Sypam
Generic Name
Clonazepam
Manufacturer
Incepta Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| sypam 2 mg tablet | ৳ 10.00 | ৳ 100.00 |
Description
Overview of the medicine
Sypam 2 mg Tablet contains Clonazepam, a benzodiazepine used to treat various seizure disorders, panic disorder, and anxiety. It works by enhancing the activity of a neurotransmitter called GABA in the brain.
Uses & Indications
Dosage
Adults
Initial: 0.25 mg orally twice daily for panic disorder; 0.5 mg orally three times daily for seizure disorders. May be increased by 0.125-0.5 mg every 3 days until desired effect or maximum dose of 20 mg/day for seizures, 4 mg/day for panic disorder.
Elderly
Lower initial doses (e.g., 0.25 mg once daily) and slower titration are recommended due to increased sensitivity and risk of adverse effects.
Renal_impairment
No specific dosage adjustment provided, but caution advised. Monitor for signs of accumulation.
Hepatic_impairment
Use with caution; consider lower doses and careful monitoring due to impaired metabolism.
How to Take
Take orally with water, with or without food. Do not chew or crush extended-release tablets. For conventional tablets, swallow whole.
Mechanism of Action
Clonazepam enhances the effect of gamma-aminobutyric acid (GABA), a major inhibitory neurotransmitter in the brain, by binding to specific benzodiazepine receptors on the GABAA receptor complex. This leads to increased chloride ion influx into neurons, resulting in hyperpolarization and reduced neuronal excitability.
Pharmacokinetics
Onset
Anticonvulsant effect: 20-60 minutes (oral); Anxiolytic effect: 30-60 minutes.
Excretion
Excreted primarily in the urine as metabolites, with less than 2% as unchanged drug. Minor fecal excretion.
Half life
18-50 hours (mean 30 hours).
Absorption
Rapidly and completely absorbed from the GI tract. Peak plasma concentrations are achieved within 1-4 hours.
Metabolism
Extensively metabolized in the liver, primarily via nitroreduction to 7-amino-clonazepam, followed by N-acetylation.
Side Effects
Contraindications
- Acute narrow-angle glaucoma
- Significant liver disease
- Hypersensitivity to benzodiazepines or any component of the formulation
- Acute respiratory insufficiency
Drug Interactions
Opioids
Increased risk of profound sedation, respiratory depression, coma, and death. Avoid concomitant use if possible.
CYP3A4 Inducers (e.g., rifampin)
May decrease clonazepam plasma concentrations.
CYP3A4 Inhibitors (e.g., ketoconazole, itraconazole)
May increase clonazepam plasma concentrations.
Antiepileptic drugs (e.g., phenytoin, phenobarbital, carbamazepine)
May alter clonazepam levels or increase CNS depression.
CNS Depressants (e.g., alcohol, barbiturates, other benzodiazepines)
Additive CNS depressant effects.
Storage
Store below 30°C in a dry place, away from light. Keep out of reach of children.
Overdose
Symptoms of overdose include somnolence, confusion, diminished reflexes, coma, and respiratory depression. Management is supportive, including monitoring vital signs and gastric lavage if appropriate. Flumazenil may be used to reverse benzodiazepine effects but should be used with caution, especially in patients with epilepsy.
Pregnancy & Lactation
Pregnancy Category D. Clonazepam can cause fetal harm when administered to a pregnant woman. It is excreted in human breast milk; therefore, use is not recommended during breastfeeding.
Side Effects
Contraindications
- Acute narrow-angle glaucoma
- Significant liver disease
- Hypersensitivity to benzodiazepines or any component of the formulation
- Acute respiratory insufficiency
Drug Interactions
Opioids
Increased risk of profound sedation, respiratory depression, coma, and death. Avoid concomitant use if possible.
CYP3A4 Inducers (e.g., rifampin)
May decrease clonazepam plasma concentrations.
CYP3A4 Inhibitors (e.g., ketoconazole, itraconazole)
May increase clonazepam plasma concentrations.
Antiepileptic drugs (e.g., phenytoin, phenobarbital, carbamazepine)
May alter clonazepam levels or increase CNS depression.
CNS Depressants (e.g., alcohol, barbiturates, other benzodiazepines)
Additive CNS depressant effects.
Storage
Store below 30°C in a dry place, away from light. Keep out of reach of children.
Overdose
Symptoms of overdose include somnolence, confusion, diminished reflexes, coma, and respiratory depression. Management is supportive, including monitoring vital signs and gastric lavage if appropriate. Flumazenil may be used to reverse benzodiazepine effects but should be used with caution, especially in patients with epilepsy.
Pregnancy & Lactation
Pregnancy Category D. Clonazepam can cause fetal harm when administered to a pregnant woman. It is excreted in human breast milk; therefore, use is not recommended during breastfeeding.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
36 months from manufacturing date
Availability
Available in pharmacies nationwide
Approval Status
Approved by DGDA and internationally
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Clonazepam has been extensively studied in various clinical trials for its efficacy in seizure disorders, panic disorder, and other anxiety-related conditions. Data support its use as an effective antiepileptic and anxiolytic agent.
Lab Monitoring
- Complete blood count (CBC) and liver function tests (LFTs) periodically, especially with long-term therapy.
- Renal function monitoring in patients with renal impairment.
Doctor Notes
- Advise patients about the potential for dependence and the importance of not discontinuing abruptly.
- Caution patients about additive CNS depression with alcohol or other sedatives.
- Regularly assess for efficacy, adverse effects, and need for continued treatment.
Patient Guidelines
- Do not suddenly stop taking this medicine as it may lead to withdrawal symptoms.
- Avoid alcohol and other CNS depressants.
- This medicine may cause drowsiness, avoid driving or operating heavy machinery.
- Inform your doctor about all other medications you are taking.
Missed Dose Advice
If you miss a dose, take it 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
Sypam 2 mg Tablet can cause drowsiness, dizziness, and impaired coordination, which may affect your ability to drive or operate machinery. Avoid such activities until you know how this medicine affects you.
Lifestyle Advice
- Regular exercise and a balanced diet can help manage anxiety and improve overall well-being.
- Practice relaxation techniques such as meditation or deep breathing to cope with stress.
- Ensure adequate sleep.
- Avoid caffeine and nicotine, which can worsen anxiety.
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