Clonazepam
Brand names
- Alti-Clonazepam
- Apo-Clonazepam
- Clonapam
- Dom-Clonazepam
- Gen-Clonazepam
- Med-Clonazepam
- Novo-Clonazepam
- Nu-Clonazepam
- PMS-Clonazepam
- Rhoxal-Clonazepam
- Riva-Clonazepam
- Rivotril
Usage
To control seizures, and to treat
panic disorder.
How it works
In general, clonazepam produces mild sedation by depressing activity in the
central nervous system (the brain and spinal cord). In particular, clonazepam appears
to enhance the effect of
gamma-aminobutyric acid
(GABA), a natural chemical
that inhibits the firing of
neurons and dampens the
transmission of nerve signals,
thus decreasing nervous
excitation.
Side effects
- Serious
- Difficulty concentrating, outbursts of anger, other behavior
problems, depression, hallucinations,
low blood pressure
(causing faintness or confusion), memory impairment,
muscle weakness, skin
rash or itching,
sore throat,
fever
and chills, sores or ulcers in throat or mouth, unusual
bruising or
bleeding, extreme
fatigue, yellowish tinge to
eyes or skin.
- Common
- Drowsiness, loss of coordination, unsteady gait,
dizziness,
lightheadedness, slurred speech.
- Less common
- Change in sexual desire or ability, constipation, false sense
of well-being, nausea and vomiting, urinary problems,
unusual fatigue.
Possible interactions
- Other medicaments:
Clonazepam taken concurrently with:
- amiodarone (Cordarone) may decrease elimination of clonazepam and also
worsen toxicity by causing low thyroid function.
- carbamazepine (Tegretol) may decrease
blood levels and hence benefits of
both medications.
- desipramine, imipramine and other tricyclic antidepressants can decrease the tricyclic antidepressant blood level and lessen its
therapeutic benefit.
- MAO inhibitors may result in very low blood pressure
and worsening of sedation and respiratory depression.
- phenytoin (Dilantin) or fosphenytoin (Cerebyx) may result in decreased
phenytoin or fosphenytoin levels.
- primidone (Mysoline) may lead to excessive drowsiness.
- ritonavir (Norvir), and perhaps other protease inhibitors,
may lead to clonazepam toxicity.
- valproic acid (Depakene, etc.) may cause continuous absence seizures.
The following medicaments may increase the effects of clonazepam:
- antifungal medicines such as itraconazole (Sporanox) and ketoconazole (Nizoral).
- cimetidine (Tagamet).
- disulfiram (Antabuse).
- macrolide antibiotics such as azithromycin, clarithromycin or erythromycin.
- omeprazole (Prilosec).
- oral contraceptives (birth control pills).
The following medicaments may decrease the effects of clonazepam:
- Herbal medicines or minerals:
- Hawthorn may react antagonistically to clonazepam.
Valerian and
kava kava may interact additively (drowsiness). Avoid
these combinations.
Kava and valerian may exacerbate central nervous system depression (avoid
this combination). Kola nut, Siberian ginseng,
mate, and
ma huang
may blunt the benefits of this medicine. While
St. John's wort is indicated
for anxiety, it is also thought to increase (induce) cytochrome P450
enzymes and will tend to blunt clonazepam effectiveness if combined with
clonazepam.
- Alcohol:
- Alcohol may increase the depressant effects
of this medicament on the brain. It is advisable to avoid alcohol
completely throughout the day and night-if it is necessary to drive or to engage in any
hazardous activity.
- Marijuana smoking:
- Increased sedation and significant impairment of intellectual and physical performance.
- Discontinuation:
- Do not stop clonazepam suddenly if it was controlling any
type of seizure, or if it was taken for more than 4 weeks. Dosing should be
slowly decreased (tapered) to prevent a withdrawal syndrome.
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