Closid
Generic Name
Clonazepam
Manufacturer
General Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| closid 1 mg tablet | ৳ 8.00 | ৳ 120.00 |
Description
Overview of the medicine
Closid 1 mg Tablet contains Clonazepam, a benzodiazepine derivative. It is primarily used to prevent and control seizures, and to treat panic disorder and anxiety. It works by calming the brain and nerves.
Uses & Indications
Dosage
Adults
Initial dose: 0.25-0.5 mg orally, 2-3 times daily. Maintenance dose: 0.5-2 mg orally, 2-3 times daily, not exceeding 20 mg/day.
Elderly
Lower initial doses (e.g., 0.25 mg once or twice daily) recommended due to increased sensitivity and risk of adverse effects.
Renal_impairment
No specific dosage adjustment recommended, but caution advised due to potential for accumulation of metabolites.
How to Take
Closid tablets should be swallowed whole with water, with or without food. Do not chew or crush. For panic disorder, the initial dose may be taken at bedtime to minimize drowsiness.
Mechanism of Action
Clonazepam enhances the effect of gamma-aminobutyric acid (GABA), a neurotransmitter that inhibits nerve activity in the brain. By binding to specific benzodiazepine receptors on GABA-A receptors, it increases the frequency of chloride channel opening, leading to hyperpolarization and decreased neuronal excitability.
Pharmacokinetics
Onset
Anticonvulsant effect within 20-60 minutes; anxiolytic effect within 30-60 minutes.
Excretion
Primarily excreted in the urine as metabolites (less than 2% as unchanged drug).
Half life
18-50 hours.
Absorption
Well absorbed orally, with peak plasma concentrations reached in 1-4 hours.
Metabolism
Extensively metabolized in the liver via nitroreduction, followed by N-acetylation and hydroxylation.
Side Effects
Contraindications
- Acute narrow-angle glaucoma
- Severe liver disease
- History of hypersensitivity to benzodiazepines or any component of the formulation
Drug Interactions
Opioids
Increased risk of profound sedation, respiratory depression, coma, and death.
Antiepileptic drugs
May alter levels of other antiepileptics (e.g., phenytoin).
Alcohol and other CNS depressants
Additive CNS depressant effects.
CYP3A4 inhibitors (e.g., ketoconazole, ritonavir)
May increase clonazepam plasma concentrations.
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, impaired coordination, diminished reflexes, and coma. Management involves supportive care, maintaining airway, and monitoring vital signs. Flumazenil may be used to reverse benzodiazepine effects, but use with caution due to risk of seizures in physically dependent patients.
Pregnancy & Lactation
Pregnancy Category D. May cause fetal harm. Use only if potential benefit justifies the potential risk to the fetus. Excreted in breast milk; not recommended during breastfeeding.
Side Effects
Contraindications
- Acute narrow-angle glaucoma
- Severe liver disease
- History of hypersensitivity to benzodiazepines or any component of the formulation
Drug Interactions
Opioids
Increased risk of profound sedation, respiratory depression, coma, and death.
Antiepileptic drugs
May alter levels of other antiepileptics (e.g., phenytoin).
Alcohol and other CNS depressants
Additive CNS depressant effects.
CYP3A4 inhibitors (e.g., ketoconazole, ritonavir)
May increase clonazepam plasma concentrations.
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, impaired coordination, diminished reflexes, and coma. Management involves supportive care, maintaining airway, and monitoring vital signs. Flumazenil may be used to reverse benzodiazepine effects, but use with caution due to risk of seizures in physically dependent patients.
Pregnancy & Lactation
Pregnancy Category D. May cause fetal harm. Use only if potential benefit justifies the potential risk to the fetus. Excreted in breast milk; not recommended during breastfeeding.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 to 36 months from manufacturing date.
Availability
Pharmacies, hospitals
Approval Status
Approved
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Extensive clinical trials have established the efficacy and safety of clonazepam for seizure disorders and panic disorder. Ongoing post-marketing surveillance and studies continue to refine understanding of its use.
Lab Monitoring
- Monitor liver function tests periodically, especially in patients with pre-existing hepatic impairment.
- Monitor complete blood count (CBC) if long-term therapy is anticipated.
Doctor Notes
- Caution with elderly, liver impairment, and respiratory depression.
- Monitor for signs of dependence and withdrawal.
- Counsel patients on the risks of concomitant opioid and alcohol use.
- Taper gradually to avoid withdrawal seizures.
Patient Guidelines
- Do not stop taking this medicine suddenly, as it can cause withdrawal symptoms.
- Avoid alcohol while taking Closid.
- Inform your doctor about all other medications you are taking.
- Be aware of potential drowsiness and impaired coordination.
Missed Dose Advice
If a dose is missed, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue your regular dosing schedule. Do not double the dose to catch up.
Driving Precautions
Closid can cause drowsiness, dizziness, and impaired coordination, which may affect your ability to drive or operate machinery. Avoid such activities until you are certain you can perform them safely.
Lifestyle Advice
- Maintain a regular sleep schedule.
- Practice stress-reduction techniques.
- Avoid driving or operating heavy machinery until you know how this medicine affects you.
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