Closid
Generic Name
Clonazepam
Manufacturer
Acme Laboratories Ltd.
Country
Bangladesh
Loading images...
Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| closid 2 mg tablet | ৳ 10.00 | ৳ 150.00 |
Description
Overview of the medicine
Clonazepam is a benzodiazepine medication used to prevent and control seizures, and to treat panic disorder. It works by calming the brain and nerves.
Uses & Indications
Dosage
Adults
Initial dose for panic disorder is 0.25 mg twice daily, increased to 1 mg/day after 3 days. For seizure disorders, initial dose is 0.5 mg three times daily, increased by 0.5-1 mg every 3 days until control is achieved (max 20 mg/day).
Elderly
Lower initial doses (e.g., 0.25 mg once daily) and slower titration recommended due to increased sensitivity and potential for adverse effects.
Renal_impairment
No specific dosage adjustment guidance for renal impairment, but caution is advised due to potential for accumulation of metabolites.
How to Take
Administer orally. Can be taken with or without food. Tablets can be scored if needed.
Mechanism of Action
Clonazepam enhances the effect of gamma-aminobutyric acid (GABA), an inhibitory neurotransmitter, in the central nervous system. This leads to reduced neuronal excitability, producing anxiolytic, anticonvulsant, sedative, and muscle relaxant effects.
Pharmacokinetics
Onset
30-60 minutes (oral) for anticonvulsant effects.
Excretion
Mainly excreted in the urine as metabolites, with a small amount excreted in feces.
Half life
Approximately 18-50 hours.
Absorption
Rapidly and completely absorbed after oral administration. Peak plasma concentrations are reached in 1-4 hours.
Metabolism
Extensively metabolized in the liver, primarily by nitroreduction by CYP3A4, followed by acetylation.
Side Effects
Contraindications
- Hypersensitivity to clonazepam or other benzodiazepines
- Acute narrow-angle glaucoma
- Severe liver disease
- Respiratory insufficiency
Drug Interactions
Opioids
Increased risk of sedation, respiratory depression, coma, and death.
Alcohol/CNS Depressants
Additive CNS depressant effects, including increased sedation and respiratory depression.
Antifungals (e.g., Ketoconazole)
May inhibit clonazepam metabolism, leading to increased plasma levels.
Enzyme Inducers (e.g., Phenytoin, Carbamazepine)
May decrease clonazepam plasma levels and efficacy.
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. Treatment is primarily supportive. Maintain a clear airway, monitor vital signs, and administer IV fluids. Flumazenil may be used in severe cases but with caution due to potential for seizures.
Pregnancy & Lactation
Pregnancy Category D. May cause fetal harm; avoid during pregnancy, especially in the first trimester. Excreted in breast milk, so avoid during lactation or discontinue breastfeeding.
Side Effects
Contraindications
- Hypersensitivity to clonazepam or other benzodiazepines
- Acute narrow-angle glaucoma
- Severe liver disease
- Respiratory insufficiency
Drug Interactions
Opioids
Increased risk of sedation, respiratory depression, coma, and death.
Alcohol/CNS Depressants
Additive CNS depressant effects, including increased sedation and respiratory depression.
Antifungals (e.g., Ketoconazole)
May inhibit clonazepam metabolism, leading to increased plasma levels.
Enzyme Inducers (e.g., Phenytoin, Carbamazepine)
May decrease clonazepam plasma levels and efficacy.
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. Treatment is primarily supportive. Maintain a clear airway, monitor vital signs, and administer IV fluids. Flumazenil may be used in severe cases but with caution due to potential for seizures.
Pregnancy & Lactation
Pregnancy Category D. May cause fetal harm; avoid during pregnancy, especially in the first trimester. Excreted in breast milk, so avoid during lactation or discontinue breastfeeding.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24-36 months from manufacturing date
Availability
Available in pharmacies, hospitals, and medical clinics
Approval Status
Approved by regulatory authorities (e.g., FDA, DGDA)
Patent Status
Off-patent (Generic available)
WHO Essential Medicine
YesClinical Trials
Extensive clinical trials have established clonazepam's efficacy and safety for its approved indications, with ongoing research exploring its potential in other neurological or psychiatric conditions.
Lab Monitoring
- Liver function tests (baseline and periodically for long-term use)
- Complete blood count (periodically for long-term use)
- Renal function tests (baseline and periodically)
Doctor Notes
- Advise patients about the risk of dependence and withdrawal; counsel on gradual tapering when discontinuing.
- Monitor for signs of abuse or diversion.
- Consider potential for respiratory depression, especially with concomitant opioid use or in patients with pre-existing respiratory conditions.
Patient Guidelines
- Do not stop taking this medicine suddenly, as it can cause withdrawal symptoms.
- Avoid alcohol and other CNS depressants while taking clonazepam.
- This medicine may cause drowsiness or dizziness; avoid driving or operating heavy machinery until you know how it affects you.
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 resume your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
Clonazepam can cause drowsiness, dizziness, and impaired coordination. Patients should be advised not to drive or operate hazardous machinery until they are certain that clonazepam does not adversely affect their ability to engage in such activities.
Lifestyle Advice
- Maintain a healthy sleep schedule.
- Practice stress-reduction techniques (e.g., meditation, yoga).
- Limit caffeine intake, especially in the evening.
Alternative Medicines in Bangladesh
Similar medicines available in the market
Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.
Other Medicines in Closid Brand
Other medicines available under the same brand name
