Description

Simple

A sedative medication used to help with panic attacks, anxiety, and seizures.

Clinical

A long-acting benzodiazepine with intermediate onset commonly used to treat panic disorders, severe anxiety, and seizures.

Overview

A benzodiazepine used to treat various seizures, including myotonic or atonic seizures, photosensitive epilepsy, and absence seizures, although tolerance may develop [FDA Label] [11, 12, 13, 14]. The agent has also been indicated for treating panic disorder [FDA Label] [7, 11, 12, Read more

Pharmacology

Indication

Clonazepam is indicated as monotherapy or as an adjunct in the treatment of Lennox-Gastaut syndrome (petit mal variant), akinetic, and myoclonic seizures [FDA Label] [ Read more

Pharmacodynamic

The pharmacodynamic properties of clonazepam are common among benzodiazepines and include anticonvulsive, sedative, muscle relaxing and anxiolytic effects [ Read more

Mechanism of action

Gamma-Aminobutyric acid (GABA) is considered the principal inhibitory neurotransmitter in the human body [ Read more

Absorption

Clonazepam is rapidly and almost entirely absorbed after oral administration as tablets [FDA Label] [12, Read more

Protein binding

The recorded plasma protein binding of clonazepam ranges between 82–86% [12, Read more

Volume of distribution

Clonazepam distributes very rapidly to various organs and body tissues with preferential uptake by brain structures [12, Read more

Clearance

The documented clearance for clonazepam is approximately 55 ml/min regardless of gender [12]. Nevertheless, clearance values normalized by weight decline with increas... Read more

Half life

The mean elimination half-life determined for clonazepam is independent of the dose given and has been documented as being about 30-40 hours [12, Read more

Route of elimination

Approximately 50-70% of a clonazepam dose is excreted in the urine and 10-30% is excreted in the feces as metabolites [12, Read more

Toxicity

Benzodiazepines like clonazepam commonly cause drowsiness, ataxia, dysarthria, and nystagmus. Overdose with clonazepam is generally not life-threatening if the drug is taken alone, but may lead to areflexia, apnea, hypotension, cardiorespiratory depression, and coma. Coma, if it does occur, usually... Read more

Adverse Effects

Contraindications

  • Hypersensitivity:
    • benzodiazepines
  • Regions: US
  • Regions: US
  • Patient Conditions:
      • Name: Acute narrow angle glaucoma
      • Drugbank Id: DBCOND0107878
      • Modification Of:
        • Base:
          • Name: Narrow angle glaucoma
          • Drugbank Id: DBCOND0104923
        • Severity:
          • Includes:
            • acute
  • Regions: US
  • Patient Conditions:
      • Name: Significant liver disease
      • Drugbank Id: DBCOND0107858

Food Interactions

  • Avoid alcohol.
  • Avoid excessive quantities of coffee or tea (Caffeine).
  • Take without regard to meals.

Interactions

Type in a drug name to check for interaction with Clonazepam
Type a drug name in the box above to get started
  • Paracetamol(acetaminophen)
  • Paxil(paroxetine)
  • Pamelor(nortriptyline)
  • Panadol(acetaminophen)
  • Patanol(olopatadine ophthalmic)
  • Pataday(olopatadine ophthalmic)
  • Parnate(tranylcypromine)
  • Pazeo(olopatadine ophthalmic)
2,5-Dimethoxy-4-ethylthioamphetamine
The risk or severity of adverse effects can be increased when Clonazepam is combined with 2,5-Dimethoxy-4-ethylthioamphetamine.
3-isobutyl-1-methyl-7H-xanthine
The therapeutic efficacy of Clonazepam can be decreased when used in combination with 3-isobutyl-1-methyl-7H-xanthine.
4-Bromo-2,5-dimethoxyamphetamine
The risk or severity of adverse effects can be increased when Clonazepam is combined with 4-Bromo-2,5-dimethoxyamphetamine.
4-Methoxyamphetamine
The risk or severity of adverse effects can be increased when Clonazepam is combined with 4-Methoxyamphetamine.
5-methoxy-N,N-dimethyltryptamine
The risk or severity of adverse effects can be increased when Clonazepam is combined with 5-methoxy-N,N-dimethyltryptamine.
6-O-benzylguanine
The therapeutic efficacy of Clonazepam can be decreased when used in combination with 6-O-benzylguanine.
7-Deazaguanine
The therapeutic efficacy of Clonazepam can be decreased when used in combination with 7-Deazaguanine.
7-Nitroindazole
The risk or severity of adverse effects can be increased when Clonazepam is combined with 7-Nitroindazole.
7,8-Dichloro-1,2,3,4-tetrahydroisoquinoline
The risk or severity of adverse effects can be increased when Clonazepam is combined with 7,8-Dichloro-1,2,3,4-tetrahydroisoquinoline.
7,9-Dimethylguanine
The therapeutic efficacy of Clonazepam can be decreased when used in combination with 7,9-Dimethylguanine.
8-azaguanine
The therapeutic efficacy of Clonazepam can be decreased when used in combination with 8-azaguanine.
8-chlorotheophylline
The therapeutic efficacy of Clonazepam can be decreased when used in combination with 8-chlorotheophylline.
9-Deazaguanine
The therapeutic efficacy of Clonazepam can be decreased when used in combination with 9-Deazaguanine.
9-Methylguanine
The therapeutic efficacy of Clonazepam can be decreased when used in combination with 9-Methylguanine.
Abacavir
Abacavir may decrease the excretion rate of Clonazepam which could result in a higher serum level.
Acarbose
Acarbose may decrease the excretion rate of Clonazepam which could result in a higher serum level.
Aceclofenac
Aceclofenac may decrease the excretion rate of Clonazepam which could result in a higher serum level.
Acefylline
The therapeutic efficacy of Clonazepam can be decreased when used in combination with Acefylline.
Acemetacin
Acemetacin may decrease the excretion rate of Clonazepam which could result in a higher serum level.
Acepromazine
The risk or severity of adverse effects can be increased when Clonazepam is combined with Acepromazine.
14 References
  1. 1 . Dreifuss FE, Penry JK, Rose SW, Kupferberg HJ, Dyken P, Sato S: Serum clonazepam concentrations in children with absence seizures. Neurology. 1975 Mar;25(3):255-8.PubMed: 1089913
  2. 2 . Robertson MD, Drummer OH: Postmortem drug metabolism by bacteria. J Forensic Sci. 1995 May;40(3):382-6.PubMed: 7782744
  3. 3 . Rosen GM, Turner MJ 3rd: Synthesis of spin traps specific for hydroxyl radical. J Med Chem. 1988 Feb;31(2):428-32.PubMed: 2828624
  4. 4 . Rosen GM, Demos HA, Rauckman EJ: Not all aromatic nitro compounds form free radicals. Toxicol Lett. 1984 Aug;22(2):145-52.PubMed: 6089382
  5. 5 . Earley JV, Fryer RI, Ning RY: Quinazolines and 1,4-benzodiazepines. LXXXIX: Haptens useful in benzodiazepine immunoassay development. J Pharm Sci. 1979 Jul;68(7):845-50.PubMed: 458601
  6. 6 . DeVane CL, Ware MR, Lydiard RB: Pharmacokinetics, pharmacodynamics, and treatment issues of benzodiazepines: alprazolam, adinazolam, and clonazepam. Psychopharmacol Bull. 1991;27(4):463-73.PubMed: 1687613
  7. 7 . Nardi AE, Machado S, Almada LF, Paes F, Silva AC, Marques RJ, Amrein R, Freire RC, Martin-Santos R, Cosci F, Hallak JE, Crippa JA, Arias-Carrion O: Clonazepam for the treatment of panic disorder. Curr Drug Targets. 2013 Mar;14(3):353-64.PubMed: 23256724
  8. 8 . Jenner P, Pratt JA, Marsden CD: Mechanism of action of clonazepam in myoclonus in relation to effects on GABA and 5-HT. Adv Neurol. 1986;43:629-43.PubMed: 2418652
  9. 9 . Fischer, Jnos; Ganellin, C. Robin (2006). Analogue-based Drug Discovery. John Wiley & Sons.
  10. 10 . Shorter, Edward (2005). A Historical Dictionary of Psychiatry. Oxford University Press.
  11. 11 . Electronic Medicines Compendium: Clonazepam Rosemont 2mg/5ml Oral Solution Link
  12. 12 . Rivotril (Clonazepam) 0.5 mg and 2 mg Tablets Canadian Product Monograph File
  13. 13 . Clonazepam Fact Sheet from http://cdn.neiglobal.com/content/pg/live/clonazepam.pdf File
  14. 14 . Rivotril (Clonazepam) Australian Product Information File