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Clonazepam, the active ingredient in Pase, is a benzodiazepine with anticonvulsant, sedative, muscle-relaxing, and anxiolytic properties. Its primary action involves enhancing GABAergic neurotransmission at inhibitory synapses. By binding to GABA receptors, clonazepam increases the affinity for GABA, enhancing chloride ion flux and inhibitory effects on neurons.
Additionally, clonazepam affects serotonin pathways and suppresses various paroxysmal EEG activities, including those seen in absence seizures, slow spike waves, and other focal or generalized epileptic discharges. These properties make it effective in treating both generalized and focal epilepsies.
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✅ Description:
Cilnidipine, a dihydropyridine calcium-channel blocker, acts by binding to L-type voltage-dependent calcium channels, reducing calcium ion (Ca²⁺) influx into vascular smooth muscle cells. This leads to muscle relaxation and vasodilation. Cilnidipine also inhibits Ca²⁺ influx via N-type calcium channels in sympathetic nerve membranes, reducing norepinephrine release and potentially preventing reflexive heart rate increases after blood pressure reduction.
Safety Advices
Alcohol
UNSAFE
Do not consume alcohol while taking Pase 0.5 as it may provoke seizures or fits and may worsen side effects possibly leading to severe sedation.
Pregnancy
UNSAFE
Pase 0.5 is generally not recommended for use in pregnant women unless considered necessary. Consult your doctor before taking it.
Breastfeeding
CONSULT YOUR DOCTOR
Pase 0.5 is generally not recommended for use in breastfeeding women as it may pass through the breast milk and may cause drowsiness and feeding difficulties. Consult your doctor before taking Pase 0.5.
Driving
CAUTION
Pase 0.5 may cause drowsiness or sleepiness which can affect your ability to drive and operate machines. Do not drive or operate any machines while taking Pase 0.5.
Kidney
CONSULT YOUR DOCTOR
Pase 0.5 should be used with caution in patients with severe kidney disease. Consult your doctor before taking it.
Liver
CONSULT YOUR DOCTOR
Pase 0.5 is not recommended for use in patients with severe liver disease. It should be used with caution in patients with mild to moderate liver disease. Consult your doctor before taking it.
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✔️ Uses of Pase 0.5
- Seizures disorders
- Panic disorders
✔️ Common side effects are due to CNS depression:
- Drowsiness (50%), ataxia (30%), behavioral issues (25%).
- Abnormal eye movements, aphonia, coma, tremors, confusion, depression, amnesia, hallucinations, increased libido, insomnia, psychosis, palpitations, and vertigo.
✔️ Overdose Effects: Pase 0.5
Symptoms: Drowsiness, ataxia, dysarthria, nystagmus, respiratory depression, hypotension, coma, or cardiac arrest (severe cases).
Treatment: Supportive measures, monitoring vitals, administering activated charcoal (if within 1-2 hours), and flumazenil (a benzodiazepine antagonist) under strict medical supervision.
✔️ Pase is prescribed for:
- Panic Disorder: Treatment of panic disorder, with or without agoraphobia, characterized by unexpected panic attacks and persistent concern about future attacks or their consequences.
- Epileptic Seizures:
- As a standalone or adjunct therapy for Lennox-Gastaut Syndrome (petit mal variant), akinetic, and myoclonic seizures.
- In patients with absence seizures (petit mal) who have not responded to succinimides.
Pase’s long-term effectiveness (beyond 9 weeks) has not been systematically studied in controlled trials. Physicians should periodically reassess its long-term usefulness for individual patients.
Take medication only as advised by a registered physician.
✔️ Dosage & Administration of Pase 0.5
Adults (Seizures):
- Initial dose: ≤1.5 mg/day divided into three doses.
- Increase in increments of 0.5-1 mg every 3 days until seizures are controlled or side effects limit further increase.
- Maximum dose: 20 mg/day.
Adults (Panic Disorder):
- Initial dose: 0.25 mg/day divided into two doses.
- Target dose: 1 mg/day after 3 days (if tolerated).
Pediatric Patients (Seizures):
- Initial dose: 0.01-0.03 mg/kg/day (max 0.05 mg/kg/day), divided into 2-3 doses to minimize drowsiness.
✔️ Drug Interactions
- Pase does not alter the pharmacokinetics of phenytoin, carbamazepine, or phenobarbital.
- Its effect on the metabolism of other drugs remains unstudied.
✔️ Pase is contraindicated in:
- Patients with hypersensitivity to benzodiazepines.
- Those with significant liver disease.
- Acute narrow-angle glaucoma (though it can be used in open-angle glaucoma with proper therapy).
✔️ Pregnancy & Lactation
Pregnancy:
- Clonazepam has potential teratogenic effects based on preclinical studies.
- It should only be used during pregnancy if the benefits outweigh the risks.
- High doses during late pregnancy or labor may cause neonatal issues (e.g., respiratory depression, hypotonia, poor feeding).
Lactation:
- Small amounts of clonazepam pass into breast milk. Breastfeeding is not recommended if treatment is necessary.
✔️ Precautions & Warnings
- Seizure Disorders: Pase may precipitate or increase generalized tonic-clonic seizures in mixed seizure types, necessitating dose adjustments or additional anticonvulsants.
- Valproic Acid Interaction: This may lead to absence status.
- Pediatric Use: In infants, Pase may increase saliva and bronchial secretions; airway patency should be monitored.
- Elderly Patients: Benzodiazepine effects are heightened; doses should be adjusted accordingly.
- Hepatic Impairment: Clearance may be reduced; use cautiously in cirrhosis patients.
✔️ Storage:
Store in a dry place, away from light and heat. Keep out of reach of children.
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