Clon
Generic Name
Clonazepam 2 mg tablet
Manufacturer
Generic Pharmaceutical Company
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| clon 2 mg tablet | ৳ 7.00 | ৳ 70.00 |
Description
Overview of the medicine
Clonazepam is a benzodiazepine used to treat various seizure disorders (like Lennox-Gastaut syndrome, akinetic, and myoclonic seizures) and panic disorder. It works by calming the brain and nerves.
Uses & Indications
Dosage
Adults
Panic Disorder: Initially 0.25 mg twice daily; may increase to 1 mg/day after 3 days. Seizure Disorders: Initially 0.5 mg three times daily; may increase by 0.5 mg to 1 mg every 3 days until seizure control, max 20 mg/day.
Elderly
Lower initial doses (e.g., 0.25 mg once daily) due to increased sensitivity and potential for adverse effects. Titrate slowly.
Renal_impairment
No specific dose adjustment recommended; however, use with caution and monitor for adverse effects due to potential accumulation of metabolites.
How to Take
Take orally with water, with or without food. Do not stop suddenly; dosage should be tapered gradually under medical supervision.
Mechanism of Action
Clonazepam enhances the activity of gamma-aminobutyric acid (GABA), a neurotransmitter that inhibits brain activity, thereby producing anxiolytic, anticonvulsant, sedative, and muscle relaxant effects.
Pharmacokinetics
Onset
20-60 minutes (oral)
Excretion
Excreted primarily in the urine as metabolites, with a small amount in feces.
Half life
18-50 hours
Absorption
Rapidly and extensively absorbed from the gastrointestinal tract; peak plasma concentrations achieved within 1-4 hours.
Metabolism
Primarily metabolized in the liver via nitroreduction by cytochrome P450 3A4 (CYP3A4) to inactive metabolites.
Side Effects
Contraindications
- Acute narrow-angle glaucoma
- Severe liver disease
- Hypersensitivity to benzodiazepines or any component of the formulation
Drug Interactions
CYP3A4 Inducers (e.g., rifampin, carbamazepine, phenytoin)
May decrease clonazepam plasma concentrations, reducing its effectiveness.
CYP3A4 Inhibitors (e.g., ketoconazole, fluconazole, ritonavir)
May increase clonazepam plasma concentrations, enhancing its effects and side effects.
Opioids, Alcohol, other CNS depressants (e.g., sedatives, hypnotics, antihistamines)
Increased risk of profound sedation, respiratory depression, coma, and death.
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, impaired coordination, and coma. Management involves supportive care, maintaining a clear airway, and monitoring vital signs. Flumazenil, a benzodiazepine receptor antagonist, may be used but should be administered with caution, especially in patients on chronic benzodiazepine therapy.
Pregnancy & Lactation
Pregnancy Category D: Avoid during pregnancy, especially in the first trimester, due to increased risk of congenital malformations and withdrawal symptoms in the newborn. Lactation: Clonazepam is excreted in breast milk; avoid breastfeeding or discontinue the drug.
Side Effects
Contraindications
- Acute narrow-angle glaucoma
- Severe liver disease
- Hypersensitivity to benzodiazepines or any component of the formulation
Drug Interactions
CYP3A4 Inducers (e.g., rifampin, carbamazepine, phenytoin)
May decrease clonazepam plasma concentrations, reducing its effectiveness.
CYP3A4 Inhibitors (e.g., ketoconazole, fluconazole, ritonavir)
May increase clonazepam plasma concentrations, enhancing its effects and side effects.
Opioids, Alcohol, other CNS depressants (e.g., sedatives, hypnotics, antihistamines)
Increased risk of profound sedation, respiratory depression, coma, and death.
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, impaired coordination, and coma. Management involves supportive care, maintaining a clear airway, and monitoring vital signs. Flumazenil, a benzodiazepine receptor antagonist, may be used but should be administered with caution, especially in patients on chronic benzodiazepine therapy.
Pregnancy & Lactation
Pregnancy Category D: Avoid during pregnancy, especially in the first trimester, due to increased risk of congenital malformations and withdrawal symptoms in the newborn. Lactation: Clonazepam is excreted in breast milk; avoid breastfeeding or discontinue the drug.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
2 to 3 years from manufacturing date.
Availability
Available in pharmacies and hospitals
Approval Status
DGDA Approved
Patent Status
Patent expired, available generically
WHO Essential Medicine
YesClinical Trials
Numerous clinical trials have established the efficacy and safety of clonazepam in the treatment of various seizure disorders and panic disorder.
Lab Monitoring
- Periodic monitoring of liver function tests (LFTs) is recommended in patients on long-term therapy or with pre-existing hepatic impairment. Complete Blood Count (CBC) may be monitored rarely.
Doctor Notes
- Emphasize the risk of dependence and the importance of gradual dose tapering.
- Use with caution in elderly patients and those with respiratory compromise.
- Monitor for signs of misuse or abuse.
Patient Guidelines
- Do not discontinue the medication abruptly; dosage should be tapered gradually under medical supervision to avoid withdrawal symptoms.
- Avoid alcohol and other CNS depressants while taking this medication.
- Report any unusual or severe side effects to your doctor immediately, especially paradoxical reactions like agitation or aggression.
- Do not drive or operate heavy machinery until you know how this medication affects you, as it can cause drowsiness and impair coordination.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not double the dose.
Driving Precautions
Clonazepam can cause drowsiness, dizziness, and impaired coordination, which may impair your ability to drive or operate machinery safely. Avoid such activities until you are certain you can perform them safely.
Lifestyle Advice
- Avoid activities requiring mental alertness, such as driving or operating machinery, until you understand how this medication affects you.
- Limit or avoid alcohol consumption.
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