AnxiRelief
Generic Name
Clonapin
Manufacturer
General Pharmaceuticals Ltd.
Country
Bangladesh
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Description
Overview of the medicine
Clonapin is a benzodiazepine derivative with anxiolytic, anticonvulsant, sedative, and muscle relaxant properties. It is used to treat various seizure disorders, panic disorder, and sometimes acute anxiety.
Uses & Indications
Dosage
Adults
Panic disorder: Initially 0.25 mg twice daily, increased to 1 mg/day after 3 days. Max 4 mg/day. Seizure disorders: Initially 0.5 mg three times daily, increased by 0.5-1 mg every 3 days. Max 20 mg/day.
Elderly
Lower initial doses (e.g., 0.25 mg once daily) and slower titration are recommended due to increased sensitivity and risk of side effects.
Renal_impairment
No specific dose adjustment guidelines; use with caution. Metabolites may accumulate.
How to Take
Take orally, with or without food. Do not stop suddenly due to withdrawal risk.
Mechanism of Action
Clonapin enhances the effect of gamma-aminobutyric acid (GABA) at the GABA-A receptors, leading to increased neuronal inhibition in the central nervous system.
Pharmacokinetics
Onset
20-60 minutes (oral)
Excretion
Excreted predominantly in the urine (50-70%) as metabolites, and a small amount in the feces.
Half life
18-50 hours
Absorption
Rapidly and completely absorbed after oral administration. Peak plasma concentrations reached within 1-4 hours.
Metabolism
Primarily metabolized in the liver by nitroreduction, followed by N-acetylation and hydroxylation, mainly by CYP3A4.
Side Effects
Contraindications
- Acute narrow-angle glaucoma
- Severe respiratory insufficiency
- Severe hepatic impairment
- Sleep apnea
- Known hypersensitivity to benzodiazepines
Drug Interactions
Opioids
Increased risk of respiratory depression and sedation.
Alcohol and other CNS depressants
Potentiated sedative effects.
CYP3A4 inducers (e.g., Carbamazepine, Phenytoin)
May decrease Clonapin levels.
CYP3A4 inhibitors (e.g., Ketoconazole, Ritonavir)
May increase Clonapin levels.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms include somnolence, confusion, diminished reflexes, coma. Management includes supportive care, gastric lavage if recent ingestion, and potentially flumazenil (a benzodiazepine antagonist), but with caution due to seizure risk.
Pregnancy & Lactation
Pregnancy Category D. Should not be used during pregnancy unless the benefits outweigh the risks. Excreted in breast milk, use with caution during lactation.
Side Effects
Contraindications
- Acute narrow-angle glaucoma
- Severe respiratory insufficiency
- Severe hepatic impairment
- Sleep apnea
- Known hypersensitivity to benzodiazepines
Drug Interactions
Opioids
Increased risk of respiratory depression and sedation.
Alcohol and other CNS depressants
Potentiated sedative effects.
CYP3A4 inducers (e.g., Carbamazepine, Phenytoin)
May decrease Clonapin levels.
CYP3A4 inhibitors (e.g., Ketoconazole, Ritonavir)
May increase Clonapin levels.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms include somnolence, confusion, diminished reflexes, coma. Management includes supportive care, gastric lavage if recent ingestion, and potentially flumazenil (a benzodiazepine antagonist), but with caution due to seizure risk.
Pregnancy & Lactation
Pregnancy Category D. Should not be used during pregnancy unless the benefits outweigh the risks. Excreted in breast milk, use with caution during lactation.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
2-3 years from manufacturing date
Availability
Available in pharmacies nationwide
Approval Status
DGDA Approved
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Extensive clinical trials have established the efficacy and safety of Clonapin (Clonazepam) for its approved indications.
Lab Monitoring
- Regular monitoring of liver function in patients with hepatic impairment. Renal function in prolonged use or renal impairment.
- Blood counts may be considered rarely.
Doctor Notes
- Counsel patients on the risks of dependence and withdrawal. Gradually taper dose to discontinue. Caution in elderly and patients with respiratory or hepatic impairment. Avoid co-prescription with opioids if possible.
- Monitor for signs of misuse or abuse.
Patient Guidelines
- Do not stop taking Clonapin abruptly, as it may lead to withdrawal symptoms.
- Avoid alcohol and other CNS depressants.
- Inform your doctor about all other medications you are taking.
Missed Dose Advice
If a dose is missed, take it as soon as you remember, unless it is almost time for your next dose. Do not double the dose.
Driving Precautions
Clonapin can cause drowsiness and decrease alertness, making driving or operating machinery dangerous. Avoid these activities until you know how the medication affects you.
Lifestyle Advice
- Avoid activities requiring mental alertness, such as driving or operating heavy machinery.
- Limit or avoid alcohol consumption.
- Regular exercise and stress management techniques may complement treatment.
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Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.