukocytosis, thrombocytopenia

RESP: Congestion, dyspnea, respiratory depression

SKIN: Rash 

Patient And Carer Advice: