Calm 10mg Tablet

Uses of Calm 10mg Tablet

Seizures associated with Lennox-Gastaut syndrome

How does Calm 10mg Tablet work?

Clobazam belongs to the class benzodiazepines. It works by increasing the effect of GABA which is an inhibitory neurotransmitter which results by increasing the permeability of chloride ions into the neuron thus resulting in hyperpolarization and stabilization of the neuron.

Side Effects of Calm 10mg Tablet

• Constipation
• Fever
• Insomnia
• Sleepiness
• Slurred Speech
• Tiredness

Quick Suggestions:

• The addiction / habit-forming potential of this medicine is very high. Take it only as per the dose and duration advised by your doctor
• It may cause dizziness. Do not drive or do anything that requires mental focus until you know how this medicine affects you.
• Avoid consuming alcohol as it may increase dizziness and drowsiness.
• Do not stop taking medication suddenly without talking to your doctor as that may lead to nausea, anxiety, agitation, flu-like symptoms, sweating, tremors, and confusion.
• Inform your doctor if you are pregnant, planning to conceive, or breastfeeding.
• Inform your doctor if you notice sores or blisters on your skin, lips, or inside your mouth.

Indications

Epilepsy (Fits):

• Definition: A neurological disorder characterized by sudden, uncontrolled disturbances in the electrical activity of nerve cells in the brain.
• Manifestations:
  • Periods of unusual sensations.
  • Abnormal brain activity.
  • Loss of awareness at times.
• Treatment Options:
  • Anti-epileptic drugs.
  • Ketogenic diet.
  • Small electrical devices.
  • Surgery.

Anxiety Disorder:

• Definition: A mental health disorder associated with fear, worry, and excessive nervousness.
• Characteristics:
  • Persistent feelings of anxiety.
  • Excessive worrying.
  • Physical symptoms like increased heart rate or sweating.
• Treatment Options:
  • Psychotherapy.
  • Medications.
  • Lifestyle changes.

Schizophrenia:

• Definition: A mental disorder affecting a person's ability to feel, think, and behave clearly.
• Characteristics:
  • Altered perception of reality.
  • Delusions and hallucinations.
  • Disorganized thinking.
• Treatment Options:
  • Antipsychotic medications.
  • Psychotherapy.
  • Social support and rehabilitation.

Pharmacology

Target Binding:

• Action: Clobazam binds to different binding sites on the post-synaptic GABA receptor.

Ionopore Interaction:

• Effect: Clobazam interacts with the chloride ionophore associated with the GABA receptor.

Ionopore Opening:

• Outcome: Clobazam increases the amount of time the chloride ionophore is open.

Receptor Distribution:

• Location: GABA receptors affected by clobazam are located throughout the central nervous system (CNS), including the limbic and reticular formation.

Resultant Actions:

• Effect on GABA: The post-synaptic inhibitory action of GABA is increased.
• Physiological Outcome: This leads to membrane hyperpolarization and stability.

Dosage & Administration of Calm 10mg Tablet

Adult Dose:

Seizures Associated with Lennox-Gastaut Syndrome (LGS) in Patients Aged 2 Years or Older, >30 kg:

• Initiate at 5 mg PO q12hr.
• Titrate as tolerated up to 40 mg/day divided q12hr.
• Dose escalation should not proceed more rapidly than once weekly.

Hepatic Impairment:

• Limited data; proceed with low and slow titration.
• Mild-to-moderate (Child-Pugh 5-9): The starting dose should be 5 mg/day and titrated according to weight, but to half the typical adult dose.
• Severe hepatic impairment: Not recommended.

Child Dose:

Seizures Associated with Lennox-Gastaut Syndrome (LGS) in Patients Aged 2 Years or Older:

• <30 kg:
  • Starting dose: 5 mg PO qDay; titrate as tolerated up to 20 mg PO daily.
  • After 7 days, may increase to 5 mg PO q12hr; if needed, may increase to 10 mg PO q12hr after an additional 7 days.

30 kg:

• Starting dose: 5 mg PO q12hr; titrate as tolerated up to 40 mg PO daily.
• After 7 days, may increase to 10 mg PO q12hr; if needed, may increase to 20 mg PO q12hr after an additional 7 days.

Renal Dose:

Renal Impairment:

• Mild or moderate renal impairment: No dose adjustment is required.
• Severe renal impairment or end-stage renal disease (ESRD): No experience.

Interaction

It's crucial to inform your doctor about all medications, including prescription, over-the-counter drugs, and herbal supplements, that you are taking. 

Other Medicines for Epilepsy:

• Phenobarbital, carbamazepine, stiripentol, valproic acid.

Anti-depressants:

• Monoamine Oxidase Inhibitors (MAOIs): Moclobemide, isocarboxazid.
• Tricyclic Anti-depressants: Trazodone.
• Selective Serotonin Re-uptake Inhibitors (SSRIs): Fluvoxamine, paroxetine.

Antipsychotics:

• Chlorpromazine, haloperidol, clozapine, olanzapine, pimozide.

Sleeping Medicines:

• Zolpidem.

Tranquilizers (Anxiolytics):

• Diazepam, temazepam, lorazepam.

Muscle Relaxants:

• Baclofen.

Antihistamines:

• Chlorphenamine, promethazine, diphenhydramine.

Lithium:

• Used to treat manic-depressive illness.

Cimetidine:

• Used for ulcers and heartburn.

Omeprazole:

• Used for acid reflux symptoms.

Ticlopidine:

• Used to prevent blood clots.

Fluconazole:

• Used to treat fungal infections.

Dextromethorphan:

• Used to relieve coughs.

Nebivolol:

• Used for high blood pressure.

Cannabidiol-containing Products:

• Medicines are used for fits.

Opioids:

• Codeine, dihydrocodeine, hydrocodone, morphine.

Hormonal Contraceptives:

• Medicines are used for preventing pregnancy.

Prednisone:

• Used to treat inflammatory conditions.

Rifampin:

• Used for tuberculosis.

Herbs with Sedative Properties:

• Chamomile, kava kava, valerian.

St. John’s Wort:

• Used for depression.

Contraindications

Avoid Use If You Have:

• Breathing disorders
• Liver disorders
• Myasthenia gravis
• Sleep apnea

Pregnancy & Lactation

Safety is not established; avoid it unless compelling reasons exist.

Precautions & Warnings

Impaired Ability:

• Calm 10mg Tablet may impair the ability to perform skilled tasks and hazardous activities. Patients should exercise caution, especially when engaging in activities that require alertness and concentration.

Elderly Patients:

• Special consideration is needed for elderly patients. They may be more sensitive to the effects of the medication, and lower initial doses and gradual adjustments may be required.

Renal or Hepatic Impairment:

• Patients with renal or hepatic impairment may require dose adjustments. Caution should be exercised, and the medication should be titrated carefully in these populations.

Obesity:

• Obesity is mentioned, and it suggests that caution should be taken in individuals with obesity. The reasons for this caution may include potential variations in drug distribution or metabolism.

Gradual Withdrawal:

• Withdrawal from Calm 10mg Tablet should be done gradually. Abrupt discontinuation can lead to withdrawal symptoms, and a gradual tapering of the dose is recommended under medical supervision.

Lactation:

• Calm 10mg Tablet is excreted in breast milk. The potential effects of exposure on infants are unknown. Women who are breastfeeding should discuss the risks and benefits with their healthcare provider.

Storage Conditions

Store in a cool and dry place, protected from light.