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 05 mg tablet | ৳ 2.01 | ৳ 20.10 |
Description
Overview of the medicine
Clonazepam is a benzodiazepine used to treat seizure disorders (epilepsy), panic disorder, and anxiety. It works by calming the brain and nerves.
Uses & Indications
Dosage
Adults
Panic Disorder: Initially 0.25 mg twice daily; may be increased to 1 mg/day after 3 days. Max 4 mg/day. Seizure Disorders: Initially 0.5 mg three times daily; may be increased by 0.5-1 mg every 3 days until seizure control is achieved. Max 20 mg/day.
Elderly
Start with lower doses (e.g., 0.25 mg once daily) and titrate carefully due to increased sensitivity and risk of adverse effects.
Renal_impairment
No specific dose adjustment needed for mild to moderate impairment, but use with caution.
How to Take
Oral, with or without food. Take exactly as prescribed. Do not stop abruptly.
Mechanism of Action
Potentiates the effect of GABA (gamma-aminobutyric acid), an inhibitory neurotransmitter, by binding to benzodiazepine receptors on the GABA-A receptor complex, leading to increased chloride influx and neuronal hyperpolarization.
Pharmacokinetics
Onset
20-60 minutes
Excretion
Primarily via urine as metabolites, with a small amount excreted in feces.
Half life
18-50 hours
Absorption
Rapidly absorbed after oral administration. Peak plasma concentrations are reached in 1-4 hours. Bioavailability is about 90%.
Metabolism
Extensively metabolized in the liver, primarily by nitroreduction by CYP3A4, followed by acetylation.
Side Effects
Contraindications
- Hypersensitivity to benzodiazepines
- Acute narrow-angle glaucoma
- Severe respiratory insufficiency
- Severe liver disease
Drug Interactions
Opioids
Increased risk of sedation, respiratory depression, coma, and death.
Alcohol/CNS depressants
Increased sedative effects.
Antifungals (e.g., Ketoconazole)
May increase clonazepam levels.
CYP3A4 inducers (e.g., Rifampin)
May decrease clonazepam levels.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms include drowsiness, confusion, impaired coordination, diminished reflexes, coma. Treatment is supportive; flumazenil may be used to reverse benzodiazepine effects, but caution is needed in patients with seizure disorders.
Pregnancy & Lactation
Pregnancy: Category D. May cause fetal harm. Use only if potential benefit outweighs risk. Lactation: Excreted in breast milk. Not recommended due to potential sedation and feeding difficulties in infants.
Side Effects
Contraindications
- Hypersensitivity to benzodiazepines
- Acute narrow-angle glaucoma
- Severe respiratory insufficiency
- Severe liver disease
Drug Interactions
Opioids
Increased risk of sedation, respiratory depression, coma, and death.
Alcohol/CNS depressants
Increased sedative effects.
Antifungals (e.g., Ketoconazole)
May increase clonazepam levels.
CYP3A4 inducers (e.g., Rifampin)
May decrease clonazepam levels.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms include drowsiness, confusion, impaired coordination, diminished reflexes, coma. Treatment is supportive; flumazenil may be used to reverse benzodiazepine effects, but caution is needed in patients with seizure disorders.
Pregnancy & Lactation
Pregnancy: Category D. May cause fetal harm. Use only if potential benefit outweighs risk. Lactation: Excreted in breast milk. Not recommended due to potential sedation and feeding difficulties in infants.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 months
Availability
Pharmacies, hospitals
Approval Status
DGDA Approved
Patent Status
Off-patent (Generic)
WHO Essential Medicine
YesClinical Trials
Extensive clinical trials have established the efficacy and safety of clonazepam for its approved indications.
Lab Monitoring
- Periodic blood counts and liver function tests are recommended with long-term therapy.
Doctor Notes
- Counsel patients on the risk of dependence and withdrawal.
- Advise against abrupt discontinuation.
- Monitor for signs of respiratory depression, especially with concomitant opioid use.
Patient Guidelines
- Do not stop taking this medicine suddenly.
- Avoid alcohol while taking this medicine.
- Do not drive or operate heavy machinery until you know how this medicine affects you.
Missed Dose Advice
Take the missed dose as soon as remembered, unless it is almost time for the next dose. Do not double the dose.
Driving Precautions
This medicine may cause drowsiness, dizziness, or impaired coordination. Avoid driving or operating machinery until you know how it affects you.
Lifestyle Advice
- Practice good sleep hygiene.
- Manage stress through relaxation techniques or therapy.
- Avoid caffeine and other stimulants.
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Global Brand Names
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