Serelam
Generic Name
Clonazepam
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| serelam 025 mg tablet | ৳ 1.00 | ৳ 10.00 |
Description
Overview of the medicine
Serelam 0.25 mg Tablet contains Clonazepam, a benzodiazepine. It is used to treat various anxiety disorders, panic disorder, and certain types of seizure disorders by calming brain activity.
Uses & Indications
Dosage
Adults
Panic Disorder: Initially 0.25 mg twice daily, increase to 1-4 mg/day. Seizure Disorders: Initially 0.5 mg three times daily, increase as needed to a maximum of 20 mg/day.
Elderly
Lower initial doses (e.g., 0.25 mg once daily) are recommended due to increased sensitivity and potential for adverse effects. Titrate cautiously.
Renal_impairment
No specific dosage adjustment is typically required, but caution is advised in severe renal impairment due to potential accumulation of metabolites.
How to Take
Take orally with or without food. Swallow the tablet whole with water. Do not crush or chew.
Mechanism of Action
Clonazepam enhances the effect of gamma-aminobutyric acid (GABA), a neurotransmitter in the brain, which leads to a reduction in nerve excitability and provides anxiolytic, anticonvulsant, sedative, and muscle-relaxant effects.
Pharmacokinetics
Onset
Anxiolytic/Sedative: 20-60 minutes; Anticonvulsant: 30-60 minutes.
Excretion
Mainly excreted in the urine as metabolites; a small amount excreted in feces.
Half life
18-50 hours (average 30-40 hours).
Absorption
Well absorbed after oral administration; peak plasma concentrations reached in 1-4 hours.
Metabolism
Extensively metabolized in the liver, primarily by nitroreduction via cytochrome P450 3A4 (CYP3A4), to inactive metabolites.
Side Effects
Contraindications
- Hypersensitivity to clonazepam or other benzodiazepines
- Acute narrow-angle glaucoma
- Severe respiratory insufficiency
- Severe hepatic insufficiency
Drug Interactions
CYP3A4 Inducers (e.g., rifampicin, carbamazepine)
May decrease clonazepam plasma concentrations, reducing efficacy.
CYP3A4 Inhibitors (e.g., ketoconazole, fluvoxamine)
May increase clonazepam plasma concentrations, requiring dose adjustment.
CNS Depressants (e.g., alcohol, opioids, other benzodiazepines)
Increased risk of profound sedation, respiratory depression, coma, and death.
Storage
Store below 25°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms include somnolence, confusion, diminished reflexes, impaired coordination, and coma. Management involves supportive care, monitoring of vital signs, and gastric lavage if appropriate. Flumazenil, a benzodiazepine receptor antagonist, can be used but with caution due to the risk of inducing seizures in patients on chronic benzodiazepine therapy.
Pregnancy & Lactation
Pregnancy Category D: Clonazepam may cause fetal harm when administered to a pregnant woman. There is an increased risk of congenital malformations and neonatal withdrawal syndrome. Not recommended during lactation as it is excreted in breast milk and may cause sedation or feeding difficulties in the infant.
Side Effects
Contraindications
- Hypersensitivity to clonazepam or other benzodiazepines
- Acute narrow-angle glaucoma
- Severe respiratory insufficiency
- Severe hepatic insufficiency
Drug Interactions
CYP3A4 Inducers (e.g., rifampicin, carbamazepine)
May decrease clonazepam plasma concentrations, reducing efficacy.
CYP3A4 Inhibitors (e.g., ketoconazole, fluvoxamine)
May increase clonazepam plasma concentrations, requiring dose adjustment.
CNS Depressants (e.g., alcohol, opioids, other benzodiazepines)
Increased risk of profound sedation, respiratory depression, coma, and death.
Storage
Store below 25°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms include somnolence, confusion, diminished reflexes, impaired coordination, and coma. Management involves supportive care, monitoring of vital signs, and gastric lavage if appropriate. Flumazenil, a benzodiazepine receptor antagonist, can be used but with caution due to the risk of inducing seizures in patients on chronic benzodiazepine therapy.
Pregnancy & Lactation
Pregnancy Category D: Clonazepam may cause fetal harm when administered to a pregnant woman. There is an increased risk of congenital malformations and neonatal withdrawal syndrome. Not recommended during lactation as it is excreted in breast milk and may cause sedation or feeding difficulties in the infant.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
2 years from the date of manufacture.
Availability
Available in pharmacies nationwide
Approval Status
Approved (by regulatory authorities like DGDA)
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Clonazepam has been extensively studied in numerous clinical trials establishing its efficacy and safety for indicated conditions. Ongoing research explores its use in other neurological and psychiatric disorders.
Lab Monitoring
- Complete blood count (CBC) and liver function tests (LFTs) should be monitored periodically during long-term therapy.
Doctor Notes
- Assess patient history for substance abuse or addiction before prescribing.
- Advise patients on the risks of concomitant use with opioids and alcohol.
- Emphasize the importance of gradual dose reduction to prevent withdrawal symptoms.
Patient Guidelines
- Do not stop taking this medicine abruptly without consulting your doctor, as it can lead to severe withdrawal symptoms.
- Avoid alcohol and other central nervous system depressants while on this medication.
- Report any unusual or severe side effects to your doctor immediately.
- This medicine may cause drowsiness or dizziness; avoid activities requiring mental alertness like driving or operating machinery.
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 resume your regular dosing schedule. Do not double the dose.
Driving Precautions
Clonazepam can cause drowsiness, dizziness, and impaired coordination, which can significantly impair your ability to drive or operate machinery. Avoid such activities until you are certain the medication does not affect your performance.
Lifestyle Advice
- Avoid activities that require full mental alertness until you know how this medicine affects you.
- Maintain a healthy sleep schedule and avoid excessive caffeine intake.
- Inform your doctor about any history of substance abuse or addiction.
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