clonazepam KLONOPIN

Class: Benzodiazepine/​Nitro
FDA Indications: Panic Disorder, Seizure Disorders
Off-Label Use: Agitation/aggression, Akathisia, Alcohol Withdrawal, Catatonia, Insomnia, Bipolar Mania, Restless Leg Syndrome, Lewy Body Dementia
Prescribing
FDA Schedule IV
Forms: 0.25, 0.5, 1, 2mg tablet
Dose Range: 0.25-6 mg/day
Starting: 0.25 mg bid; ↑ in increments of 0.125 to 0.25 mg bid q3 days
Stopping: Taper by 0.25 mg q3 days, slower for difficult-to-taper patients

NAMI drug fact sheet

Precautions
Contraindications: Sleep apnea, significant hepatic impairment
Serious Side Effects: Overdose can result in hypotension, respiratory depression, and coma
Side Effects: sedation/somnolence, dizziness, confusion, disequilibrium, ataxia, lightheadedness, weakness/asthenia, decreased libido, dysarthria, constipation, increased appetite, weight gain
Pharmacodynamics
1° MOA: GABAAR PAM
2° MOA: May enhance serotonergic neurotransmission
Target: GABAA: α2, α3, γ2 (high); α1 (low to moderate)
Pharmacokinetics
t½: 34 (19-60)° TMAX: 1-4°
Absorption Rate: Rapid
Lipid Solubility: Low
Substrate of: 3A4; 2B4, 2E1
Inhibits: ∅ ; Induces:
Active Metabolites:
DDIs
Misc
  • - moderate degree of sedation
  • - longer t½ makes it easier to taper
  • - better tolerability profile ie ↓ euphoria and abuse potential
Special Populations

Category D—↑ risk of oral cleft by 0.01%, use just before delivery associated with floppy infant syndrome, 3rd trimester use can cause withdrawal in newborns

RID 1.5-3%; ∅ AE's have been reported


Initiate with low doses and observe closely


Metabolites may accumulate in patients with renal impairment

There are no dosage adjustments provided in the manufacturer's labeling

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Last updated August 27 2018 18:45:06. Disclaimer: This website does not provide medical advice, nor is it a substitute for clinical judgment.