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Clonazepam
- Panic Disorder (with or without agoraphobia)
- Seizure Disorders, including:
- Lennox-Gastaut Syndrome (petit mal variant)
- Akinetic & Myoclonic Seizures
- Absence Seizures (Petit Mal) (if unresponsive to succinimides)
🔹 Long-term use (>9 weeks) should be periodically reassessed
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✅ Description:
- Clonazepam is a benzodiazepine that enhances GABAergic neurotransmission by increasing GABA receptor affinity.
- Also affects serotonin and rapidly suppresses paroxysmal EEG activity.
Relevant Products / প্রাসঙ্গিক পণ্য
✔️ Dosage & Administration of Denixil 1
Oral
For Seizures
Adults: Start with 1.5 mg/day (divided into 3 doses); increase by 0.5–1 mg every 3 days if needed.
- Max dose: 20 mg/day
Children (<10 years or <30 kg): Start with 0.01–0.03 mg/kg/day (max 0.05 mg/kg/day) in 2–3 divided doses.
For Panic Disorder
- Adults: Start at 0.25 mg/day (in 2 doses) and increase to 1 mg/day after 3 days.
- Children: May increase saliva & bronchial secretions → monitor airway.
- Elderly: More sensitive due to slower metabolism → lower doses recommended.
- Renal Impairment: No dose adjustment is needed.
- Hepatic Impairment: Cirrhosis may reduce clearance, so monitor closely.
✔️ Contraindications
- Hypersensitivity to benzodiazepines
- Severe liver disease
- Acute narrow-angle glaucoma
(✅ Can be used in open-angle glaucoma with appropriate treatment.)
✔️ Drug Interactions
- No significant effects on phenytoin, carbamazepine, or phenobarbital.
- Caution with valproic acid, as it may cause absence status epilepticus.
✔️ Side Effects
- CNS Depression:
- Drowsiness (50%), Ataxia (30%), Behavioral issues (25%)
- Other Effects:
- Tremor, vertigo, confusion, amnesia, hallucinations, increased libido, insomnia, psychosis, palpitations.
✔️ Overdose Effects & Management
Symptoms:
- Drowsiness, ataxia, coma, respiratory depression, hypotension.
- More severe with alcohol/CNS depressants.
🔹 Treatment:
- Activated charcoal within 1–2 hours (if awake).
- Flumazenil (benzodiazepine antagonist) only in severe cases.
- Monitor vitals, airway, respiration.
✔️ Pregnancy & Lactation
🚨 Use only if benefits outweigh risks
Pregnancy: Clonazepam may cause congenital malformations; high doses near term can cause:
- Irregular fetal heartbeat, hypothermia, hypotonia, mild respiratory depression.
- Abrupt discontinuation may trigger epileptic episodes.
Lactation: Small amounts excreted in breast milk → Avoid breastfeeding if taking Denixil.
✔️ Storage Conditions
- Keep in a dry place, away from light & heat.
- Keep out of children's reach.
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