Restonix
Generic Name
Clonazepam 2 mg Tablet
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| restonix 2 mg tablet | ৳ 10.00 | ৳ 100.00 |
Description
Overview of the medicine
Clonazepam is a benzodiazepine derivative that possesses anxiolytic, anticonvulsant, muscle relaxant, and hypnotic properties. It is used to treat various seizure disorders and panic disorder.
Uses & Indications
Dosage
Adults
For panic disorder: Initially 0.25 mg twice daily, may increase to target dose of 1 mg daily after 3 days. Max 4 mg/day. For seizure disorders: Initially 0.5 mg three times daily, may increase by 0.5-1 mg every 3 days. Max 20 mg/day.
Elderly
Initially lower doses (e.g., 0.25 mg once daily for panic disorder) should be used, with careful titration due to increased sensitivity and slower metabolism.
Renal_impairment
No specific dosage adjustments are required for mild to moderate renal impairment, but caution is advised in severe renal impairment. Metabolites may accumulate.
How to Take
Oral administration. May be taken with or without food. For panic disorder, the tablet should be swallowed whole. For seizure disorders, the tablets can be scored for precise dosing.
Mechanism of Action
Clonazepam enhances the activity of gamma-aminobutyric acid (GABA), the main inhibitory neurotransmitter in the central nervous system. It binds to specific benzodiazepine receptors on the GABA-A receptor complex, increasing chloride ion influx and hyperpolarizing the neuron, leading to reduced neuronal excitability.
Pharmacokinetics
Onset
20-60 minutes
Excretion
Primarily excreted in the urine as metabolites (approx. 50-70%) and a small amount in feces. Less than 2% is excreted unchanged in urine.
Half life
18-50 hours (average 30-40 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 to 7-aminoclonazepam and hydroxylation.
Side Effects
Contraindications
- Known hypersensitivity to clonazepam or other benzodiazepines
- Acute narrow-angle glaucoma
- Severe respiratory insufficiency
- Severe hepatic insufficiency
Drug Interactions
Opioids
Increased risk of respiratory depression, sedation, and coma.
Alcohol and other CNS depressants
Potentiation of sedative effects and respiratory depression.
Antifungals (e.g., Ketoconazole), SSRIs
May inhibit clonazepam metabolism, leading to increased plasma levels and enhanced effects.
Storage
Store below 30°C in a dry place, away from light. Keep out of reach of children.
Overdose
Symptoms include drowsiness, confusion, ataxia, diminished reflexes, and coma. Treatment is primarily supportive. Flumazenil may be used as an antidote, but caution is advised in patients on long-term benzodiazepine therapy due to risk of acute withdrawal.
Pregnancy & Lactation
Pregnancy Category D: Evidence of fetal risk, but benefits may outweigh risks in serious situations. Use only if clearly needed. Excreted into breast milk; breastfeeding not recommended.
Side Effects
Contraindications
- Known hypersensitivity to clonazepam or other benzodiazepines
- Acute narrow-angle glaucoma
- Severe respiratory insufficiency
- Severe hepatic insufficiency
Drug Interactions
Opioids
Increased risk of respiratory depression, sedation, and coma.
Alcohol and other CNS depressants
Potentiation of sedative effects and respiratory depression.
Antifungals (e.g., Ketoconazole), SSRIs
May inhibit clonazepam metabolism, leading to increased plasma levels and enhanced effects.
Storage
Store below 30°C in a dry place, away from light. Keep out of reach of children.
Overdose
Symptoms include drowsiness, confusion, ataxia, diminished reflexes, and coma. Treatment is primarily supportive. Flumazenil may be used as an antidote, but caution is advised in patients on long-term benzodiazepine therapy due to risk of acute withdrawal.
Pregnancy & Lactation
Pregnancy Category D: Evidence of fetal risk, but benefits may outweigh risks in serious situations. Use only if clearly needed. Excreted into breast milk; breastfeeding not recommended.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
36 months from manufacturing date.
Availability
Pharmacies nationwide
Approval Status
Approved by DGDA
Patent Status
Generic available
WHO Essential Medicine
YesClinical Trials
Numerous clinical trials have established clonazepam's efficacy in treating panic disorder, various seizure types, and anxiety. Studies focus on long-term safety, withdrawal, and comparisons with other anxiolytics/anticonvulsants.
Lab Monitoring
- Liver function tests (baseline and periodically, especially in long-term use)
- Complete blood count (periodically in long-term use)
Doctor Notes
- Educate patients on the risks of dependence and withdrawal. Gradually taper the dose when discontinuing.
- Assess for co-occurring mental health conditions and substance use history.
- Monitor for signs of respiratory depression, especially with concomitant opioid use.
Patient Guidelines
- Do not stop taking this medicine abruptly without consulting your doctor, as withdrawal symptoms may occur.
- Avoid alcohol while taking this medicine.
- This medicine may cause drowsiness; 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
Take the missed dose as soon as you remember, unless it is almost time for your next dose. In that case, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
May cause drowsiness, dizziness, and impaired coordination. Do not drive or operate machinery until you know how this medication affects you.
Lifestyle Advice
- Practice good sleep hygiene.
- Engage in stress-reducing activities like yoga or meditation.
- Maintain a balanced diet and regular exercise routine.
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Global Brand Names
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