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Clonazepam

Why it's used

Clonazepam is used to treat various types of epileptic and seizure disorders such as akinetic and myoclonic seizures, absence seizures (petit mal) including atypical absence seizures, Lennox-Gastaut syndrome (petit mal variant), primary or secondarily generalized tonic-clonic seizures (grand mal), partial (focal) seizures, or various forms of myoclonic seizures, myoclonus and associated abnormal movements. This medicine works by reducing abnormal electrical activity in the brain. Clonazepam is also used to treat panic disorder with or without fear in open public space (agoraphobia), and to treat symptoms of involuntary movement disorder and behavior or motor function abnormality (acute catatonic reactions).
Benzodiazepine
Clonazepam is a prescription medicine that belongs to a class of medicines called Benzodiazepine. Benzodiazepines are a class of drugs used to treat a range of conditions, including anxiety and insomnia. These medicines work by slowing down the activity of the central nervous system by relaxing the muscles and inducing sleep.

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How to use

Follow directions on the product label, information guide, and provided by your doctor before using Clonazepam. Eat this medicine as per your doctor's instructions.
Clonazepam is eaten with or without food. Swallow the whole tablet with water. Clonazepam is usually taken one to three times a day.

Typical Dosage

The typical adult dose of Clonazepam is 1 mg/day for panic disorder (not more than 4 mg in one day). The maximum dose for adults of Clonazepam is 20 mg/day for seizure disorder and 4 mg/day for panic disorder per day. Habit forming tendencies may sometimes be seen with this medicine. You may be at higher than normal risk if you have an addiction to alcohol, or to drugs. To reduce your risk of addiction, take this medicine exactly as prescribed.
Clonazepam is to be used for longer periods of time. You should continue to use this medicine as directed by the doctor even if you feel well.
If using the orally-disintegrating form of this medicine, make sure you do not consume any food or fluid 5 minutes before or after taking this medicine. Before taking the medicine out of the package, wash your hands thoroughly. Place the medicine on the tongue. Make sure you do not chew or swallow the medicine. You do not need to drink water after consuming the medicine. In certain cases, the medicine can taste slightly bitter. Also, ensure that you do not break or split the medicine.

Talk to Your Doctor

Tell your doctor if your condition persists or worsens or if you develop new symptoms. Talk to your doctor if suicide thoughts, feeling agitated or restless, panic attacks, insomnia, new or worse depression, anxiety or irritability, acting aggressive, being angry, or violent, an extreme increase in activity and talking, unusual behavior or mood changes, attempt to commit suicide, and acting on dangerous impulses. If you have any kidney disease, the dose of Clonazepam should be reduced in patients with abnormal functioning of the kidney. If you have issues with the health of your liver, the lowest effective dose should be considered in patients with abnormal functioning of the liver. Consult with your doctor before stopping the use of Clonazepam.
To see the impact of Clonazepam on the body, your doctor may recommend a lower initial dose. Please follow your doctor's instructions carefully. Taking a high dose of this medicine is known to increase the chances of side-effects. Older patients may see an increase in the risk of side-effects. Hence, a lower dose may be recommended.
When stopping this medicine, it is possible that you may experience withdrawal symptoms such as state of unease or dissatisfaction, insomnia, tremor, sweating, agitation, sleep disturbances, anxiety, headaches, muscle pain, anxiety, tension, restlessness, confusion, irritability, derealisation, feeling unreal, hearing disorder, numbness, tingling, allergic reaction to light, hallucinations, convulsions, psychosis behavioral disorder, and abdominal cramps. You may need to gradually decrease the dose of this medicine before stopping.

Use in Children

If you are giving Clonazepam to a child, be sure to use a product that is meant for use in children. Before giving this medicine, use the child's weight or age to find the right dose from the leaflet or product package. You can also read the dosage section of this page to know the correct dose for your child. Else, consult with your doctor and follow their recommendation.

Avoid Alcohol

Avoid grapefruit and grapefruit juice while using Clonazepam. Consult with the doctor about drinking grapefruit juice and eating grapefruit while taking Clonazepam therapy. Avoid drinking alcohol with Clonazepam.

Storage

Store Clonazepam 15° to 30°C (59° to 86°F), and away from moisture. Keep this medicine away from children and pets.
Medicines may be given for uses other than those listed in the medicine guide. Do not use Clonazepam for symptoms for which it was not prescribed. Do not give Clonazepam to others who may have similar symptoms as you. Self-medication can cause harm.

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How to take Clonazepam

Your dose may depend on several personal factors. You should consult with your doctor to find out the dose that is best for you. The dose of Clonazepam depends on the following factors:
  • patient's age
  • patient's weight
  • patient's health
  • the health of the patient's liver
  • the health of the patient's kidneys
  • medicines recommended by your doctor
  • any other medicines in use
  • herbal supplements consumed
  • response to treatment

Clonazepam Dosage

Dosage for seizure disorders

Adult
  • Initial: 0.5-1 mg every three days or dosage should not be increased by 1.5 mg/day divided into three doses, and maintenance dosage falls within the range 4-8 mg/day
  • Maximum: 20 mg/day
Children (infants and small children)
  • Initial: 0.25 mg/day and maintenance dosage falls within the ranges 1-3 mg/day (1-5 years), 0.5-1 mg/day (0-1 year) or 3-6 mg/day (5-12 years)
Children (infants and children (up to 10 years or 30 kg (66.1lb) of body weight))
  • Initial: 0.01 and 0.03 mg/kg (0.0045-0.013 mg/lb)/day but doses should not to exceed 0.05 mg/kg (0.023 mg/lb)/day given in two or three divided doses and dosage can be increased to 0.25 to 0.5 mg every 3 days until a daily maintenance dose of 0.1 to 0.2 mg/kg (0.045-0.09 mg/lb) of body weight has been reached
Older Adults
  • Initial: 0.5 mg/day

Dosage for panic disorder

Adult (panic disorder with or without fear in open public space (agoraphobia))
  • Recommended: 1 mg/day
  • Initial: 0.25 mg twice daily which can be increased to the target dose of 1 mg/day may be made after three days and Clonazepam therapy should be stopped gradually, with a decreased dose of 0.125 mg twice every three days, until the drug is completely withdrawn
  • Maximum: 4 mg/day

Dosage calculation for children

To calculate the dosage for children please use the weight based dose calculator to calculate the appropriate dosage as per the weight of your child.

Forms

Tablet
Strength: 0.5 mg, 1.0 mg, 2 mg
Orally disintegrating tablet
Strength: 0.125 mg, 0.25 mg, 0.5 mg, 1 mg, 2 mg
Wafer
Strength: 0.125 mg, 0.25 mg, 0.5 mg, 1 mg, 2 mg

Missed Dose

A missed dose should be taken as early as you remember it. However, if the time for the next dose is almost there, then the missed dose should be skipped, and the regular dosing schedule should be continued. Avoid taking a repeated dose to make up for a missed dose.

Overdose

What to do if you overdose on Clonazepam?
In case of overdose, pulse rate, respiration, and blood pressure should be monitored. Immediate stomach emptying and general supportive measures should be performed. Maintain proper breathing and fluids should be given through the vein. The use of levarterenol or metaraminol may combat low blood pressure. Flumazenil should be given for the reversal of sleeping effects due to Clonazepam overdose. It should be given with proper monitoring of respiratory insufficiency, re-sedation and other remaining benzodiazepine effects for some period after the treatment. Flumazenil is not used in patients with epilepsy who are using benzodiazepines. The opposite effect of the Clonazepam effect in such patients may cause seizures. If the overdose has happened within the last 1-2 hours, the harmful effect can be reduced by taking activated charcoal and treatment according to the symptoms should be considered for heart and respiratory or central nervous system effects.
Symptoms of an overdose of Clonazepam
If you use too much of this medicine, it could lead to dangerous levels of the medicine in your body. In such cases, symptoms of an overdose may include:
If you think you have overdosed on Clonazepam, call a poison control center immediately. You can look up the poison control center information from the Poison Center Finder at TabletWise.com.

Precautions while using Clonazepam

Before you use Clonazepam, tell your doctor of your medical and health history including the following:
  • angle-closure glaucoma
  • excessive production of saliva
  • history of drug abuse or alcoholism
  • history of mental disorders such as mood problems, depression, or suicidal thoughts or behavior
  • kidney problems
  • liver disease
  • liver disease
  • long-term respiratory problems
  • patients with the build-up of chemicals (porphyria)
  • reduced or absent activity of lactase and abnormal absorption of glucose and galactose in the body
  • seizures disorders
  • sensitive to benzodiazepines
  • swelling in the brain or spinal
  • taking codeine, hydrocodone, fentanyl, hydromorphone, meperidine, methadone, morphine, oxycodone, tramadol, amiodarone, antibiotics, antidepressants, antifungal, antihistamines, calcium channel blockers, HIV protease inhibitors, medicines used to treat anxiety, allergies, or cold, mental illness, antiepileptics drugs, sedatives, selective serotonin reuptake inhibitors and tranquilizers
  • taking other central nervous system depressant drugs
Patients with a history of mental disorders may experience behavior effects such as confusion, hallucination and sleeplessness when using Clonazepam. Clonazepam may cause worsening of the seizure when used in patients with seizures disorders. Patients with abnormality in the functioning of the kidney may experience increased accumulation of Clonazepam. Clonazepam may cause convulsions in patients with build-up of chemicals (porphyria). Physical and mental dependence can occur in patients with alcoholism or drug abuse when using Clonazepam.
Before you use Clonazepam, tell your doctor if you are allergic to it or its ingredients. Your doctor may prescribe an alternative medicine and update your medical records to record this information. Discuss with your doctor if you are allergic to alprazolam, lorazepam, chlordiazepoxide, diazepam, clorazepate, estazolam, flurazepam, oxazepam, temazepam, midazolam, or triazolam.
Before having any surgery, discuss with your doctor and dentist about medicines you use including prescription medicines, non-prescription medicines, and herbal supplements.
The use of Clonazepam may change body weight. Clonazepam may cause either increase or decrease in body weight.

Use when Pregnant

Clonazepam should be used only when required in patients who are pregnant or planning to become pregnant. Clonazepam should be used during pregnancy after evaluating the potential benefits and risks to the fetus. This medicine may cause increased birth defects, irregularities in the heartbeat, reduced muscle strength (hypotonia), weakness or reduced muscle tone (neonatal flaccidity), low body temperature, and feeding and respiratory difficulties. Infants born to mothers who have consumed this medicine during later stages of pregnancy are at risk of developing physical dependence and associated withdrawal symptoms. Pregnancy can also worsen epilepsy.

If Breastfeeding

Clonazepam is not safe for use in women who are breastfeeding. If you are breastfeeding, discuss with your doctor if you should either discontinue breastfeeding, or stop using this medicine during this period. Clonazepam may pass into breast milk.

If trying to Conceive

Consult with your doctor on the use of Clonazepam, if you are trying to conceive. Patients planning to become pregnant are advised to talk to their doctor about the desirability for stopping the use of Clonazepam.

Alcohol

Avoid drinking alcohol with Clonazepam. Consumption of alcohol may cause increased sleepiness, increased dizziness, increased sedation, slow and ineffective breathing, worsening of heart disease, and inability to operate machinery or drive a vehicle.

Seizures

Clonazepam can make you feel sleepy. Be careful, especially while driving, while using heavy machinery, or when doing any activity that needs you to be completely alert. The consumption of alcohol with Clonazepam can worsen the sleepiness. Clonazepam may cause seizures in some people. Hence, you should discuss with your doctor before performing any activities where a loss of consciousness may cause harm to you or others.

Increase in Risk

This medicine may increase your sensitivity to sunlight and make you prone to sunburn. If this happens, limit your time outdoors to prevent sunburn. Use a sunscreen and cover your skin.

Side-effects in Older Patients

Older patients may have a higher incidence of side-effects when using Clonazepam. Elderly patients may see an increased risk of sedation, confusion, falls, and fracture.

Side-effects in Children

Younger patients may have a higher incidence of side-effects with Clonazepam. Younger patients may see an increased risk of increased saliva and bronchial secretion, and dropping saliva uncontrollably from the mouth (drooling).

Long-term Use

Patients using Clonazepam for long-term may experience a sudden occurrence of seizure which may last for longer than five minutes (status epilepticus). Also, these patients may experience dependence with withdrawal symptoms such as behavioral disorder, convulsions, hallucinations, tremor, psychosis, and abdominal or muscle cramps. Such patients may also experience speech disorder due to muscle weakness, rapid involuntary movements of the eyes (nystagmus), reduced coordination of movements and gait disorder and double vision (diplopia).

What precautions should be taken during Pregnancy and Nursing, and administering Clonazepam to Children or the Older Adults?

Pregnant Women

Only When Necessary
Warning: Clonazepam should be used during pregnancy after evaluating the potential benefits and risks to the fetus. This medicine may cause increased birth defects, irregularities in the heartbeat, reduced muscle strength (hypotonia), weakness or reduced muscle tone (neonatal flaccidity), low body temperature, and feeding and respiratory difficulties. Infants born to mothers who have consumed this medicine during later stages of pregnancy are at risk of developing physical dependence and associated withdrawal symptoms. Pregnancy can also worsen epilepsy.

Breastfeeding

Contraindicated or Not Recommended
Warning: Clonazepam may pass into breast milk

Younger Adults Population

Precaution
Warning: Clonazepam may cause secondary sex characteristics (incomplete precocious puberty), suicidal behavior, increased production of bronchial secretion and saliva with drooling in children and infants. Special attention should be given to maintenance of the airways. Long-term use of Clonazepam may cause side effects on mental or physical development, evaluation of the benefit-risk should be considered for long-term use in children with seizure disorder.

Older Adults Population

Precaution
Warning: Elderly patients with liver or kidney disease may experience decreased elimination or increased accumulation of Clonazepam respectively. They may experience falls, fracture, confusion, and over-sedation when using Clonazepam. A low dose of Clonazepam should be given to these patients. Precaution along with monitoring of the functioning of the kidney should be advised during dose selection and when giving this medicine in patients with an abnormality in the functioning of the kidney.

Clonazepam Side-effects

The following side-effects may commonly occur when using Clonazepam. If any of these side-effects worsen or last for a long time, you should consult with your doctor:
The following side-effects may commonly occur in older patients on the use of Clonazepam. Discuss with your doctor if any of these side-effects last for a long time or are severe:
The following side-effects may commonly occur in children when using Clonazepam. Discuss with your doctor if any of these side-effects last for a long time or are severe:
  • increased saliva or bronchial secretion with drooling
  • mental problems
  • reversible development of premature secondary sex (incomplete precocious puberty)
Rarely, the use of Clonazepam may cause the following side-effects:
  • abnormal condition of the blood (blood dyscrasias)
  • abnormal dryness of the eye (xerophthalmia)
  • abnormal hunger
  • abnormal involuntary movement (choreiform movements)
  • abnormal liver function
  • abrasions
  • aggressiveness
  • alcohol poisoning
  • ankle and facial swelling
  • back pain
  • bacterial skin infection (cellulitis)
  • bladder dysfunction
  • breast pain
  • build-up of fluids and mucus in the lungs (chest congestion)
  • burning or prickling sensation
  • chest pain
  • coated tongue
  • coughing
  • decreased ejaculation
  • decreased muscle tone (muscular hypotonia)
  • decreased or aggressive reactions
  • dermal bleeding
  • difficult urination
  • disconnected or detached feeling (depersonalization)
  • double vision
  • dry mouth
  • earache
  • emotional lability
  • enlarged liver (hepatomegaly)
  • enlarged lymph nodes
  • erectile dysfunction
  • exaggerated or uncontrollable emotion or excitement (hysteria)
  • excess fluid trapped in the body
  • excessive dreaming
  • excessive sneezing
  • excessive urination at night (enuresis/nocturia)
  • excitability
  • excitement
  • extreme dryness of the skin (xeroderma)
  • eye irritation
  • eye twitching
  • falling
  • feeling mad
  • feeling of discomfort
  • flare acne
  • flatulence
  • flushing
  • foot or eye swelling
  • frequent bowel movements
  • frequent urination (micturition frequency)
  • fungal infection (mycotic infection)
  • fungal infection on the skin or mucous membranes (moniliasis)
  • glassy-eyed appearance
  • headache
  • heartburn (pyrosis)
  • heavy head feeling
  • hives
  • hoarseness
  • hyperactivity
  • hypersecretion in upper respiratory passages
  • illusion
  • impotence
  • inability to perform rapidly alternating movements
  • inability to speak (aphonia)
  • increase in the number of eosinophils in the blood (eosinophilia)
  • increased appetite
  • increased production of bronchial secretion and saliva with drooling
  • increased risk for falls and fractures
  • increased saliva
  • indigestion
  • infection of the lungs (pneumonia)
  • inflammation of a vein in the leg (leg thrombophlebitis)
  • inflammation of the inside of the nose (rhinitis)
  • inflammation of the lining of bronchial tubes (bronchitis)
  • inflammation of the skin (contact dermatitis)
  • inflammation of the tissue between the lungs and chest cavity (pleurisy)
  • inflammation of the vagina (colpitis)
  • inflammation or irritation of a tendon (tendinitis)
  • influenza
  • injury
  • insomnia
  • involuntary leaking of feces (encopresis)
  • irregular heartbeat
  • irregular menstrual
  • irritability
  • jaw pain
  • knee swelling
  • lack of attention
  • lack of interest (apathy)
  • leg pain
  • localized inflammation
  • loss of the ability to create new memories (anterograde amnesia)
  • lost or increased libido
  • low back pain (lumbago)
  • mental disorders
  • migraine
  • mononucleosis infectious
  • motion sickness
  • muscle or leg cramps
  • muscle pain
  • muscle weakness
  • nape, ankle, feet, knee, joint or shoulder pain
  • nausea
  • nervousness
  • nightmares
  • nosebleed
  • organic disinhibition
  • pain
  • painful lump near the edge of the eyelid (styes)
  • painful periods (dysmenorrhea)
  • partial paralysis or weakness
  • pelvic pain
  • pigmentation changes
  • piles (hemorrhoids)
  • poor focus
  • pus-filled bumps on the skin (pustular reaction)
  • reduced sense of touch or sensation (hypoesthesia)
  • restlessness
  • reversible development of premature secondary sex (incomplete precocious puberty)
  • runny nose (rhinorrhea)
  • severe itching
  • severe pain, redness and tenderness in joints (gout)
  • shivering
  • shortness of breath/asthmatic attack
  • skin burning
  • skin rash
  • sleep disturbances
  • slurred speech
  • sore gums
  • sprains and strains
  • stomach or intestinal (gastrointestinal) inflammation
  • stomach pain
  • stomach upset
  • streptococcal infection
  • suicide ideation
  • taste loss
  • thick tongue
  • thirst
  • tooth disorder
  • toothache
  • transient hair loss
  • traumatic fracture
  • tremor
  • twitching
  • uncontrolled leakage of urine (urinary incontinence)
  • unfriendliness (hostility)
  • unwanted hair growth (hirsutism)
  • urine discoloration
  • vertigo
  • viral infection
  • visual disturbance
  • visual field defect
  • vivid dreams
  • weakness on one side of the body (hemiparesis)
  • weight loss or gain
  • wound
  • yawning
The following severe side-effects may also occur when using Clonazepam:
  • stomach and intestinal disorders
    Symptoms: eating disorder (anorexia), constipation, diarrhea, stomach inflammation (gastritis) dehydration
  • Symptoms: slow and ineffective breathing, upper respiratory tract infection, inflammation of the nasal sinus (sinusitis), inflammation of the pharynx (pharyngitis) breathing difficulty
  • heart disorder
    Symptoms: heart failure/arrest low blood pressure on quickly standing up
  • mental and neurological disorders
  • immune system disorders
    Symptoms: allergic reaction, life-threatening allergic reaction (anaphylaxis) swelling of the lower layer of the skin
  • Symptoms: decreased platelet count, low red blood cells, decrease in the number of leukocytes abnormally low levels of thrombocytes
  • urinary system disorders
    Symptoms: inability to completely or partially empty the bladder, urinary tract infection, inflammation of the bladder (cystitis) urinary tract bleeding
  • hearing and vision disorders
    Symptoms: blurred vision middle ear infection (otitis)
  • liver disorders
    Symptoms: increased liver enzymes (transaminases and alkaline phosphatase)
  • fever | herpes simplex infection |
Your doctor has prescribed this Clonazepam because they have judged that the benefits outweigh the risks posed by side-effects. Many people using this medicine do not have serious side-effects. This is not a complete list of possible side-effects for Clonazepam.
If you experience side-effects or notice other side-effects not listed above, contact your doctor for medical advice. You may also report side-effects to your local food and drug administration authority. You can look up the drug authority contact information from the Drug Authority Finder at TabletWise.com.

Side-effects and Allergic Reactions of Clonazepam by Severity and Frequency

Common Side-effects

Following are the common side-effects of this medicine:

Infrequent and Rare Side-effects

Following are the infrequent and rare side-effects of this medicine:

Severe Side-effects

Following are the severe side-effects of this medicine:

Side-effects in Older Adults

Following are the side-effects of this medicine in elderly patients:

Side-effects in Children

Following are the side-effects of this medicine in young patients:
  • incomplete precocious puberty
  • increased saliva or bronchial secretion with drooling
  • mental impairment

Side-effects differences in men and women

While using Clonazepam in women the common side effects observed are breast pain, dysmenorrhea, colpitis, and menstrual irregularity. In men, delayed ejaculation and impotence occur while using this medicine.

Mild Allergic Reactions

Following are the symptoms of mild allergic reactions to this medicine:

Serious Allergic Reactions

Following are the symptoms of serious allergic reactions to this medicine:
If you experience side-effects or notice other side-effects not listed above, contact your doctor for medical advice. You may also report side-effects to your local food and drug administration authority. You can look up the drug authority contact information from the Drug Authority Finder at TabletWise.com.

Warnings

Suicidal behavior and ideation

Patients taking Clonazepam are at increased risk. Use of antiepileptic drugs including Clonazepam may increase the risk of suicidal thoughts or behavior. Patients treated with any antiepileptic drugs for any indication should be monitored for the suicidal thoughts or behavior, changes in mood and development or worsening of depression. Appropriate therapy should be considered in such patients. Patients, families and their caregivers should be instructed of the need to be alert for these sign and symptoms.

depression and suicide attempts

Patients with a history of depression and suicide attempts are at an increased risk when taking this medicine. Such patients should be kept under close observation.

kidney and liver problem or anticonvulsant agents

Patients with kidney and liver problem, undergoing treatment with other centrally acting medicines or anticonvulsant agents are at an increased risk when taking this medicine. Patients with abnormal functioning of the kidney may experience increased accumulation of Clonazepam. When Clonazepam is used with anticonvulsants, it may cause sedation, lack of interest (apathy), harmful effects, or epilepsy (absence status epilepticus). Also, it may increase the clearance of Clonazepam by decreasing the level of Clonazepam. Precaution should be taken in such patients. In these cases, the dose of the Clonazepam should be reduced.

Pregnant women or child-bearing women

Children born to mother using Clonazepam are at an increased risk. Children are at risk of birth defects, feeding difficulties, or reduced muscle tone etc. They may experience physical dependence/withdrawal symptoms such as behavioral disorder, tremor, psychosis, and insomnia after birth. Discontinuation of anticonvulsants should not be made in patients whom therapy is needed. But discontinuation should be considered in patients whom removal of medicines does not possess a serious threat. The use of Clonazepam in women with childbearing potential should be considered only after evaluating the benefit to the children. Clonazepam should not be used in early pregnancy. Patients should be notified about the risk to the fetus.

Interference with memory and movement performance

Patients taking Clonazepam are at an increased risk. Clonazepam may cause central nervous depression, which may lead to decrease mental alertness in driving a motor vehicle or operating machinery. Precaution should be taken in such patients. These patients should be warned about the combined use of other central nervous depressant or alcohol during Clonazepam therapy.

Dependence and withdrawal reactions

There is a risk of dependence/withdrawal reactions in patients taking Clonazepam for long-term or high-dose. This may occur in patients with a history of alcohol/drug abuse. Patients using Clonazepam may have a risk of physical/psychological dependence on Clonazepam. Long-term or high dose therapy may lead to speech or movement disorders, involuntary eye movement and double vision. Patients using benzodiazepines at therapeutic/high dosages may increase the frequency of seizures/risk of anterograde amnesia. This medicine also causes withdrawal symptoms including sweating, insomnia, agitation, etc. These may occur after abrupt discontinuation or withdrawal of Clonazepam. Dose reduction should be considered when discontinuing Clonazepam and another anticonvulsant can be used.

Worsening of seizures

Patients with different types of seizure are at increased risk when using Clonazepam. Such patients may experience increased occurrence or worsen of the seizure involving the entire body (generalized tonic-clonic seizures). Also combined use of valproic acid and Clonazepam may produce seizure involving the entire body which may last for hours and even last for days (absence status epilepticus). Suitable anticonvulsants or increased dosages of these medicines should be added in the therapy.

Breastfeeding women taking Clonazepam

This medicine should not be used in women who are breatfeeding.

Brain problems, depressants, drug/alcohol abuse

Patients with swelling in the brain and spinal, taking other drugs (central nervous system depressants) or alcohol, history of drug abuse or alcohol taking other drugs or drinking alcohol are at an increased risk when using Clonazepam. Such patients may experience an increased risk of dependence, clinical effects of Clonazepam such as sedation, slow and ineffective breathing, sleepiness, dizziness, and worsening of heart disease. Precaution should be taken in patients with swelling in the brain or spinal and history of alcohol or drug abuse. Patients should not drink alcohol when using Clonazepam.

Increased saliva and bronchial secretion

Infants and small children are at an increased risk when using this medicine. Use of Clonazepam in infant and small children may cause increased production of saliva and bronchial secretion. Special care must be given in patients to maintaining airways patency, and this should be considered before giving the Clonazepam to patients who are difficulty handling secretions.

Build-up of natural chemicals (porphyrin) in the body

Patients with a build-up of natural chemicals in the body (porphyria) are at an increased risk when taking this medicine. Such patients may have an increased risk of convulsions. Clonazepam should be used with precaution in patients with porphyria.

Pulmonary insufficiency, elderly or weak patients

Patients with long-term pulmonary insufficiency, elderly or weak patients (debilitated) are at an increased risk when taking this medicine. Precaution should be taken in such patients. In these cases, the dose of the Clonazepam should be reduced.

Rare genetic problems

Patients with rare genetic problems of galactose intolerance, the Lapp lactase deficiency or disturbed absorption of glucose-galactose are at an increased risk when taking this medicine. This medicine should not be used in such patients.

Interactions with Clonazepam

When two or more medicines are taken together, it can change how the medicines work and increase the risk of side-effects. In medical terms, this is called as a Drug Interaction.
This page does not contain all the possible interactions of Clonazepam. Share a list of all medicines that you use with your doctor and pharmacist. Do not start, stop, or change the dose of any medicines without the approval of your doctor.
Clonazepam may interact with ranitidine, which is used to decrease stomach acid. When Clonazepam is used with ranitidine, it may alter the activity of Clonazepam in the body.
There may be an interaction of Clonazepam with propantheline, which is used for the treatment of excessive sweating. When propantheline is used with Clonazepam, it may decrease the level of Clonazepam in the body.
Clonazepam interacts with anticonvulsants (hydantoins, phenobarbital, clonazepam, carbamazepine, phenytoin, and sodium valporate), which are used to treat epilepsy. When Clonazepam is used with anticonvulsants, it may cause sedation, lack of interest (apathy), harmful effects, or epilepsy (absence status epilepticus). Also, it may increase the clearance of Clonazepam by decreasing the level of Clonazepam. Precaution should be taken and the risk should be kept in mind when using these medicines together.
Special instructions need to be followed while taking this medicine along with narcotics, non-barbiturate hypnotics, and barbiturates, which are used to treat pain, sleeplessness, and anxiety respectively. When Clonazepam is used with narcotics, non-barbiturate hypnotics, or barbiturates, it may increase the calming effect (central nervous system depressant effect) of Clonazepam on brain.
Your doctor's guidelines may need to be followed while taking this medicine along with antianxiety, thioxanthene, and butyrophenones, which are used to treat anxiety, mental or emotional conditions, and schizophrenia respectively. When Clonazepam is used with antianxiety, thioxanthene, or butyrophenones,it may increase the calming effect (central nervous system depressant effect) of Clonazepam on brain.
Clonazepam may interact with phenothiazines, monoamine oxidase inhibitors, and tricyclic antidepressants, which are used to treat schizophrenia, anxiety, and depression respectively. When Clonazepam is used with phenothiazines, monoamine oxidase inhibitors, or tricyclic antidepressants, it may increase the calming effect (central nervous system depressant effect) of Clonazepam on brain.
There may be an interaction of Clonazepam with primidone and theophylline, which are used to treat epilepsy and asthma. When Clonazepam is used with primidone or theophylline, it may decrease the levels of Clonazepam.
Clonazepam interacts with amprenavir, which is used in the treatment of human immunodeficiency virus infection. When Clonazepam is used with amprenavir, it may increase the risk of slow or ineffective breathing and sedation.
Special instructions need to be followed while taking this medicine along with cimetidine, fluvoxamine, disulfiram, and ritonavir, which are used to treat heartburn, depression, alcoholism, and human immunodeficiency virus infection respectively. When Clonazepam is used with cimetidine, fluvoxamine, disulfiram, or ritonavir, it may increase the levels of Clonazepam in the blood.
Your doctor's guidelines may need to be followed while taking this medicine along with rifampicin and levodopa, which is used to treat tuberculosis and symptoms of movement disorders (Parkinson-like symptoms) respectively. When Clonazepam is used with rifampicin, it may interfere in the metabolism of Clonazepam. Also using Clonazepam with levodopa may decrease the effect of Clonazepam.
Clonazepam may interact with moxonidine or alpha-blockers, which are used to treat high blood pressure. When Clonazepam is used with alpha-blockers or moxonidine, it may increase the blood pressure lowering and sedative effects.
There may be an interaction of Clonazepam with antihypertensive drugs (angiotensin-converting enzyme inhibitors, beta-blockers, adrenergic neuron blockers, hydralazine, angiotensin-II receptor antagonists, calcium channel blockers, clonidine, methyldopa, diazoxide, diuretics, minoxidil, nitrates or nitroprusside) which are used to treat high blood pressure. When Clonazepam is used with antihypertensive drugs, it may increase the blood pressure lowering effect of these medicines.
Clonazepam interacts with antihistamines, baclofen, and general anesthetics, which are used to treat allergies, muscle spasms and during surgery respectively. When Clonazepam is used with general anesthetics, antihistamines, or baclofen, it may increase the sedative effects of Clonazepam.
Special instructions need to be followed while taking this medicine along with mirtazapine and lofexidine, which are used to treat depression and withdrawal symptoms caused during stopping opioids respectively. The sedative effects of Clonazepam are increased when this medicine is used with baclofen, mirtazapine, or lofexidine.
Your doctor's guidelines may need to be followed while taking this medicine along with nabilone, tizanidine, and opioid analgesics, which are used to treat nausea and vomiting during cancer treatment, muscle cramps and pain respectively. Using Clonazepam with nabilone, tizanidine, or opioid analgesics may increase the sedative effects of Clonazepam.
Clonazepam may interact with central nervous system depressants. When Clonazepam is used with central nervous system depressants, it may increase the risk of severe sedation, slow and ineffective breathing and worsen of heart disease. Patients should not use both medicines together.

Interactions of Clonazepam by Severity

Severe

The following medicines are usually not to be taken together without consulting with your doctor or pharmacist.

Moderate

The following medicines may interact when taken together and can increase your risk of harmful effects. Please consult with your doctor or pharmacist before taking these medicines together.

When should Clonazepam be not used?

Allergic to benzodiazepines

This medicine should not be used in patients who are allergic to benzodiazepines. These patients may have the following symptoms if they use this medicine:
  • life-threatening allergic reaction (anaphylaxis)
  • swelling of the lower layer of skin

Liver disease such as severe liver insufficiency

This medicine should not be used in patients with liver disease.

Optic nerve damage

This medicine should not be used in patients with acute narrow-angle glaucoma.

Patients in a coma

This medicine should not be used in patients in a coma.

Drugs abuse or alcohol

This medicine should not be used in patients known to be abusing drugs or alcohol. Such patients may experience an increased risk of sleepiness, dizziness, sedation, slow and ineffective breathing, worsening of heart disease, and inability to operate machinery or drive a vehicle.

Patients with respiratory problems

This medicine should not be used in patients with respiratory problems such as acute pulmonary insufficiency, severe respiratory insufficiency and breathing difficulty during sleep (sleep apnoea syndrome).

Patients with muscle weakness

This medicine should not be used in patients with muscle weakness.

Patients with lactose intolerance

This medicine should not be used in patients with rare problems of galactose intolerance, the Lapp lactase deficiency or disturbed absorption of glucose-galactose.

Use of central nervous system depressants

Patients should not use both medicines together. When Clonazepam is used with central nervous system depressants, it may increase the risk of severe sedation, slow and ineffective breathing and worsen of heart problems.

Traveling With Medication

  • Ensure that you carry enough doses of each of your prescription medicines to last the entire trip. The best place to store your medicines is in the carry on baggage. However, while flying, if carrying liquid medicines, make sure you do not go over the limits imposed for carry-on liquids.
  • While traveling overseas, make sure that you can carry each of your prescription medicines legally to your destination country. One way to ensure this is by checking with your destination country's embassy or website.
  • Make sure that you carry each of your medicines in their original packaging, which should typically include your name and address, and the details of the prescribing doctor.
  • If your travel involves crossing time zones, and you are required to take your medicine as per a fixed schedule, make sure that you adjust for the change in time.

Expired Medication

Taking a single dose of expired Clonazepam is unlikely to cause a side-effect. However, please discuss with your doctor or pharmacist, if you feel unwell or sick. An expired medicine may become ineffective in treating your prescribed conditions. To be on the safe side, it is important not to use an expired drug. You are much safer by always keeping a fresh supply of unexpired medicines.

Safe Disposal of Medication

  • If there are disposal instructions on the package, please follow the instructions.
  • If there are medicine take-back programs in your country, you should contact the respective authority to arrange for the disposal of the medicine. For example, in the USA, the Drug Enforcement Administration regularly hosts National Prescription Drug Take-Back events.
  • If there are no take-back programs, mix the medicine with dirt and place them in a sealed plastic bag. Throw the plastic bag in your household trash. Separately, remove all personal information including the prescription label from the medicine packaging and then dispose off the container.
  • If specifically indicated on the medicine package that it needs to be flushed down the toilet when no longer needed, perform the required step.
This page provides information for Clonazepam .

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