Novotril
Generic Name
Clonazepam
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
Loading images...
Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| novotril 2 mg tablet | ৳ 9.00 | ৳ 90.00 |
Description
Overview of the medicine
Clonazepam is a benzodiazepine derivative used to prevent and control seizures (also called anticonvulsants or antiepileptics). It is also used to treat panic disorder. It works by calming the brain and nerves.
Uses & Indications
Dosage
Adults
For Panic Disorder: Initial 0.25 mg orally twice daily; increase to 1 mg/day after 3 days; target dosage 1-4 mg/day. For Seizure Disorders: Initial 0.5 mg orally three times daily; increase by 0.5 to 1 mg every 3 days until seizures are controlled or side effects become prohibitive; maximum 20 mg/day.
Elderly
Lower initial doses (e.g., 0.25 mg once daily) and slower titration recommended due to increased sensitivity and risk of adverse effects.
Renal_impairment
No specific dose adjustment is generally required, but caution is advised in patients with severe renal impairment.
How to Take
Take orally with or without food. Swallow the tablet whole with a glass of water. Do not crush, chew, or break it unless specified by your doctor.
Mechanism of Action
Clonazepam enhances the effect of gamma-aminobutyric acid (GABA), a natural chemical in the body that calms nerve activity in the brain. This leads to decreased neuronal excitability.
Pharmacokinetics
Onset
20-60 minutes
Excretion
Excreted primarily in the urine as metabolites, with a small amount of unchanged drug.
Half life
19-60 hours (average 30-40 hours)
Absorption
Well absorbed from the gastrointestinal tract; peak plasma concentrations reached in 1-4 hours.
Metabolism
Extensively metabolized in the liver, primarily by nitroreduction via CYP3A4 to 7-aminoclonazepam and hydroxylation.
Side Effects
Contraindications
- Hypersensitivity to benzodiazepines or any component of the formulation
- Acute narrow-angle glaucoma
- Significant liver disease
Drug Interactions
Phenytoin, Carbamazepine
May alter clonazepam blood levels or the effectiveness of these anticonvulsants.
Opioids, Alcohol, Other CNS Depressants
Increased risk of profound sedation, respiratory depression, coma, and death.
CYP3A4 Inhibitors (e.g., Ketoconazole, Fluconazole)
May increase clonazepam plasma concentrations, leading to enhanced effects and side effects.
Storage
Store in a cool, dry place below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include somnolence, confusion, impaired coordination, diminished reflexes, and coma. Management involves supportive care, maintaining a patent airway, and monitoring vital signs. Flumazenil may be used as an antidote in severe cases, but with caution due to the risk of precipitating withdrawal symptoms.
Pregnancy & Lactation
Pregnancy Category D: There is positive evidence of human fetal risk. Should only be used if the potential benefit outweighs the potential risk to the fetus. Lactation: Excreted in breast milk; advise against breastfeeding.
Side Effects
Contraindications
- Hypersensitivity to benzodiazepines or any component of the formulation
- Acute narrow-angle glaucoma
- Significant liver disease
Drug Interactions
Phenytoin, Carbamazepine
May alter clonazepam blood levels or the effectiveness of these anticonvulsants.
Opioids, Alcohol, Other CNS Depressants
Increased risk of profound sedation, respiratory depression, coma, and death.
CYP3A4 Inhibitors (e.g., Ketoconazole, Fluconazole)
May increase clonazepam plasma concentrations, leading to enhanced effects and side effects.
Storage
Store in a cool, dry place below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include somnolence, confusion, impaired coordination, diminished reflexes, and coma. Management involves supportive care, maintaining a patent airway, and monitoring vital signs. Flumazenil may be used as an antidote in severe cases, but with caution due to the risk of precipitating withdrawal symptoms.
Pregnancy & Lactation
Pregnancy Category D: There is positive evidence of human fetal risk. Should only be used if the potential benefit outweighs the potential risk to the fetus. Lactation: Excreted in breast milk; advise against breastfeeding.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 to 36 months from the date of manufacture, specific to manufacturer.
Availability
Available in pharmacies nationwide
Approval Status
Approved by FDA (USA) and DGDA (Bangladesh)
Patent Status
Generic versions available
WHO Essential Medicine
YesClinical Trials
Extensive clinical trials have established clonazepam's efficacy and safety in the treatment of various seizure disorders and panic disorder.
Lab Monitoring
- Regular monitoring of liver function tests may be considered in patients on long-term therapy.
- Complete blood counts may be performed periodically, though blood dyscrasias are rare.
Doctor Notes
- Emphasize the importance of gradual tapering to avoid withdrawal symptoms.
- Caution patients about the risks of concurrent use with opioids and alcohol.
- Monitor for signs of depression or suicidal ideation, especially in patients with pre-existing psychiatric conditions.
Patient Guidelines
- Do not stop taking this medication abruptly, as it can cause withdrawal symptoms including seizures. Always consult your doctor for gradual tapering.
- Avoid alcohol and other central nervous system 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 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 return to your regular dosing schedule. Do not double the dose.
Driving Precautions
Clonazepam can cause drowsiness, dizziness, and impaired coordination. Do not drive or operate machinery until you are certain how this medication affects your ability to perform such tasks safely.
Lifestyle Advice
- Maintain a regular sleep schedule and practice stress-reducing techniques (e.g., meditation, yoga) to complement treatment.
- Avoid caffeine and other stimulants, especially in the evening, to improve sleep quality.
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 Novotril Brand
Other medicines available under the same brand name
