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Action/Kinetics:
Benzodiazepine derivative which increases presynaptic inhibition and suppresses the spread of seizure activity.
Peak plasma levels: 1-2 hr.
t
1/2: 18-60 hr.
Therapeutic serum levels: 20-80 ng/mL. More than 80% bound to plasma protein; metabolized almost completely in the liver to inactive metabolites, which are excreted in the urine.
Even though a benzodiazepine, clonazepam, is used only as an anticonvulsant. However, contraindications, side effects, and so forth are similar to those for diazepam.
Uses:
Absence seizures (petit mal) including Lennox-Gastaut syndrome, akinetic and myoclonic seizures. Some effectiveness in clients resistant to succinimide therapy.
Investigational: Parkinsonian dysarthria, acute manic episodes of bipolar affective disorder, leg movements (periodic) during sleep, adjunct in treating schizophrenia, neuralgias, multifocal tic disorders.
Contraindications:
Sensitivity to benzodiazepines. Severe liver disease, acute narrow-angle glaucoma. Pregnancy.
Special Concerns:
Effects on lactation not known.
Additional Side Effects:
In clients in whom different types of seizure disorders exist, clonazepam may elicit or precipitate
grand mal seizures.
Drug Interactions:
-
CNS depressants / Potentiation of CNS depressant effect of clonazepam
-
Phenobarbital /
Effect of clonazepam due to
breakdown by liver
-
Phenytoin /
Effect of clonazepam due to
breakdown by liver
-
Valproic acid /
Chance of absence seizures
How Supplied:
Tablet: 0.5 mg, 1 mg, 2 mg
Dosage
?Tablets
Seizure disorders.
Adults, initial: 0.5 mg t.i.d. Increase by 0.5-1 mg/day q 3 days until seizures are under control or side effects become excessive;
maximum: 20 mg/day.
Pediatric up to 10 years or 30 kg: 0.01-0.03 mg/kg/day in two to three divided doses up to a maximum of 0.05 mg/kg/day. Increase by increments of 0.25-0.5 mg q 3 days until seizures are under control or maintenance of 0.1-0.2 mg/kg is attained.
Parkinsonian dysarthria.
Adults: 0.25-0.5 mg/day.
Acute manic episodes of bipolar affective disorder.
Adults: 0.75-16 mg/day.
Periodic leg movements during sleep.
Adults: 0.5-2 mg nightly.
Adjunct to treat schizophrenia.
Adults: 0.5-2 mg/day.
Neuralgias.
Adults: 2-4 mg/day.
Multifocal tic disorders.
Adults: 1.5-12 mg/day.
