💊 Clonazepam (Clonazepam)
Clonazepam is a benzodiazepine used to treat certain seizure disorders and panic disorder. It is available by prescription only, and the dose and duration are set by your doctor or pharmacist.
In Arabic: كلونازيبام
🏷️ Brand names & manufacturers
Packages shown are US-market (DailyMed). Brands available in Palestine are in the price section below.
Klonopin🏭 H2-Pharma, LLC
Clonazepam🏭 Advagen Pharma Ltd
Clonazepam🏭 Par Health USA, LLC✅ What it is used for
- Seizure disorders: Lennox-Gastaut syndrome (petit mal variant), akinetic and myoclonic seizures, alone or as an add-on
- May be useful in absence (petit mal) seizures in patients who failed to respond to succinimides
- Panic disorder, with or without agoraphobia
🧪 Active ingredient
Clonazepam: its anti-seizure and anti-panic effects are believed to be related to enhancing the activity of gamma-aminobutyric acid (GABA), the major inhibitory neurotransmitter in the central nervous system.
🌿 Benefits
- Helps control certain types of seizures
- Helps treat panic disorder and reduce panic attacks
📝 How to use
- Taken by mouth; swallow the tablet whole with water
- The dose is set by your doctor or pharmacist based on your condition and response; do not change it yourself
- In panic disorder, your doctor may advise one dose at bedtime to reduce drowsiness
- Do not stop suddenly; the dose must be reduced gradually under medical supervision
💊 Dosage forms
- Tablets: 0.25 mg, 0.5 mg, 1 mg and 2 mg
⚠️ Common side effects
- Drowsiness (about 50% of seizure patients)
- Ataxia/unsteadiness (about 30%)
- Behavior problems (about 25% of seizure patients)
- Dizziness, muscle weakness, headache
- Constipation or diarrhea, dry mouth, nausea
- Changes in appetite or weight
🚨 Serious — seek medical help
- Respiratory depression and coma
- Confusion, depression, psychosis, hallucinations
- Paradoxical reactions such as aggression, agitation, nightmares
- Blood count changes (anemia, leukopenia, thrombocytopenia)
- Liver enzyme elevations and hepatomegaly
- Serious withdrawal reactions if stopped abruptly
⛔ Do not use if
- History of sensitivity to benzodiazepines
- Clinical or biochemical evidence of significant liver disease
- Acute narrow angle glaucoma (may be used in open angle glaucoma with appropriate therapy)
❗ Warnings & precautions
- Boxed warning: Use with opioids may cause profound sedation, respiratory depression, coma, and death
- Risk of abuse, misuse, and addiction, which can lead to overdose or death
- Continued use may cause physical dependence; abrupt discontinuation or rapid dose reduction may cause life-threatening withdrawal reactions
- Some loss of effect may occur during treatment
- With long-term use in panic disorder, the physician should periodically reevaluate usefulness
- Caution in patients with liver or kidney impairment
- In children treated for seizures, long-term benefit-risk should be considered because effects on physical or mental development may appear only after many years
🔄 Drug interactions
- Opioids: increased risk of respiratory depression and sedation
- Alcohol and other CNS depressants: may add to sedation and can be dangerous
- Phenytoin: clonazepam may affect its concentration; monitoring is recommended
- Phenytoin, carbamazepine, lamotrigine, phenobarbital: induce clonazepam metabolism, lowering plasma levels by about 38%
- Multiple anticonvulsants together may increase CNS depressant effects
- Tell your doctor or pharmacist about all medicines you take
🤰 Pregnancy
Neonates born to mothers using benzodiazepines late in pregnancy may experience sedation and/or withdrawal symptoms. Animal studies in rabbits showed developmental toxicity and fetal malformations at doses similar to or below therapeutic doses. Discuss benefits and risks with your doctor; pregnant women are encouraged to enroll in the NAAED Pregnancy Registry (1-888-233-2334).
🍼 Breastfeeding
Clonazepam passes into breast milk. Sedation, poor feeding, and poor weight gain have been reported in exposed infants. Infants should be monitored for these signs; discuss with your doctor.
🧒 Children
In seizure disorders, pediatric dosing is weight-based and set by the doctor. Safety and effectiveness in panic disorder have not been established in patients under 18.
👴 Older adults
There is insufficient clinical trial experience in patients 65 and older. Start at low doses with close monitoring, as elderly patients are more prone to confusion and over-sedation and to reduced liver and kidney function.
🌡️ Storage
Store at 20°C to 25°C (68°F to 77°F), away from children.
⏰ Missed dose
The label gives no specific instructions for a missed dose. Ask your doctor or pharmacist, and do not double the dose on your own.
🆘 Overdose
Overdose causes drowsiness, confusion, lethargy, unsteadiness and muscle weakness, and may progress to respiratory depression and coma; risk is higher with alcohol or opioids. Seek emergency medical help immediately or contact a poison control center.
💰 Price & brands in your area
🏛️ Official price in Palestine — Ministry of Health price list:
| Product | Company | Pack | Price |
|---|---|---|---|
| CLONEX 2MG TAB ` Clonazepam | Teva | 30 tab | 16 ₪ |
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Mechanism of action
Benzodiazepine whose anti-seizure and anti-panic effects are believed to relate to enhancement of GABA activity. Rapidly and completely absorbed orally (about 90% bioavailability), Tmax 1-4 hours, about 85% protein bound, extensively metabolized (<2% excreted unchanged in urine) mainly by reduction of the 7-nitro group; CYP3A may play a role. Elimination half-life typically 30-40 hours.
Labeled dosing
Dose is determined by the prescriber. Seizure disorders (adults): initial dose not to exceed 1.5 mg/day in three divided doses, increased by 0.5-1 mg every 3 days until seizures are controlled or side effects preclude increase; maximum recommended 20 mg/day. Panic disorder (adults): initial 0.25 mg twice daily, increased after 3 days to target 1 mg/day for most patients; some may benefit from up to 4 mg/day maximum, with increments of 0.125-0.25 mg bid every 3 days. Discontinue gradually, decreasing by 0.125 mg twice daily every 3 days.
- No evidence defines how long patients should remain on treatment; reevaluate long-term usefulness periodically
- Assess risk of abuse, misuse, and addiction before prescribing and throughout treatment
- When co-prescribed with opioids, use the lowest effective dosages and shortest durations and monitor for respiratory depression and sedation
- Monitor phenytoin concentration when co-administered
- Overdose: general supportive measures, IV fluids, airway maintenance; flumazenil may precipitate withdrawal and seizures and is contraindicated in patients who received a benzodiazepine for a life-threatening condition
🎓 Key points for students
- Class: benzodiazepine; enhances inhibitory GABA activity
- Indications: Lennox-Gastaut syndrome, akinetic and myoclonic seizures, absence seizures, panic disorder
- Boxed warning: opioid co-use, abuse/misuse/addiction, dependence and withdrawal reactions
- Contraindications: benzodiazepine hypersensitivity, significant liver disease, acute narrow angle glaucoma
- Half-life 30-40 h, bioavailability about 90%, hepatic metabolism with possible CYP3A involvement
- CYP450 inducers (phenytoin, carbamazepine, lamotrigine, phenobarbital) lower levels by about 38%
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What is clonazepam used for?
It is used to treat certain seizure disorders and panic disorder, by prescription only.
Can I stop clonazepam suddenly?
No. Abrupt discontinuation or rapid dose reduction can cause serious withdrawal reactions; it must be tapered gradually under medical supervision.
Can I take it with alcohol or opioid painkillers?
This is not advised. Combining with opioids or alcohol can cause profound sedation and respiratory depression and may be fatal.
What are the common side effects?
Drowsiness, unsteadiness, behavior problems, dry mouth and dizziness; some may lessen over time.
Is it safe in pregnancy and breastfeeding?
It may cause sedation or withdrawal symptoms in newborns and passes into breast milk. Consult your doctor before use.
Can clonazepam cause addiction?
Yes, it can lead to abuse, misuse, addiction, and physical dependence, so use it exactly as prescribed.
⚕️ For education only — not a substitute for advice from your doctor or pharmacist. Do not start or stop any medicine without advice. Source: official FDA drug label via openFDA (2026-06), simplified. Updated: 2026-11-11.