Clonazepam 0.5 mg for anxiety
Clonazepam: medicine to control seizures or fits, muscle spasms and restless legs syndrome
1. About
Clonazepam belongs to a group of medicines called benzodiazepines.
It's used to control seizures or fits due to epilepsy, involuntary muscle spasms, panic disorder and sometimes restless legs syndrome.
Clonazepam is available on prescription only. It comes as tablets and as a liquid that you swallow.
2. Key facts
- Clonazepam works by increasing levels of a calming chemical in your brain. This can relieve anxiety, stop seizures and fits or relax tense muscles.
- The most common side effect is feeling sleepy (drowsy) during the daytime.
- Clonazepam is not likely to be addictive if you take it for a short time (2 to 4 weeks).
- If you take clonazepam for more than 2 to 4 weeks, your dose will need to be reduced gradually before you stop taking it.
- Do not drink alcohol while taking clonazepam. There's a risk you can sleep very deeply and you may have trouble waking up.
3. Who can and cannot take clonazepam
Clonazepam tablets and liquid can be taken by adults aged 18 years and over.
It can also be taken by children from 1 month old for epilepsy.
It's not suitable for everyone.
To make sure it's safe for you, tell your doctor before starting clonazepam if you:
- have had an allergic reaction to clonazepam or any other medicine in the past
- have myasthenia gravis, a condition that causes muscle weakness
- have sleep apnoea, a condition that causes breathing problems when you're asleep
- have lung, liver or kidney problems
- have spinal or cerebellar ataxia (where you may become shaky and unsteady and have slurred speech)
- have (or have had) problems with alcohol or drugs
- have recently had a loss or bereavement, depression or thoughts of harming yourself or suicide
- have been diagnosed with a personality disorder
- are trying to get pregnant, are already pregnant or breastfeeding
- are going to have a general anaesthetic for an operation or dental treatment
4.
How and when to take it It's important to take clonazepam exactly as your doctor tells you to.
You'll usually start on a low dose and gradually increase it over 2 to 4 weeks until your doctor thinks the dose is the right dose.
Your doctor will tell you if you need to take clonazepam in 1 dose or split your dose so you take it up to 3 times each day. Ask a doctor or pharmacist if you're not sure how to take it.
The usual dose for:
- epilepsy in adults – the starting dose is 1mg taken at night (increasing to 4mg to 8mg over 2 to 4 weeks)
- epilepsy in children – the dose varies depending on their age. It will be increased gradually over 2 to 4 weeks
- involuntary muscle spasms (adults) – the starting dose is 1mg taken at night (increasing to 4mg to 8mg over 2 to 4 weeks)
- panic disorder – 1mg to 2mg each day
- restless legs syndrome – 500 micrograms to 2mg each day
If you're older than 65 or have kidney, liver or severe breathing problems, your doctor may recommend a lower dose.
Take clonazepam tablets with a drink of water. You can take the tablets or liquid with or without food.
What if I forget to take it?
If you forget to take your clonazepam, take it as soon as you remember, unless it's nearly time for your next dose.
In this case, just leave out the missed dose and take your next dose as usual.
Never take 2 doses at the same time. Never take an extra dose to make up for a forgotten one.
If you forget doses often, it may help to set an alarm to remind you.
You could also ask a pharmacist for advice on other ways to remember your medicines.
What if I take too much?
The amount of clonazepam that can lead to an overdose varies from person to person.
If you take too much clonazepam, you may get symptoms including:
- poor coordination or trouble speaking
- feeling sleepy
- a slow or irregular heartbeat
- uncontrolled eye movements
- muscle weakness
- feeling overexcited
Urgent advice: Contact 111 for advice if:
- you take too much clonazepam
Go to 111.
nhs.uk or call 111
If you need to go to A&E, do not drive yourself. Get someone else to drive you or call for an ambulance.
Take the clonazepam packet, or the leaflet inside it, plus any remaining medicine with you.
5. Side effects
Like all medicines, clonazepam can cause side effects in some people, but many people have no side effects or only minor ones.
Common side effects
These common side effects happen in more than 1 in 100 people.
If you get these side effects, keep taking the medicine and speak to a doctor if they bother you or do not go away:
- disturbed sleep (such as vivid dreams)
- feeling sleepy (drowsy) in the daytime
- feeling light-headed, unsteady or dizzy
- muscle weakness
Serious side effects
It happens rarely, but some people can have serious side effects when taking clonazepam.
Tell a doctor straightaway if:
- your breathing becomes very slow or you have short, shallow breaths
- your skin or the whites of your eyes turn yellow – this could be a sign of liver problems
- you find it difficult to remember things (amnesia) or are confused
- you see or hear things that are not there (hallucinations) or think things that aren't true (delusions)
- problems with your coordination or controlling your movements
- you have swollen ankles, a racing heartbeat, cough and feel tired – this could be a sign of heart problems
- you bruise easily, feel tired, have nosebleeds and have breathlessness – this can be a sign of blood problems
- you notice mood changes such as talking too much, feeling overexcited, restless, irritable or aggressive (mood changes can become serious and are more likely in children and people over 65 years old)
Serious allergic reaction
In rare cases, clonazepam may cause a serious allergic reaction (anaphylaxis).
Immediate action required: Call 999 or go to A&E now if:
- you get a skin rash that may include itchy, red, swollen, blistered or peeling skin
- you're wheezing
- you get tightness in the chest or throat
- you have trouble breathing or talking
- your mouth, face, lips, tongue or throat start swelling
You could be having a serious allergic reaction and may need immediate treatment in hospital.
These are not all the side effects of clonazepam. For a full list, see the leaflet inside your medicine packet.
You can report any suspected side effect to the UK safety scheme.
6. How to cope with side effects
What to do about:
- disturbed sleep (such as vivid dreams) – speak to a doctor; they may suggest a different medicine or a lower dose.
- feeling sleepy (drowsy) in the daytime – this should get better after a week or so but speak to a doctor; they may suggest a lower dose. Do not drive, ride a bike or use machinery or tools until you feel better.
- feeling lightheaded, unsteady or dizzy – try to lie down or sit down. Do not drive, ride a bike or use machinery or tools until you feel better. If you still have these side effects after a week or they get worse, speak to a doctor.
- muscle weakness – try to sit down if you feel weak. If you still have these side effects after a week or so, or if they get worse, speak to a doctor.
7. Pregnancy and breastfeeding
Clonazepam is not usually recommended during pregnancy. There's not enough information to know if it's safe, and it might mean your baby is born with withdrawal side effects.
If you become pregnant while taking clonazepam, speak to a doctor.
Do not stop taking clonazepam suddenly if you have been taking it regularly.
Your doctor can explain the risks and benefits of taking clonazepam and will help you choose the best treatment for you and your baby.
You may need to keep taking clonazepam during pregnancy as it's important for you to remain well.
Clonazepam and breastfeeding
Clonazepam is not recommended while breastfeeding.
If you're breastfeeding or want to breastfeed, talk to a doctor or pharmacist, as there might be better medicines for you. It will depend on what you're taking clonazepam for.
If your doctor says it's OK to take clonazepam while breastfeeding and you notice that your baby's not feeding as well as usual, seems unusually sleepy, has unusual breathing, or you have any other concerns about them, talk to your health visitor or doctor as soon as possible.
Non-urgent advice: Tell your doctor if you're:
- trying to get pregnant
- pregnant
- breastfeeding
8. Cautions with other medicines
Some medicines interfere with the way clonazepam works and increase the chance of you having side effects.
Before you start taking clonazepam, tell a doctor if you're taking:
- anticonvulsants, used to treat epilepsy
- antipsychotics and antidepressants, used to treat mental health problems and depression
- hypnotics, used to treat anxiety or sleep problems
- medicines used to treat muscle spasms, such as baclofen or tizanidine
- medicines used to lower blood pressure including ACE inhibitors such as enalapril and lisinopril; calcium channel blockers such as amlodipine and felodipine; and diuretics such as indapamide and bendroflumethiazide
- drowsy (sedating) antihistamines, such as chlorphenamine or promethazine
- strong painkillers such as codeine, methadone, morphine, oxycodone, pethidine or tramadol
- cimetidine, a medicine for stomach problems and heartburn
- rifampicin (to treat bacterial infections) or antifungal medicines such as fluconazole
Mixing clonazepam with herbal remedies or supplements
There's very little information about taking herbal remedies and supplements with clonazepam.
Do not take herbal medicines for anxiety or insomnia, such as valerian or passionflower, with clonazepam. They can increase the drowsy effects of clonazepam and may also have other side effects.
Important: Important
For safety, tell a doctor or pharmacist if you're taking any other medicines, including herbal medicines, vitamins, or supplements.
9. Common questions
How does clonazepam work?Clonazepam belongs to a group of medicines called benzodiazepines.
It works by increasing levels of a calming chemical, gamma-amino-butyric-acid (GABA), in your brain.
Depending on your health condition, this can relieve anxiety, stop seizures and fits or relax tense muscles. This can also help relieve muscle spasms or symptoms of restless legs syndrome.
How will it make me feel?Clonazepam will help you feel calmer and it can reduce your feelings of anxiety.
It can also make you feel sleepy and relaxed and might make you feel confused when you first start taking it.
This will usually get better as you get used to taking the medicine.
It is important to not drive, ride a bike or use tools or machinery if you have any of these side effects.
How long does it take to work?How quickly clonazepam works will depend on what condition you're taking it for.
For seizures, fits and involuntary muscle spasms, it might take a few days to a week for clonazepam to work fully. This is because your dose will be increased gradually until you're taking the right amount.
For panic disorder and restless legs syndrome, clonazepam should take around 1 hour to start working.
How long will I take it for?How long you take it for will depend on why you're taking it.
When used for epilepsy, clonazepam is usually prescribed long term.
For other conditions, your doctor will want to regularly review if you still need clonazepam.
If you're prescribed clonazepam for more than 4 weeks, your doctor may reduce your dose gradually before stopping it, to prevent withdrawal symptoms.
Will I become addicted?Clonazepam is not likely to be addictive if you take it for a short time (2 to 4 weeks).
If you've been taking it for longer than 2 to 4 weeks, your doctor will reduce your dose gradually if they want you to stop taking it.
You're more likely to get addicted if you have, or have previously had, problems with alcohol or drugs.
Speak to your doctor if you've had problems with alcohol or recreational drugs. They may want to try you on a different medicine.
If your doctor recommends you stop taking clonazepam and you've been taking it for more than 2 to 4 weeks, they will reduce your dose gradually.
This allows your body to get used to being without the medicine and reduces the chance of side effects when you stop taking it.
If you stop taking it suddenly, you may get some side effects, such as:
- confusion
- seizures or fits
- depression
- feeling nervous or irritable
- sweating
- diarrhoea
The risk of these side effects will be reduced if you lower your dose gradually.
Important: Important
Do not stop taking clonazepam without talking to a doctor.
Do not drink alcohol while taking clonazepam. Alcohol can increase the side effects of clonazepam.
It can make you go into a very deep sleep. There's a risk you may not be able to breath properly and you may have difficulty waking up. This can be dangerous.
Will recreational drugs affect it?Using cannabis, heroin or methadone with clonazepam will increase the drowsy effects of clonazepam.
It can make you go into a very deep sleep. There's a risk you will not be able to breathe properly, and you may have difficulty waking up. This can be dangerous.
Using cocaine or other stimulants such as MDMA (ecstasy) and amphetamines with clonazepam can also lead to drowsiness.
Talk to a doctor if you think you might use recreational drugs while taking clonazepam.
It's best to not have drinks such as coffee, tea and cola, or to eat a lot of chocolate because these contain caffeine. Caffeine is a stimulant and may reduce the calming effects of clonazepam.
Alcohol can increase the effects of clonazepam and make you go into a very deep sleep. It's important you do not drink alcohol while you're taking clonazepam. There's a risk you will not be able to breathe properly and you may have difficulty waking up. This can be dangerous.
Will it affect my contraception?Clonazepam will not affect any contraception, including the combined pill and emergency contraception.
Will it affect my fertility?There's no evidence that clonazepam will affect fertility in either men or women.
If you're trying to get pregnant, or you're having problems getting pregnant while on clonazepam, speak to a doctor.
Do not drive a car or ride a bike if clonazepam makes you sleepy, gives you blurred vision, or makes you feel dizzy, clumsy or unable to concentrate or make decisions.
This may be more likely when you first start taking clonazepam, but could happen at any time (for example, when starting another medicine).
It's an offence to drive a car if your ability to drive safely is affected.
It's your responsibility to decide if it's safe to drive. If you're in any doubt, do not drive.
Even if your ability to drive is not affected, the police have the right to request a saliva sample to check how much clonazepam is in your body.
GOV.UK has more information on the law on drugs and driving.
Talk to a doctor or pharmacist if you're unsure whether it's safe for you to drive while taking clonazepam.
If you have panic disorder, there are some things you can try to help, including:
- read a self-help book for anxiety based on the principles of CBT (ask your doctor to recommend one)
- try complementary therapies such as massage and aromatherapy, or activities such as yoga or pilates, to help you relax
- learn breathing techniques to help ease symptoms
- exercise regularly to reduce stress and tension
- it may help to find out more about how to deal with panic attacks
If you have restless legs syndrome, there are some lifestyle changes that can help, including:
- quitting smoking
- exercising regularly (but avoid exercising close to bedtime)
- good sleep habits, such as going to bed and getting up at the same time every day, not napping during the day, taking time to relax before going to bed
- avoiding medicines that trigger the symptoms or make them worse (if you think medicine is causing your symptoms, continue to take it and make an appointment to see a doctor)
Differences, dosage, and side effects
Alprazolam (Xanax) and clonazepam (Klonopin) are both medications that affect a person’s central nervous system (CNS) by slowing it down.
They belong to a family of drugs called benzodiazepines. Doctors tend to prescribe these to treat anxiety and panic disorders.
The most common use of Xanax is as an antianxiety medication. Pharmaceutical company Upjohn created this drug in 1969, and doctors now write more than 50 million prescriptions for Xanax each year.
Clonazepam can help treat seizure disorders, among other things. It is an anticonvulsant and antiepileptic medication. Doctors may also prescribe clonazepam for panic disorder.
Xanax and clonazepam both affect the CNS and have the potential for misuse, with some people becoming dependent on them.
Xanax is a useful medication for people who experience panic attacks. The drug helps relieve the symptoms and reduce the frequency of attacks.
Some doctors prescribe Xanax for depression, but there is limited evidence to suggest that it is effective unless the person also has anxiety.
Clonazepam is also a benzodiazepine. Doctors use it to treat seizure disorders in both adults and children.
It can help address chemical imbalances in the brain and reduce the number of panic attacks.
Taking clonazepam increases a person’s levels of gamma-aminobutyric acid (GABA), which is a chemical that sends signals around the CNS.
A lack of GABA activity can cause people to become excitable and may lead to panic attacks or seizures. Having more GABA activity in the body helps reduce instances of panic attacks and seizures.
At first glance, Xanax and clonazepam are very similar. Both medications are benzodiazepines, CNS depressants, and ways of treating anxiety or panic attacks.
Both are short acting drugs, but clonazepam stays in the body for longer than Xanax. The half-life of Xanax is 6–25 hours, while for clonazepam, it is 22–54 hours.
Clonazepam can also treat seizures, whereas Xanax does not. Both drugs have their different off-label uses, which the sections below will look at in more detail.
Dosages usually differ depending on the individual and the condition that a doctor is trying to treat.
Clonazepam dosage
For panic and anxiety, the dosage for adults is 0.25 milligrams (mg) twice per day.
A doctor can increase the dosage in increments of 0.125 mg to 0.25 mg every 3 days until the panic is under control. However, the maximum dosage does not usually exceed 4 mg per day.
For seizures, the dosage for adults is 0.5 mg three times per day. A doctor can increase the dosage in increments of 0.5 mg to 1 mg until the seizures are under control. The maximum dosage should not exceed 20 mg per day.
Xanax dosage
For anxiety disorders, the dosage for adults typically starts at 0.25 mg to 0.5 mg three times per day. A doctor may incrementally increase the dosage to maximize the effect. However, the maximum dosage does not usually exceed 4 mg per day.
For panic disorders, the required dose of Xanax may exceed 4 mg per day.
Controlled trials involving 1,700 people found that Xanax worked for panic disorder when participants received 1–10 mg per day.
Changing dosage
Whether prescribing clonazepam or Xanax, a doctor will usually start at the lowest possible dosage, regularly reassess the dosage, and consider reducing it, for example, if panic attacks stop.
If a doctor advises reducing the dosage, they must ensure that a person does this slowly. If a person stops taking either drug abruptly, it could result in withdrawal symptoms.
Both Xanax and clonazepam typically begin taking effect after a few hours or days of starting the medication.
A dose of Xanax will affect a person for a few hours. A dose of clonazepam can last around three times longer.
Benzodiazepine dependence
Long-term use of benzodiazepines can lead to dependence on these drugs. Dependence can begin after using the drugs for as little as 1 month.
As Xanax remains in the body for less time than clonazepam, it may carry a higher risk of overuse or misuse, which may lead to dependence.
It is critical that a person does not stop taking either drug suddenly.
Doing so can lead to adverse effects, such as life threatening seizures, as well as withdrawal symptoms.
A doctor or pharmacist should carefully monitor how a person uses benzodiazepines to manage the risk of dependence.
Clonazepam comes in the form of an oral tablet that a person swallows. There is also a version that dissolves in the mouth.
Xanax is available in immediate-release and extended-release oral tablets, as well as an oral solution.
These drugs can have a number of adverse effects. The sections below will look at these in more detail.
Clonazepam
Some of the more common side effects of clonazepam include:
- drowsiness
- shaky movements and unsteady gait
- dizziness
- depression
- fatigue
- memory problems
- constipation or diarrhea
- nausea
If any of these side effects develop, a person should talk to their doctor.
Some rarer and more severe side effects of clonazepam include:
- depressed mood or suicidal thoughts
- seizures, especially if a person stops taking the drug suddenly
- hallucinations
- mood and behavioral changes
- sweating
- abnormal eye movements
- anxiety
- difficulty speaking
- insomnia
- excessive bleeding and bruising, from reduced platelets in the blood
- menstrual problems
- difficulty urinating
If any of these side effects develop, a person needs immediate medical attention.
Xanax
Some of the more common side effects of Xanax include:
- drowsiness and fatigue
- lightheadedness
- headaches
- nausea
- dry mouth
- irritability
- becoming talkative
- forgetfulness or difficulty concentrating
- difficulty passing urine
- constipation
- joint pain
- changes in appetite
- changes in weight
- sexual dysfunction
If any of these side effects develop, a person should make an appointment to see their doctor.
Some rarer and more severe side effects of Xanax include:
- yellowing of the skin or eyes
- difficulty speaking
- poor coordination and balance
- seizures
- mood changes
- hallucinations
- confusion or memory problems
- depression or suicidal thoughts
- a severe rash
If any of these side effects develop, a person needs immediate medical attention.
As both Xanax and clonazepam may cause drowsiness and poor coordination, people taking these drugs should be cautious about driving and operating machinery.
With either drug, a severe allergic reaction is unlikely. However, if a person develops any symptoms of a reaction — such as a rash, difficulty breathing, itching, or swelling — they need emergency help.
People taking Xanax or clonazepam should not mix them with alcohol or opioid medication. Doing so can cause dangerous side effects that could be fatal.
Other CNS depressants can also interact with Xanax or clonazepam and change the way they work. Such changes can also lead to severe side effects.
Some other CNS depressants include:
- cannabis
- antihistamines
- sedatives and sleeping pills
- tranquilizers
- mood stabilizers
- muscle relaxants
- seizure medications
- pain medications
Before starting to take a new medication, a person should tell their doctor or pharmacist about any other drugs that they are taking or planning to take.
Off-label uses are uses that are not indicated on the Food and Drug Administration (FDA)-approved packaging but for which a doctor might still prescribe the drug.
Some off-label uses for Xanax include the following:
- irritable bowel syndrome
- essential tremor
- ringing in the ears
- depression
- agoraphobia, or a fear of open spaces
- premenstrual syndrome
Some off-label uses for clonazepam include the following:
- burning mouth syndrome
- essential tremor
- depression
- multiple sclerosis
- periodic limb movement disorder
- restless legs syndrome
- ringing in the ears
- Tourette’s syndrome
- vertigo
- West syndrome
Although clonazepam and Xanax are similar types of drug, there are times when one might be better to use than the other.
Xanax is not a seizure medication. Therefore, a person trying to control and treat seizures may find clonazepam more useful.
People with anxiety disorders should make an appointment with their doctor to discuss the various treatment options and the pros and cons of each.
The doctor will ask about the person’s symptoms and medical history.
They will consider any current medication the individual is taking before advising which prescription is most suitable.
Some people’s bodies react badly to particular medications, or the drug may be ineffective. If this is the case, a person should talk to their doctor, who can make an alternative recommendation.
Arpimed
What Clonazepam is and what it is used for
Clonazepam is the active ingredient in Clonazepam.
Clonazepam belongs to a group of medicines called benzodiazepines.
Clonazepam is used to treat epilepsy in infants and older children and adults.
Clonazepam reduces the frequency of seizures.
Clonazepam reduces the severity of epileptic seizures.
What you need to know before you use Clonazepam
Do not take Clonazepam,
- If you are allergic (hypersensitive) to clonazepam or any of the other ingredients of this medicine.
- If you are allergic (hypersensitive) to other benzodiazepines, including diazepam, flurazepam, temazepam.
If you have any of these conditions, check with your doctor before using clonazepam.
Do not take Clonazepam,
- If you have breathing problems or lung disease.
- If you have severe liver failure.
- If you have myasthenia gravis (muscle weakness and increased muscle fatigue).
- If you have obstructive sleep apnea (stopping breathing during sleep)
- If you abuse alcohol or take prescription or recreational drugs.
If you have any of these conditions, check with your doctor before using clonazepam.
Warnings and precautions
While being treated with antiepileptic drugs like clonazepam, some people have thoughts of harming themselves or committing suicide. If you experience any of these, tell your doctor immediately.
Talk to your doctor or pharmacist before taking clonazepam if:
- If you have liver or kidney problems or impaired lung function.
- Have you ever been depressed.
- If you have ever had suicidal thoughts.
- If you have recently lost a loved one.
- If you regularly use alcohol or recreational drugs or have abused alcohol or recreational drugs in the past.
- You suffer from spinal or cerebellar ataxia (movements become inaccurate, balance is disturbed when standing, slurred speech and rapid eye movement sleep develop).
- You have a rare genetic blood disorder called porphyria.
- If you are an elderly or malnourished patient, your doctor may need to adjust your dose of clonazepam.
If you have any of these conditions, check with your doctor before using clonazepam.
Drug interactions
Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines, including OTC and herbal remedies. Clonazepam may interfere with the effects of certain drugs. Some drugs may also affect the effects of clonazepam.
The following drugs are especially important to note:
- Other epilepsy drugs such as carbamazepine, hydantoins, phenobarbital, phenytoin, primidone, or sodium valproate.
- Cimetidine (used to treat stomach problems and heartburn).
- Rifampicin (an antibiotic used to treat infections).
- Sleeping drugs.
- Medicines used to relieve anxiety (tranquilizers).
- Painkillers (analgesics) and drugs that reduce muscle tone (muscle relaxants).
Surgery
Tell your doctor or dentist that you are taking clonazepam if you are having surgery or dental work that requires pain relief. clonazepam and alcohol
Pregnancy and breast-feeding
It is not recommended to take clonazepam if you are pregnant, think you might be pregnant, or are breastfeeding, unless your doctor has told you to. Clonazepam has an adverse effect on fetal development during pregnancy.
Effects on ability to drive and use machines
Talk to your doctor about driving and using machines before using clonazepam, because clonazepam slows down your response rate, especially when you start taking it. If you have any doubts about your ability to perform certain activities, contact your doctor. Clonazepam affects the ability to drive vehicles, as the drug can cause drowsiness and dizziness.
- Do not drive while taking this drug until you know how it affects you.
- If you know that this drug affects your ability to drive, driving while taking the drug is a legal violation.
- You will not be held liable if:
- Clonazepam has been prescribed for medical and dental problems and,
- You have taken clonazepam as prescribed by your doctor or as described in this package insert and, Clonazepam
- does not affect the ability to drive safely.
- If you have any doubts about your ability to drive safely while taking clonazepam, talk to your doctor.
Development of dependence
When taking clonazepam, there is a risk of dependence, which increases with increasing dose and duration of treatment, in patients with a history of alcohol and / or drug abuse.
Important information about the ingredients of Clonazepam
Clonazepam tablets contain lactose.
If you have been told by your doctor that you have an intolerance to some sugars, check with your doctor before taking clonazepam.
How to take Clonazepam
Clonazepam should be taken exactly as directed by your doctor. If you have any doubts, then you should consult with your doctor.
- Clonazepam should be started at a low dose and increased gradually over 2-4 weeks until the optimal maintenance dose is found to meet the patient's needs.
- Usually, on the recommendation of a physician, the daily dose is divided into 3 doses per day in equal doses for each dose with an equal interval of time between doses.
- If the daily dose cannot be evenly divided into several doses, take the largest dose at bedtime.
- After reaching an effective maintenance dose, the drug can be taken in a single daily dose at bedtime.
Adults and children over 12 years old
- The usual starting dose is 1 mg or less per day.
- Then the dose is gradually increased (usually up to 4-8 mg per day). The maximum daily dose should not exceed 20 mg.
Old age
- The usual starting dose is 0.5 mg or less per day.
- Then the dose is gradually increased (usually up to 4-8 mg per day). The maximum daily dose should not exceed 20 mg.
Children under 1 year
- The usual starting dose is 0.25 mg or less per day.
- Then the dose is gradually increased (usually up to 0.5-1 mg per day).
Children 1 to 5 years
- The usual starting dose is 0.25 mg or less per day.
- Then the dose is gradually increased (usually up to 1-3 mg per day).
Children 5 to 12 years old
- The usual starting dose is 0.5 mg or less per day.
- Then the dose is gradually increased (usually up to 3-6 mg per day).
If you have taken more Clonazepam than recommended
- If you have taken more clonazepam than recommended, contact your doctor or nearest hospital immediately. Take a pack of medicines with you.
- If you have taken a large amount of clonazepam, you may experience lethargy, drowsiness, dizziness, incoordination and decreased body reaction.
If you forget to take Clonazepam
- If you forget to take Clonazepam, skip the missed dose and take your next dose at the scheduled time.
- Do not take a double dose to make up for a missed one.
Stopping Clonazepam
If you take clonazepam for a long time, you may develop addiction and withdrawal symptoms if you stop taking it.
- You should talk to your doctor before you stop taking clonazepam, because if you suddenly stop taking the drug, you may have a recurrence of epileptic seizures and the development of a withdrawal syndrome. (see Possible Side Effects).
- If you need to reduce the dose or stop taking the drug, you need to do it gradually. Your doctor will tell you how to do this.
If someone else has taken clonazepam by mistake, they should contact their doctor or the nearest hospital immediately.
If you have any further questions on the use of this medicine, ask your doctor or pharmacist.
Possible side effects
Like all medicines, clonazepam can cause side effects, although not everyone gets them.
Important side effects :
Allergic reactions .
If you develop an allergic reaction, call your doctor immediately.
Allergic reactions may manifest as the following symptoms:
- Sudden swelling of the larynx, face, lips and mouth. These symptoms can lead to difficulty breathing or swallowing.
- Sudden swelling of hands, feet and ankles.
- Skin rash or itching.
Cardiovascular adverse reactions
If you have any of these symptoms, you should contact your doctor immediately.
These symptoms include:
- Shortness of breath, swelling of the ankles, cough, fatigue and palpitations.
- Pain in the chest area, which can radiate to the neck, shoulder and left arm.
Nervous system side effects
If you have any of these symptoms, you should talk to your doctor.
These symptoms include:
- Feelings of aggression, agitation, irritability, nervousness, agitation, anxiety and hostility.
- Sleep disturbance, nightmares and vivid dreams.
- Hallucinations, manias and speech impairment.
- Development of new types of seizures not previously observed
Children and infants
- Special care should be taken when taking clonazepam in children and infants, since clonazepam may lead to the development of respiratory dysfunction, coughing and a feeling of suffocation. This may be caused by excessive salivation.
- Early puberty possible. After the abolition of clonazepam, this process stops.
Other possible side effects
Taking clonazepam may cause the following symptoms:
- Drowsiness and fatigue
- Dizziness and fatigue.
- Muscle weakness or flexibility, jerky movements (poor coordination)
- Walking instability
Tell your doctor if you have any of these symptoms. Your healthcare provider will prescribe you a low dose, if necessary, by gradually increasing the dose of clonazepam.
The following symptoms may occur at any time during treatment with clonazepam
Circulatory, renal and hepatic system Your healthcare provider should perform periodic blood tests if necessary. Gastrointestinal tract Organs of vision Respiratory system Skin and hair Sexual system Syndrome Withdrawal When taking benzodiazepines such as clonazepam, addiction to the drug may develop. The following symptoms are less common: Trauma Patients taking benzodiazepines are at an excessive risk of falling or breaking bones, especially the elderly, patients taking sedatives, including alcohol. Reporting side effects insert. How to store Clonazepam Package contents and additional information What Clonazepam contains One tablet contains: active substance - clonazepam - 2 mg; excipients: microcrystalline cellulose, lactose monohydrate, corn starch, povidone, sodium starch glycolate, magnesium stearate, purified talc. What Clonazepam looks like and contents of the pack: White, round, flat tablets scored on one side. Carton containing 24 tablets (1 blister of 24 tablets) with leaflet. Dispensing conditions Prescription Prices in pharmacies Prices in pharmacies Prices in pharmacies Enhances the inhibitory effect of GABA (a mediator of pre- and postsynaptic inhibition in all parts of the central nervous system) on the transmission of nerve impulses. Stimulates benzodiazepine receptors located in the allosteric center of postsynaptic GABA receptors of the ascending activating reticular formation of the brain stem and intercalary neurons of the lateral horns of the spinal cord; reduces the excitability of the subcortical structures of the brain (limbic system, thalamus, hypothalamus), inhibits polysynaptic spinal reflexes. Rapidly and almost completely absorbed when taken orally. Bioavailability after oral administration - 90%, after i / m administration - 93%. epilepsy in children and adults (major and minor seizures), convulsive syndrome of various etiologies, psychomotor crisis. the dose is set individually. Treatment begins with low doses, gradually increasing them until the optimal therapeutic effect is achieved. Adults are usually prescribed at an initial dose of 1.5 mg / day in 3 divided doses. Gradually (every 3rd day) the dose is increased by 0.5-1 mg until the optimal therapeutic effect is achieved. Usually prescribed 4-8 mg / day; it is not recommended to exceed a dose of 20 mg / day. Newborns and children under the age of 1 year are prescribed 0.1–1 mg/day; from 1 year to 5 years - 1.5-3 mg / day; 6-16 years - 3-6 mg / day. For children weighing up to 30 kg, the dose is usually prescribed at the rate of 0.01-0.03 mg / kg / day in 3 divided doses. The dose of 0.05 mg/kg should not be exceeded. The dose is gradually increased, but not more than 0.25-0.5 mg every 3rd day. hypersensitivity to clonazepam and other benzodiazepines, pregnancy and lactation, acute respiratory, cardiac and hepatic failure, myasthenia gravis, coma, shock, angle-closure glaucoma, acute alcohol intoxication. possible drowsiness, fatigue, nausea, dizziness, headache, imbalance, decreased muscle tone, visual impairment, dynamic ataxia, psychomotor disorders, dyspepsia, rarely - changes in the composition of peripheral blood. do not stop treatment with clonazepam suddenly; cancel, gradually reducing the dose. Clonazepam passes into breast milk and can cause the development of neuropsychiatric disorders and growth retardation in newborns. During treatment, you should not drive vehicles and work with potentially dangerous mechanisms. During the period of treatment, you can not drink alcohol. Due to the possibility of developing paradoxical reactions, clonazepam is used with extreme caution in elderly patients. Mutual enhancement of the effects of antipsychotics, tricyclic antidepressants, other antiepileptics, general anesthetics, hypnotics, narcotic analgesics, muscle relaxants and ethanol. Inhibitors of microsomal oxidation, increasing T ½ , increase the risk of developing toxic effects.
Therefore, with a sudden discontinuation or dose reduction of clonazepam, a withdrawal syndrome may develop. Withdrawal syndrome can lead to the development of the following symptoms:
You can also report side effects to Arpimed LLC by going to the website www.arpimed.com and filling out the appropriate form “Report a side effect or ineffectiveness of a drug” and to the Scientific Center for Expertise of Drugs and Medical Technologies named after. Academician E.Gabrielyan, by going to the website www.pharm.am in the section “Report a side effect of a drug” and fill out the form “Map of reporting a side effect of a drug”. Scientific center hotline: +37410237665; +37498773368 By reporting side effects, you help provide more information about the safety of this drug.
Ask your doctor or pharmacist how to dispose of medicines you no longer need. Keep the medicine with you if your doctor has instructed you to do so. Active substance CLONAZEPAMUM | Compendium - drug reference book
Medicines containing the active substance CLONAZEPAM
The anxiolytic effect is due to the effect on the amygdala complex of the limbic system and is manifested in a decrease in emotional stress, weakening anxiety, fear, anxiety. The sedative effect is due to the effect on the reticular formation of the brain stem and nonspecific nuclei of the thalamus and is manifested by a decrease in the symptoms of neurotic origin (anxiety, fear). Anticonvulsant action is realized by enhancing presynaptic inhibition. The spread of epileptogenic activity is suppressed, but does not eliminate the excited state of the focus. Clonazepam is effective in generalized and focal forms of epilepsy. The central muscle relaxant effect is due to the inhibition of polysynaptic spinal afferent inhibitory pathways (to a lesser extent, monosynaptic ones). Direct inhibition of motor nerves and muscle function is also possible. 
C max after oral administration is achieved after 1-2 hours, in some patients - after 4-8 hours; after i / m administration - after 3 hours. The optimal therapeutic effect is achieved at a concentration of clonazepam in the blood plasma of 20-70 ng / ml (average - about 55 ng / ml). The average volume of distribution is 3.2 l / kg of body weight. 85% of clonazepam is bound to plasma proteins. Penetrates through the BBB and the placenta, excreted in breast milk. It is metabolized in the liver by oxidative hydroxylation and reduction of the 7-nitro group with the formation of 7-amino and 7-acetylamino compounds, which can later be conjugated. The main metabolite is 7-aminoclonazepam, which has only minor anticonvulsant activity. It is excreted in the urine and feces almost completely in the form of free or conjugated metabolites; <0.5% of the dose - unchanged in the urine. 
