Cloma
Generic Name
Clonazepam
Manufacturer
ACI Pharmaceuticals
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| cloma 2 mg tablet | ৳ 10.00 | ৳ 100.00 |
Description
Overview of the medicine
Clonazepam is a benzodiazepine used to treat various conditions, including seizure disorders (epilepsy) and panic disorder. It works by calming the brain and nerves.
Uses & Indications
Dosage
Adults
Initial dose for seizures: 0.5 mg three times daily, gradually increased by 0.5-1 mg every 3 days to a maximum of 20 mg/day. For panic disorder: Initial 0.25 mg twice daily, increased to 1 mg/day.
Elderly
Lower initial doses (e.g., 0.25 mg once daily) should be used, with slow titration, due to increased sensitivity to benzodiazepines.
Renal_impairment
No specific dosage adjustment is usually required for mild to moderate renal impairment, but caution is advised. For severe impairment, start with lower doses.
How to Take
Take orally with or without food. Swallow the tablet whole with water. Do not crush or chew.
Mechanism of Action
Clonazepam enhances the activity of gamma-aminobutyric acid (GABA), a neurotransmitter that inhibits brain activity, thereby producing anxiolytic, anticonvulsant, muscle relaxant, and sedative effects.
Pharmacokinetics
Onset
Oral: 20-60 minutes (anxiolytic, anticonvulsant effects)
Excretion
Excreted primarily in the urine as metabolites, with a small amount excreted in feces.
Half life
Approximately 18-50 hours, allowing for once or twice daily dosing.
Absorption
Rapidly and completely absorbed from the gastrointestinal tract after oral administration. Peak plasma concentrations are reached within 1-4 hours.
Metabolism
Extensively metabolized in the liver, primarily by CYP3A4, via nitroreduction to 7-amino clonazepam, followed by acetylation and hydroxylation.
Side Effects
Contraindications
- Acute narrow-angle glaucoma
- Severe liver disease
- Known hypersensitivity to clonazepam or other benzodiazepines
- Severe respiratory insufficiency
Drug Interactions
Cimetidine, Fluoxetine
May inhibit clonazepam metabolism, leading to increased clonazepam levels.
Phenytoin, Carbamazepine, Phenobarbital
May alter clonazepam levels or increase CNS depressant effects.
Opioids, Alcohol, Barbiturates, Antidepressants, Antihistamines
Increased CNS depression, sedation, and respiratory depression.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include somnolence, confusion, impaired coordination, diminished reflexes, and coma. Treatment is primarily supportive; maintain airway, breathing, and circulation. Flumazenil, a benzodiazepine receptor antagonist, may be used in certain cases but carries risks of precipitating withdrawal or seizures.
Pregnancy & Lactation
Pregnancy Category D: There is positive evidence of human fetal risk, but the benefits from use in pregnant women may be acceptable despite the risk. Clonazepam is excreted in breast milk; therefore, it is generally not recommended during lactation.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from the date of manufacture
Availability
Available in pharmacies and hospitals
Approval Status
Approved by regulatory bodies (e.g., FDA, DGDA)
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Numerous clinical trials have established the efficacy and safety of clonazepam in treating seizure disorders and panic disorder. Ongoing research explores its use in other neurological and psychiatric conditions.
Lab Monitoring
- Liver function tests (periodically, especially with long-term use)
- Complete blood count (periodically, with long-term use)
Doctor Notes
- Counsel patients thoroughly about the risks of dependence, abuse, and withdrawal symptoms, especially when prescribing for long durations.
- Emphasize the dangers of concomitant use with opioids and alcohol.
- Instruct patients on the importance of gradual tapering when discontinuing treatment to minimize withdrawal effects.
- Monitor for signs of depression or suicidal ideation, particularly in patients with pre-existing psychiatric conditions.
Patient Guidelines
- Do not stop taking this medicine abruptly, as it can lead to withdrawal symptoms.
- Avoid alcohol and other CNS depressants while on this medication.
- Report any unusual mood changes, aggression, or new or worsening symptoms to your doctor.
- Do not share this medication with others.
Missed Dose Advice
If you miss a dose, take it as soon as you remember, unless it is almost time for your next dose. In that case, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
Cloma can cause drowsiness, dizziness, and impaired coordination. Do not drive or operate machinery until you know how this medication affects you.
Lifestyle Advice
- Avoid activities requiring mental alertness, such as driving or operating heavy machinery, until you know how this medication affects you.
- Maintain a regular sleep schedule and practice stress-reduction techniques.
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