Relux
Generic Name
Clonazepam
Manufacturer
Drug International Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| relux 05 mg tablet | ৳ 4.00 | ৳ 40.00 |
Description
Overview of the medicine
Relux 0.5 mg tablet contains Clonazepam, a benzodiazepine, used to treat anxiety disorders, panic attacks, and certain types of seizures. It works by enhancing the effect of a natural chemical in the body (GABA) that calms brain activity.
Uses & Indications
Dosage
Adults
Initial dose for panic disorder: 0.25 mg twice daily, may be increased to 1 mg/day after 3 days. Max: 4 mg/day. For seizures: Initial dose 0.5 mg three times daily, may be increased by 0.5-1 mg every 3 days. Max: 20 mg/day.
Elderly
Lower initial doses (e.g., 0.25 mg once daily) and slower titration are recommended due to increased sensitivity and potential for adverse effects.
Renal_impairment
No specific dosage adjustment recommended for mild to moderate renal impairment, but caution is advised due to potential accumulation of metabolites. Monitor patient response.
How to Take
Oral administration. Tablets should be swallowed whole with water. Can be taken with or without food. Do not discontinue abruptly.
Mechanism of Action
Clonazepam enhances the activity of gamma-aminobutyric acid (GABA), an inhibitory neurotransmitter, by binding to specific benzodiazepine receptors on the GABA-A receptor complex. This leads to increased chloride ion influx, hyperpolarization of neurons, and reduced neuronal excitability, resulting in anxiolytic, anticonvulsant, sedative, and muscle relaxant effects.
Pharmacokinetics
Onset
Anxiolytic effects: 30-60 minutes; Anticonvulsant effects: 20-60 minutes.
Excretion
Primarily excreted in the urine as metabolites, with a small amount excreted in feces.
Half life
18-50 hours (average 30-40 hours).
Absorption
Well absorbed orally, peak plasma concentrations typically reached within 1-4 hours.
Metabolism
Extensively metabolized in the liver, primarily via nitroreduction by cytochrome P450 enzymes (mainly CYP3A4) and subsequent acetylation.
Side Effects
Contraindications
- Acute narrow-angle glaucoma
- Severe respiratory insufficiency
- Severe hepatic insufficiency
- Hypersensitivity to clonazepam or other benzodiazepines
Drug Interactions
Opioids
Increased risk of sedation, respiratory depression, coma, and death.
Antiepileptic drugs
Altered serum levels of both drugs may occur. Caution advised.
Alcohol and CNS depressants
Additive CNS depressant effects.
Strong 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, diminished reflexes, and coma. Management involves supportive care, maintaining airway, monitoring vital signs, and if appropriate, flumazenil (a benzodiazepine receptor antagonist) can be used, but with caution due to seizure risk.
Pregnancy & Lactation
Pregnancy Category D. May cause fetal harm. Use only if potential benefit outweighs the risk to the fetus. Excreted in breast milk, not recommended during lactation due to potential sedation and feeding difficulties in infants.
Side Effects
Contraindications
- Acute narrow-angle glaucoma
- Severe respiratory insufficiency
- Severe hepatic insufficiency
- Hypersensitivity to clonazepam or other benzodiazepines
Drug Interactions
Opioids
Increased risk of sedation, respiratory depression, coma, and death.
Antiepileptic drugs
Altered serum levels of both drugs may occur. Caution advised.
Alcohol and CNS depressants
Additive CNS depressant effects.
Strong 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, diminished reflexes, and coma. Management involves supportive care, maintaining airway, monitoring vital signs, and if appropriate, flumazenil (a benzodiazepine receptor antagonist) can be used, but with caution due to seizure risk.
Pregnancy & Lactation
Pregnancy Category D. May cause fetal harm. Use only if potential benefit outweighs the risk to the fetus. Excreted in breast milk, not recommended during lactation due to potential sedation and feeding difficulties in infants.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from manufacturing date.
Availability
Pharmacies
Approval Status
Approved by regulatory bodies (e.g., FDA, DGDA)
Patent Status
Generic available
WHO Essential Medicine
YesClinical Trials
Clonazepam has undergone numerous clinical trials establishing its efficacy and safety for various seizure disorders and panic disorder. Ongoing research explores its use in other neurological and psychiatric conditions.
Lab Monitoring
- Liver function tests (baseline and periodically for long-term use)
- Complete blood count (periodically for long-term use, especially if blood dyscrasias suspected)
- Renal function tests (for patients with severe renal impairment)
Doctor Notes
- Counsel patients on potential for dependence and withdrawal symptoms. Emphasize gradual tapering when discontinuing.
- Assess for concomitant use of opioids or other CNS depressants and warn about severe adverse reactions.
- Monitor for signs of depression, suicidal ideation, and paradoxical reactions.
Patient Guidelines
- Do not stop taking this medicine abruptly without consulting your doctor, as withdrawal symptoms may occur.
- Avoid alcohol and other CNS depressants while on this medication.
- This medicine may cause drowsiness or dizziness; avoid driving or operating heavy machinery until you know how it affects you.
- Report any unusual mood or behavior changes to your doctor.
Missed Dose Advice
If a dose is missed, take it as soon as you remember, unless it is almost time for your next dose. In that case, 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
This medicine can cause drowsiness, dizziness, and impaired coordination. Do not drive or operate machinery until you know how this medication affects you and are certain you can perform such activities safely.
Lifestyle Advice
- Maintain a regular sleep schedule.
- Practice relaxation techniques like deep breathing or meditation.
- Limit caffeine intake.
- Engage in regular physical activity.
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Global Brand Names
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