How often can you take clonazepam

Form, strengths, how to take, and more

Klonopin (clonazepam) is a brand-name drug that treats certain seizure disorders, panic disorder, and agoraphobia. Klonopin comes as an oral tablet that’s typically taken two or three times per day. The dosage can vary depending on the condition being treated.

Specifically, Klonopin treats the following conditions:

certain seizure disorders, including absence seizures, akinetic seizures (also called atonic seizures), and myoclonic seizures, in adults and children of all ages
panic disorder with or without agoraphobia (fear of leaving home or going places that may be difficult to escape) in adults

Klonopin belongs to a drug class called benzodiazepines. It is available in a generic version.

Keep reading for specific information about the dosage of Klonopin, including its strengths and how to take the medication. For a comprehensive look at Klonopin, see this article.

Note: This article describes typical dosages for Klonopin provided by the drug’s manufacturer. When taking Klonopin, always follow the dosage prescribed by your doctor.

Below is a dosage chart that summarizes Klonopin’s dosages. Keep reading for more details.

Klonopin form	Strengths	Typical starting dosages
oral tablet	• 0.5 milligrams (mg) • 1 mg • 2 mg	• for seizures in adults: 0.5 mg three times per day • for panic disorder in adults: 0.25 mg twice per day

Klonopin form

Klonopin is available as a tablet that is taken by mouth.

Klonopin strengths (0.5 mg, 1 mg, 2 mg)

Klonopin comes in three strengths:

0.5 mg
1 mg
2 mg

Typical dosages

Typically, your doctor will start you on a low dosage. Then they’ll adjust it over time to reach the amount that’s right for you. Your doctor will ultimately prescribe the smallest dosage that provides the desired effect.

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

Dosage for panic disorder

The recommended starting dosage of Klonopin for panic disorder in adults is 0.25 mg twice per day. This is the lowest dose of Klonopin that your doctor will recommend. Starting with the smallest dose helps your body adjust to the medication. It also helps your doctor see how well the drug is working for you.

Your doctor may monitor you for the first 3 days after you start treatment with Klonopin to see if the smallest dose is working for you. In some cases, they may recommend a dose increase every 3 days until the drug is working to manage your symptoms.

Many people taking Klonopin for panic disorder take a dose of 0.5 mg twice per day. However, in some cases, it’s possible a maximum daily dose of 4 mg of Klonopin (2 mg twice daily) is needed to treat panic disorder. This is the highest dose of Klonopin that’s recommended for panic disorder.

Dosage for seizure disorders

The recommended starting dosage of Klonopin for seizure disorders in adults is 0.5 mg three times per day. This is likely the lowest dose of Klonopin that your doctor will recommend for seizure disorders.

Your doctor may recommend increasing your dose of Klonopin every 3 days as needed to better manage your seizures. So, the best dose for you will be determined by how well Klonopin is working to treat your condition.

The maximum recommended dosage of Klonopin to treat seizure disorders is 20 mg per day. This may be split up into multiple doses per day. Be sure to follow your doctor’s instructions about how long to go between doses.

Children’s dosage

The recommended dosage of Klonopin to treat children with seizure disorders is based on your child’s age and weight. The starting dose for children up to 10 years of age and younger or children who weigh less than 30 kg* (about 66 lb) is between 0. 01 and 0.03 milligrams per kilogram (mg/kg) of body weight per day.

So, if your child weighs 20 kg (about 44 lb), their starting dosage would be from 0.2 mg to 0.6 mg per day. This dosage would likely be split into two or three doses per day. For example, your child may get a dose of 0.2 mg three times daily. The starting daily dose of Klonopin in children should not be more than 0.05 mg/kg. For the example above, the maximum starting dosage of Klonopin should be 1 mg per day.

After your child starts treatment with Klonopin, their doctor may increase their dose every 3 days until their symptoms are managed. The recommended maintenance dosage of Klonopin in children is 0.1 to 0.2 mg/kg of body weight per day. So, if your child weighs 20 kg (about 44 lb), their maintenance dosage would be from 2 to 4 mg per day. This may be split into three daily doses, taken as 1 mg three times per day.

For children ages 10 years and older who weigh at least 30 kg (about 66 lb), the recommended dosage is the same as for adults. For more information on the dosage recommended in children ages 10 years and older, see the “Dosage for seizure disorders” section above.

Klonopin is not approved for use in children with panic disorder. So there’s no recommended dosage for this use.

* One kilogram (kg) is about 2.2 pounds (lb).

Long-term treatment

It’s possible that Klonopin may be a long-term treatment. How long you take this medication may depend on many factors, including what condition you’re taking the drug to treat. If Klonopin works to manage your condition, your doctor may recommend that you take it long term.

However, it’s important to note that Klonopin hasn’t been studied in people with panic disorder for longer than 9 weeks. So, it’s not known what long-term effects the drug may have. Taking Klonopin long term may also increase your risk of dependence. (With dependence, your body needs the drug to feel like you usually do.)

Due to these risks, your doctor will recommend taking the lowest dosage of Klonopin for the shortest amount of time possible. It’s possible that your doctor may recommend taking Klonopin short term for your condition. Then, they may recommend switching to a different treatment option.

For more information about how long you should take Klonopin for your condition, talk with your doctor. They can discuss the best treatment plan for you.

Klonopin isn’t approved to treat anxiety. In fact, this medication is only approved to treat panic disorder and seizures in certain people.

However, panic disorder is a type of anxiety disorder. So, it’s possible that your doctor may recommend treating panic disorder related to your anxiety with Klonopin.

Because the drug isn’t approved to treat anxiety specifically, there aren’t “normal” or maximum doses. However, if your doctor recommends taking Klonopin for your anxiety, they will recommend the best dosage for you.

Klonopin is not approved to treat sleep disorders, such as insomnia. However, this medication may cause sleepiness or drowsiness as side effects.

Due to this, your doctor may recommend taking Klonopin off-label for sleep problems. Off-label use of a drug is when your doctor prescribes a medication for a different use than what it was approved for.

There isn’t a recommended dosage of Klonopin to treat sleep problems. However, if your doctor recommends taking the drug off-label for this condition, they will prescribe the best dosage for you.

Below are some frequently asked questions about Klonopin.

What are the maximum and lowest doses of Klonopin?

The maximum and lowest doses of Klonopin will depend on which condition you’re using the drug to treat. To treat panic disorder in adults, the lowest recommended dosage is 0.25 milligrams (mg) twice per day. The maximum dosage for this use is 2 mg twice per day.

For people with seizure disorders, the lowest recommended dosage of Klonopin is typically 0.5 mg three times per day. And the maximum recommended dosage for this use is up to 20 mg per day, divided into multiple doses throughout the day.

For more information about the specific dosing of Klonopin, see “Typical dosages” in the “Klonopin dosage” section above.

Is there a dosage for Klonopin’s use as a muscle relaxer?

Klonopin isn’t approved for use as a muscle relaxer. So, there isn’t a dosage that’s recommended for this use.

However, other benzodiazepines, such as Valium (diazepam), may be used along with other medications to treat muscle spasms.

If you’re experiencing muscle spasms and think you may need a muscle relaxer, talk with your doctor about the best treatment option for you.

The Klonopin dosage your doctor prescribes will depend on several factors. These include:

the type and severity of the condition you’re using Klonopin to treat
your age
your weight (for children)

Other medical conditions you have can also affect your Klonopin dosage.

Dosage adjustments

Your doctor may recommend a lower dosage for you if you take medications that may interact with Klonopin, including opioid medications, such as Roxicodone (oxycodone). They may also recommend a lower dosage if you have other medical conditions, such as liver problems.

Klonopin comes as an oral tablet. The tablet should be swallowed whole with water.

If you have trouble swallowing tablets, see this article for tips on how to take this form of medication. You can also talk with your doctor or pharmacist.

There isn’t a sublingual dosage form (a dose that dissolves under your tongue) or a liquid form of Klonopin available. However, if you’re having trouble swallowing your dose of Klonopin, talk with your doctor about switching to clonazepam (the generic form of Klonopin). This version is available as an orally disintegrating tablet.

If you only need to take Klonopin once per day, take your dose at bedtime. However, in most cases, you will take Klonopin two to three times per day. It may be helpful to take Klonopin around the same times each day. This helps maintain a steady level of the drug in your body so Klonopin can work effectively.

It’s important to note that if you need to stop treatment with Klonopin for any reason, you should talk with your doctor. They will recommend slowly decreasing your dosage of Klonopin to prevent withdrawal symptoms. This is very important since Klonopin withdrawal can cause serious risks and can be life threatening. For more information about withdrawal symptoms, see the “Klonopin and withdrawal and dependence” section below.

ACCESSIBLE DRUG LABELS AND CONTAINERS
If you’re having trouble reading your prescription label, talk with your doctor or pharmacist. Some pharmacies offer labels with large print, braille, or a code you scan with a smartphone to convert text to speech. If your local pharmacy doesn’t have these options, your doctor or pharmacist might be able to recommend a pharmacy that does.

If you’re having trouble opening medication bottles, ask your pharmacist about putting Klonopin in an easy-open container. They also may recommend tools that can make it easier to open bottles.

If you miss your dose of Klonopin, talk with your doctor or pharmacist about when to take your next dose. In some cases, they may recommend taking your dose as soon as you remember. However, if it’s almost time for your next scheduled dose, they may recommend skipping your missed dose and continuing with your regular dosing schedule.

You should not take an extra dose to make up for a missed dose. Taking extra doses can increase your risk of serious side effects, including overdose.

To help make sure that you don’t miss a dose, try using a medication reminder. This can include setting an alarm or using a timer. You could also download a reminder app on your phone.

Klonopin has a boxed warning for the risk of misuse and addiction occurring during treatment. In fact, all benzodiazepines, including Klonopin, may increase your risk of misuse and addiction. A boxed warning is the most serious warning from the FDA. The purpose of a boxed warning is to inform doctors and patients about the risks of taking a medication.

Misuse means using a medication differently than how it was prescribed. And addiction refers to the inability to stop taking a medication or substance, even if you know it can be harmful to your health. It’s possible for addiction to occur even if you’re taking Klonopin exactly as your doctor prescribed.

Misuse and addiction can increase your risk of serious side effects, including overdose, which can be life threatening. Symptoms of misuse may include:

abdominal pain
anxiety or depression
aggression
blurry vision
confusion
slurred speech
paranoia
suicidal thoughts or actions
seizures
coma
difficulty breathing

Due to this risk, your doctor will monitor you throughout your treatment for signs of misuse or addiction. In some cases, they may recommend a different treatment option for you.

It’s important to tell your doctor if you have a history of drug misuse or addiction before taking Klonopin. They can recommend the best treatment option for you.

If you take more Klonopin than your doctor prescribes, you may develop serious side effects.

It’s important that you do not use more Klonopin than your doctor advises.

Symptoms of an overdose

Overdose symptoms of Klonopin can include:

sleepiness
confusion
low blood pressure
slower reflexes
coma

If you take more than the recommended amount of Klonopin

Call your doctor right away if you believe you’ve taken too much Klonopin. Another option is to call America’s Poison Centers at 800-222-1222 or use its online tool. If you have severe symptoms, immediately call 911 or your local emergency number, or go to the nearest emergency room.

It’s possible for benzodiazepines, such as Klonopin, to cause symptoms of withdrawal or dependence. These symptoms may occur even if you take Klonopin exactly as your doctor prescribed. In fact, Klonopin has a boxed warning for the risk of withdrawal and dependence. A boxed warning is the most serious warning from the FDA. The purpose of a boxed warning is to inform doctors and patients about the risks of taking a medication.

Withdrawal symptoms can occur if your body becomes used to taking a medication and then you stop treatment. Dependence can occur if your body is used to a drug and you need it to feel well. Klonopin can cause both withdrawal and dependence.

You may be at an increased risk of withdrawal or dependence if you’re taking a higher dose of Klonopin or you’ve taken the drug for a long period of time. However, it’s possible for withdrawal to occur even if you’re using Klonopin for a short period of time.

Klonopin withdrawal symptoms

Withdrawal symptoms vary from person to person, but most people experience symptoms in two phases. The first phase is called acute withdrawal and occurs right after you stop Klonopin. How long acute withdrawal lasts can vary based on how much Klonopin you were taking and for how long. However, it’s possible for acute withdrawal to last for a few weeks. Symptoms of acute withdrawal from Klonopin may include:

anxiety
depression
nausea or vomiting
diarrhea
high blood pressure
panic attacks
seizures
suicidal thoughts or actions
insomnia
hallucinations

After acute withdrawal, you may experience the second phase of withdrawal, called protracted withdrawal. This can occur for weeks after your acute withdrawal. In some cases, symptoms may even last 12 months or longer. Symptoms of protracted withdrawal may include:

anxiety
depression
muscle weakness or twitching
ringing in the ears
numbness or tingling in your arms or legs
difficulty thinking
memory problems
insomnia

If you need to stop treatment with Klonopin for any reason, be sure to talk with your doctor first. They will recommend slowly decreasing your dose of Klonopin to prevent withdrawal symptoms. This is very important, since Klonopin withdrawal can cause serious risks and can be life threatening. Your doctor will be able to recommend a dosage taper, or slow decrease in your Klonopin dose, to avoid these side effects.

The dosages in this article are typical dosages provided by the drug’s manufacturer. If your doctor recommends Klonopin for you, they will prescribe the dosage that’s right for you. Always follow the dosage that your doctor prescribes for you.

As with any drug, never change your dosage of Klonopin without your doctor’s recommendation. If you have questions about the dosage of Klonopin that’s best for you, talk with your doctor.

Besides learning about dosage, you may want other information about Klonopin. These additional articles might be helpful to you:

More about Klonopin. For information about other aspects of Klonopin, refer to this article.
Side effects. To learn about side effects of Klonopin, see this article. You can also look at the Klonopin prescribing information.
Drug comparison. The active drug in Klonopin is clonazepam. To find out how clonazepam compares with Xanax, read this article.
Interactions. If you’d like to learn about Klonopin’s interactions, you can see this article.
Details about your condition. For details about seizure disorders, see our epilepsy and seizures hub and list of related articles. And to learn more about panic disorder, visit our mental health hub.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

Form, strengths, how to take, and more

Specifically, Klonopin treats the following conditions:

certain seizure disorders, including absence seizures, akinetic seizures (also called atonic seizures), and myoclonic seizures, in adults and children of all ages
panic disorder with or without agoraphobia (fear of leaving home or going places that may be difficult to escape) in adults

Klonopin belongs to a drug class called benzodiazepines. It is available in a generic version.

Keep reading for specific information about the dosage of Klonopin, including its strengths and how to take the medication. For a comprehensive look at Klonopin, see this article.

Note: This article describes typical dosages for Klonopin provided by the drug’s manufacturer. When taking Klonopin, always follow the dosage prescribed by your doctor.

Below is a dosage chart that summarizes Klonopin’s dosages. Keep reading for more details.

Klonopin form	Strengths	Typical starting dosages
oral tablet	• 0.5 milligrams (mg) • 1 mg • 2 mg	• for seizures in adults: 0.5 mg three times per day • for panic disorder in adults: 0.25 mg twice per day

Klonopin form

Klonopin is available as a tablet that is taken by mouth.

Klonopin strengths (0.5 mg, 1 mg, 2 mg)

Klonopin comes in three strengths:

0.5 mg
1 mg
2 mg

Typical dosages

Dosage for panic disorder

Dosage for seizure disorders

Children’s dosage

The recommended dosage of Klonopin to treat children with seizure disorders is based on your child’s age and weight. The starting dose for children up to 10 years of age and younger or children who weigh less than 30 kg* (about 66 lb) is between 0.01 and 0.03 milligrams per kilogram (mg/kg) of body weight per day.

Klonopin is not approved for use in children with panic disorder. So there’s no recommended dosage for this use.

* One kilogram (kg) is about 2.2 pounds (lb).

Long-term treatment

For more information about how long you should take Klonopin for your condition, talk with your doctor. They can discuss the best treatment plan for you.

Klonopin isn’t approved to treat anxiety. In fact, this medication is only approved to treat panic disorder and seizures in certain people.

However, panic disorder is a type of anxiety disorder. So, it’s possible that your doctor may recommend treating panic disorder related to your anxiety with Klonopin.

Klonopin is not approved to treat sleep disorders, such as insomnia. However, this medication may cause sleepiness or drowsiness as side effects.

There isn’t a recommended dosage of Klonopin to treat sleep problems. However, if your doctor recommends taking the drug off-label for this condition, they will prescribe the best dosage for you.

Below are some frequently asked questions about Klonopin.

What are the maximum and lowest doses of Klonopin?

For people with seizure disorders, the lowest recommended dosage of Klonopin is typically 0. 5 mg three times per day. And the maximum recommended dosage for this use is up to 20 mg per day, divided into multiple doses throughout the day.

For more information about the specific dosing of Klonopin, see “Typical dosages” in the “Klonopin dosage” section above.

Is there a dosage for Klonopin’s use as a muscle relaxer?

Klonopin isn’t approved for use as a muscle relaxer. So, there isn’t a dosage that’s recommended for this use.

However, other benzodiazepines, such as Valium (diazepam), may be used along with other medications to treat muscle spasms.

If you’re experiencing muscle spasms and think you may need a muscle relaxer, talk with your doctor about the best treatment option for you.

The Klonopin dosage your doctor prescribes will depend on several factors. These include:

the type and severity of the condition you’re using Klonopin to treat
your age
your weight (for children)

Other medical conditions you have can also affect your Klonopin dosage.

Dosage adjustments

Klonopin comes as an oral tablet. The tablet should be swallowed whole with water.

If you have trouble swallowing tablets, see this article for tips on how to take this form of medication. You can also talk with your doctor or pharmacist.

ACCESSIBLE DRUG LABELS AND CONTAINERS
If you’re having trouble reading your prescription label, talk with your doctor or pharmacist. Some pharmacies offer labels with large print, braille, or a code you scan with a smartphone to convert text to speech. If your local pharmacy doesn’t have these options, your doctor or pharmacist might be able to recommend a pharmacy that does.
If you’re having trouble opening medication bottles, ask your pharmacist about putting Klonopin in an easy-open container. They also may recommend tools that can make it easier to open bottles.

You should not take an extra dose to make up for a missed dose. Taking extra doses can increase your risk of serious side effects, including overdose.

To help make sure that you don’t miss a dose, try using a medication reminder. This can include setting an alarm or using a timer. You could also download a reminder app on your phone.

Misuse and addiction can increase your risk of serious side effects, including overdose, which can be life threatening. Symptoms of misuse may include:

abdominal pain
anxiety or depression
aggression
blurry vision
confusion
slurred speech
paranoia
suicidal thoughts or actions
seizures
coma
difficulty breathing

Due to this risk, your doctor will monitor you throughout your treatment for signs of misuse or addiction. In some cases, they may recommend a different treatment option for you.

It’s important to tell your doctor if you have a history of drug misuse or addiction before taking Klonopin. They can recommend the best treatment option for you.

If you take more Klonopin than your doctor prescribes, you may develop serious side effects.

It’s important that you do not use more Klonopin than your doctor advises.

Symptoms of an overdose

Overdose symptoms of Klonopin can include:

sleepiness
confusion
low blood pressure
slower reflexes
coma

If you take more than the recommended amount of Klonopin

Klonopin withdrawal symptoms

anxiety
depression
nausea or vomiting
diarrhea
high blood pressure
panic attacks
seizures
suicidal thoughts or actions
insomnia
hallucinations

anxiety
depression
muscle weakness or twitching
ringing in the ears
numbness or tingling in your arms or legs
difficulty thinking
memory problems
insomnia

As with any drug, never change your dosage of Klonopin without your doctor’s recommendation. If you have questions about the dosage of Klonopin that’s best for you, talk with your doctor.

Besides learning about dosage, you may want other information about Klonopin. These additional articles might be helpful to you:

More about Klonopin. For information about other aspects of Klonopin, refer to this article.
Side effects. To learn about side effects of Klonopin, see this article. You can also look at the Klonopin prescribing information.
Drug comparison. The active drug in Klonopin is clonazepam. To find out how clonazepam compares with Xanax, read this article.
Interactions. If you’d like to learn about Klonopin’s interactions, you can see this article.
Details about your condition. For details about seizure disorders, see our epilepsy and seizures hub and list of related articles. And to learn more about panic disorder, visit our mental health hub.

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,
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 of age

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 reaction of the body.

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

Anxiety

Difficulty in remembering new things

Headache

Depression

Slow or broken speech

Poor coordination of movements, including unsteadiness when walking

Increased incidence of epileptic seizures

Circulatory, renal and hepatic system

Liver dysfunction (diagnosed by laboratory liver tests)

Uncontrolled urination

Problems with the circulatory system. Symptoms include feeling tired, bruising from minor concussions, shortness of breath, and nosebleeds.

Your healthcare provider should perform periodic blood tests if necessary.

Gastrointestinal tract

Nausea

Gastric disorders

Organs of vision

Diplopia (double vision)

Involuntary oscillatory movements (nystagmus)

Respiratory system

Respiratory failure (respiratory depression). The first signs include sudden noisy, labored and uneven breathing. The development of cyanosis of the skin is possible.

Skin and hair

Skin rash, urticaria and pruritus.

Skin discoloration

Hair loss

Sexual system

Libido reduction

Erectile dysfunction

Syndrome Withdrawal

When taking benzodiazepines such as clonazepam, addiction to the drug may develop. 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:

Sleep disorder

Muscle pain, tremor and restlessness

Feelings of increased anxiety, tension, feelings of irritability or agitation, or mood changes

Increased sweating

Headache

The following symptoms are less common:

Hypersensitivity to light, noise and physical contact

Hallucinations

Tingling and numbness of hands and feet

Feeling out of touch with reality

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. 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.

How to store Clonazepam

The drug should be stored out of the reach of children, dry, protected from light at a temperature not exceeding 25 ⁰

Shelf life - 3 years. Do not use clonazepam after the expiration date which is stated on the package. When specifying the expiration date, the last day of the specified month is meant.

Do not throw away leftover tablets. 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.

If the tablets have changed color or show other signs of deterioration, ask your pharmacist how to dispose of the medicine.

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.

Vacation Conditions

is released according to the recipe

Instructions for use, Classification, Articles »Handbook of LS

1 Tablet contains clonazepama 2 mg

Auxiliary substances: Potato starch, rice starch, sodium -sneake -up of Krakhmala, gelatin, gelatin. , polysorbate 80, sodium lauryl sulfate, talc, magnesium stearate, lactose.

Clonazepam belongs to the group of benzodiazepines. The drug acts on many structures of the central nervous system, primarily on the limbic system and the hypothalamus, that is, structures associated with the regulation of emotional functions. Like all benzodiazepines, clonazepam enhances the inhibitory effect of GABAergic neurons in the cerebral cortex, hippocampus, cerebellum, medulla, and other structures of the central nervous system. The result of this is a decrease in the activity of various groups of neurons: noradrenergic, cholinergic, dopaminergic and serotonergic. The existence of benzodiazepine-specific junctions has been found, which are proteinaceous mucous structures associated with a complex consisting of a GABA-A receptor and a channel for incoming currents of chloride ions. The action of clonazepam may be to change the "sensitivity" of the GABAergic receptor, increases the affinity of this receptor for gamma-aminobutyric acid (GABA) and is an endogenous uplifting neurotransmitter. The consequence of activation of the benzodiazepine receptor or GABA-A is an increase in the influx of chloride ions into the neuron through the channel for incoming chloride ion currents. This leads to hyperpolarization of the cell membrane, resulting in a slowdown in the functions of the neuron (the so-called release of neurotransmission). Clinically, clonazepam acts as an anticonvulsant, sedative, eliminates anxiety syndromes, reduces skeletal muscle tension, and to a lesser extent has a hypnotic effect. Clonazepam increases the level of the seizure threshold and prevents the occurrence of generalized seizures. Facilitates the course of both general and focal epileptic seizures.

Clonazepam is well absorbed from the gastrointestinal tract after oral administration, with a bioavailability of about 92%. After taking a single dose of the drug (2 mg), the maximum concentration in the blood serum is reached after 1 - 4:00. Clonazepam is 85% bound to blood proteins. The drug penetrates the blood-brain and placental barriers, penetrates into breast milk. Clonazepam is metabolized in the liver, turning into inactive metabolites. The half-life is 20 - 40 hours. Clonazepam is eliminated from the body mainly in the urine as metabolites. About 2% of the accepted dose of the drug is removed through the kidneys unchanged.

All forms of epilepsy in adults and children (mainly akinetic, myoclonic, generalized submaximal temporal and focal attacks)

focal epileptic seizures, simple and complex;

secondary conditioned simple attacks;

small seizures (petit mal), including atypical ones;

primary and secondary tonic-clonic seizures (grand mal)

attacks of myoclonic and clonic convulsions and other conditions of motor excitation;

Lenox-Gastaut syndrome

syndrome of paroxysmal fear, state of fear, phobia (agoraphobia) - except for patients under 18 years of age.

Hypersensitivity to a benzodiazepine or to any component of the formulation

respiratory disorders of central origin and respiratory failure of various origins, sleep apnea syndrome,

disorders of consciousness;

glaucoma;

myasthenia gravis;

severe liver and kidney failure

lactation.

The dose is selected individually and depends on the patient's response to the drug. Treatment should begin with small doses (0.5 mg), gradually increasing them (from 0.5 to 1 mg every 3 days) until an appropriate therapeutic effect is obtained or the maximum daily dose is reached. Do not abruptly interrupt treatment with the drug. A gradual dose reduction is recommended, even after short-term use. Abrupt discontinuation of clonazepam provokes epileptic seizures.

epilepsy

adults

The initial daily dose should not exceed 1 mg. The maintenance dose is set individually for each patient, depending on the therapeutic effect.

The usual adult daily dose is 4 - 8 mg achieved within 2 - 4 weeks of treatment. The drug should be taken 3 or 4 times a day at regular intervals. If it is not possible to use equal doses, a larger dose should be taken at bedtime. After reaching an effective maintenance dose, the drug can be taken once, at bedtime.

The maximum maintenance daily dose should not exceed 20 mg.

children

Taking into account the impossibility of precise dosing (breaking the tablet), it is not recommended to use in pediatric practice.

Syndrome of paroxysmal fear

adults

The initial dose of Clonazepam is 0.25 mg 2 times a day. The target dose of the drug for most adults is 1 mg per day in 2 divided doses, which can be taken after 3 days. The daily dose should not exceed 1 mg, since in studies with increasing doses, no increase in the effectiveness of the drug was recorded, while more side effects were observed. However, for some patients, increasing the daily dose to 4 mg may be effective; in this case, the dose should be increased by 0.125 to 0.25 mg 2 times a day every 3 days.

To reduce drowsiness during the day, the drug can be taken as a single dose at bedtime.

children

The safety and efficacy of Clonazepam in children under 18 years of age with paroxysmal fear syndrome have not been established.

Treatment of patients with impaired renal and hepatic function

Clonazepam is metabolized in the liver and eliminated via the kidneys as metabolites. Given that the drug can accumulate, it should be used with caution in patients with impaired renal and hepatic function, prescribing in smaller doses.

Treatment of elderly patients (over 65 years old)

Elderly patients are more sensitive to drugs that act on the central nervous system, so the doctor individually for each patient selects an effective dose that eliminates pathological symptoms. The usual daily dose should not exceed 0.5 mg.

Patients with chronic respiratory diseases

The drug may cause hypersecretion of the respiratory mucosa and suppress the respiratory center, increase ventilation disorders and respiratory failure. Therefore, when treating such patients with Clonazepam, the doctor should carefully monitor them and stop the drug in case of exacerbation of respiratory failure.

The use of benzodiazepines can cause both mental and physical dependence . The risk of developing dependence increases with increasing dose and time of treatment. Patients with alcoholism or similar diseases in history are especially susceptible to this

Abrupt discontinuation of long-term treatment with Clonazepam may cause withdrawal syndrome : feeling of fear, increased sweating and tension, motor agitation, restlessness, sleep disturbance, headache and muscle pain, fatigue, disorientation, irritability

long-term use of clonazepam gradually leads to a weakening of its action as a result of the development of tolerance , which is observed in approximately 1/3 of patients who are treated with clonazepam for 3 to 6 months;

Clonazepam should be used with caution in patients with renal and hepatic insufficiency, chronic heart disease and the elderly;

the drug should be used with caution in the treatment of patients with ataxia of the cerebellum and spinal cord, after alcohol abuse or after taking an increased dose of any drugs,

especially carefully and according to very balanced indications, Clonazepam should be prescribed to patients with alcoholism and similar diseases (drug addiction, etc. ) in history

In children, the use of Clonazepam may cause excessive secretion of saliva and secretions in the respiratory tract, therefore airway patency should be monitored

patients with depression and a history of suicidal attempts while using Clonazepam should be under constant monitoring;

should be aware of the possible interaction of Clonazepam with drugs that affect the central nervous system, and individually select doses to achieve the optimal effect;

Clonazepam has a positive effect on mood disorders in patients with epilepsy, but in some cases there are paradoxical attacks of aggression, irritability, increased nervous excitement, hostility, fear, sleep disturbance, nightmares, hallucinations, psychotic symptoms or epileptic seizures of a different kind than were in patient earlier. In such cases, the indications for further use of the drug should be verified

during long-term treatment with Clonazepam, peripheral blood morphology and liver function should be monitored periodically.

Clonazepam may induce seizures in some patients with hepatic porphyria.

During treatment with clonazepam, it is forbidden to drink any alcoholic beverages due to the likelihood of seizures.

Use during pregnancy and lactation

Preliminary clinical studies and epidemiological data indicate a teratogenic effect of the drug. The use of Clonazepam by pregnant women is allowed only in case of emergency, when taking the corresponding analogue is impossible or contraindicated. The use of the drug in large doses in the III trimester of pregnancy or before childbirth can lead to a violation of the heart rhythm, respiratory function in the fetus and newborn, as well as to a disorder of the sucking reflex. There have been drug dependence symptoms in children and withdrawal symptoms in neonates immediately after birth whose mothers continued to take benzodiazepines into late pregnancy.

Do not breastfeed during lactation. If necessary, the use of the drug breast-feeding should be discontinued.

Influence on the ability to drive vehicles and operate machinery

Clonazepam, like other benzodiazepines, affects the reaction rate depending on the dose and individual sensitivity. When using Clonazepam, as well as a few days after stopping treatment, you should not drive vehicles and service mechanical devices.

The most common side effects in the treatment of Clonazepam are observed on the part of the central nervous system : Feeling of fatigue, muscle weakness, impaired coordination of movements, dizziness, ataxia, increased sensitivity to light. These symptoms are often temporary and spontaneously disappear with continued treatment or with a decrease in the dose of the drug.

Decreased concentration, sleep disturbances, confusion, disorientation, retrograde amnesia, behavioral disorders, depression may increase with increasing dose of the drug.

It should be remembered that memory impairment and depression can be caused by both treatment and a symptom of the underlying disease.

With prolonged therapy or treatment with high doses of the drug, reverse slurred and slow speech, impaired motor coordination, visual disturbance in the form of double vision and nystagmus may occur.

Gastrointestinal tract : dyspeptic symptoms, abnormal liver function tests (in exceptional cases).

Skin: urticaria, eczema, hair loss, pigmentation disorder.

Genitourinary system: decreased libido, impotence, premature onset of secondary sexual characteristics (in exceptional cases), urinary incontinence.

Respiratory system: rarely - depression of the respiratory center (with the simultaneous use of other drugs that act depressing on the respiratory center).

Allergic reactions: hypersensitivity symptoms - angioedema, anaphylactic symptoms (in exceptional cases).

The use of benzodiazepines can cause both mental and physical drug dependence . The occurrence of dependence is related to the dose and duration of treatment. Patients with a history of alcohol disease or other addictions are especially prone to this condition.

Abrupt discontinuation of treatment with Clonazepam after prolonged use may cause withdrawal symptoms - a feeling of fear, increased sweating, motor agitation, anxiety, sleep disturbance, headache and muscle pain, tension, fatigue, disorientation, irritability.

There is a risk of convulsions or epileptic seizures. In extreme cases, there are violations of the sense of reality, perception of one's own personality, increased sensitivity to light, sound and touch, paresthesia of the limbs, hallucinations. Withdrawal symptoms usually occur in cases of abrupt discontinuation of treatment. Therefore, to stop the drug, the dose should be gradually reduced.

Rarely, speech disturbances, decreased ability to learn, emotional lability, decreased libido, confusion, constipation, abdominal pain, decreased appetite, allergic skin reactions, muscle pain, menstrual irregularities, frequent urination, decreased white blood cells, red blood cells, platelets in the blood, a transient increase in the concentration of transaminases and alkaline phosphatase in the blood.

In addition, paradoxical reactions may be observed - psychomotor agitation, insomnia.

Signs of overdose, which depend on the age, body weight and individual sensitivity of the patient, are increased drowsiness and muscle weakness. In such cases, if necessary, symptomatic treatment should be carried out with the provision of airway patency. Gastric lavage is effective when carried out soon after an overdose.

Signs of poisoning are drowsiness, stupefying state to confusion, stupor to coma with concomitant respiratory disorders and vascular collapse. The described symptoms of poisoning are rare - in the case of the simultaneous use of other drugs similar to Clonazepam or the use of alcohol. This should be taken into account when suicidal attempts are suspected and such patients should be treated in a hospital.

In case of poisoning with Clonazepam, it is necessary to take measures aimed at the rapid elimination from the body of the drug that has not yet been absorbed, or to reduce its absorption from the digestive tract (vomiting, gastric lavage, taking activated charcoal - subject to the patient's consciousness).

Symptomatic treatment consists of monitoring respiratory status, heart rate, blood pressure, and providing catheterization for appropriate fluid therapy, if necessary.

The specific antidote is flumazenil (a benzodiazepine receptor antagonist) given intravenously.

Flumazenil is contraindicated in patients taking Clonazepam for a long time. Although this drug has a weak anticonvulsant effect, the abrupt cessation of the action of a benzodiazepine can provoke seizures.

In case of acute clonazepam poisoning, dialysis is not effective.

Alcohol may cause epileptic seizures regardless of treatment. With the simultaneous use of Clonazepam, there is a risk of unexpected symptoms, as well as a decrease in the effectiveness of Clonazepam. Simultaneous use of the drug with other anticonvulsants (especially with hydantoin or phenobarbital) may lead to increased side effects.

An epileptic state of the unconscious seizure type has been observed with antiepileptic drugs Valproate Sodium .
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