Skip to main content

Clonazepam (Oral route)

Pronunciation:

kloe-NAZ-e-pam

Brand Names:

  • KlonoPIN
  • KlonoPIN Wafers

Dosage Forms:

  • Tablet, Disintegrating
  • Solution
  • Tablet

Classifications:

Therapeutic—

Antianxiety

Pharmacologic—

Benzodiazepine, Short or Intermediate Acting

Uses of This Medicine:

Clonazepam is used alone or together with other medicines to treat certain seizure (convulsive) disorders (e.g., Lennox-Gastaut syndrome, akinetic or myoclonic seizures). It is also used to treat panic disorder in some patients. Clonazepam is a benzodiazepine. Benzodiazepines belong to the group of medicines called central nervous system (CNS) depressants, which are medicines that slow down the nervous system.

This medicine is available only with your doctor's prescription.

Before Using This Medicine:

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies—

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Children—

Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of clonazepam in children with seizure disorders. However, safety and efficacy in children with panic disorder have not been established.

Older adults—

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of clonazepam in the elderly. However, elderly patients are more likely to have confusion and severe drowsiness, or age-related heart, liver, or kidney problems, which may require caution and an adjustment in the dose for patients receiving clonazepam.

Pregnancy—

Pregnancy CategoryExplanation
All TrimestersDStudies in pregnant women have demonstrated a risk to the fetus. However, the benefits of therapy in a life threatening situation or a serious disease, may outweigh the potential risk.

Breast-feeding—

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Other medicines—

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Alfentanil
  • Amobarbital
  • Anileridine
  • Aprobarbital
  • Buprenorphine
  • Butabarbital
  • Butalbital
  • Carbamazepine
  • Carbinoxamine
  • Carisoprodol
  • Ceritinib
  • Chloral Hydrate
  • Chlorzoxazone
  • Clarithromycin
  • Cobicistat
  • Codeine
  • Dantrolene
  • Ethchlorvynol
  • Fentanyl
  • Fospropofol
  • Hydrocodone
  • Hydromorphone
  • Idelalisib
  • Ketoconazole
  • Levorphanol
  • Meclizine
  • Meperidine
  • Mephenesin
  • Mephobarbital
  • Meprobamate
  • Metaxalone
  • Methadone
  • Methocarbamol
  • Methohexital
  • Morphine
  • Morphine Sulfate Liposome
  • Orlistat
  • Oxycodone
  • Oxymorphone
  • Pentobarbital
  • Phenobarbital
  • Primidone
  • Propoxyphene
  • Remifentanil
  • Secobarbital
  • Siltuximab
  • Sodium Oxybate
  • Sufentanil
  • Suvorexant
  • Tapentadol
  • Thiopental
  • Zolpidem

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Amiodarone
  • Desipramine
  • Ginkgo
  • Nevirapine
  • Perampanel
  • Ritonavir
  • St John's Wort
  • Theophylline

Other interactions—

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following is usually not recommended, but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.

  • Ethanol

Other medical problems—

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Depression, history of or
  • Lung or breathing problems—Use with caution. May make these conditions worse.
  • Glaucoma, acute narrow angle or untreated open-angle or
  • Liver disease, severe—Should not be used in patients with these conditions.
  • Kidney disease or
  • Liver disease—Use with caution. The effects may be increased because of slower removal of the medicine from the body.

Proper Use of This Medicine:

Take this medicine only as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered.

If you or your child are using the orally disintegrating tablet (wafer), make sure your hands are dry before you handle the tablet. Do not open the blister pack that contains the tablet until you are ready to take it. Remove the tablet from the blister pack by peeling back the foil. Do not push the tablet through the foil. Do not break or split the tablet. Place the tablet in your mouth. It should melt quickly. After the tablet has melted, you may take a sip of water.

Dosing—

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage forms (tablets or disintegrating tablets):
    • For seizures:
      • Adults, teenagers, and children 10 years of age and older—At first, 0.5 milligram (mg) three times a day. Your doctor may adjust your dose if needed. However, the dose is usually not more than 20 mg per day.
      • Infants and children younger than 10 years of age and weighing 30 kilograms (kg)—Dose is based on body weight and must be determined by your doctor.
    • For panic disorder:
      • Adults—At first, 0.25 milligram (mg) two times a day. Your doctor may adjust your dose if needed. However, the dose is usually not more than 4 mg per day.
      • Children—Use and dose must be determined by your doctor.

Missed dose—

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage—

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions While Using This Medicine:

It is very important that your doctor check the progress of you or your child at regular visits to see if the medicine is working properly and to allow for changes in the dose. Blood tests may be needed to check for any unwanted effects.

Using this medicine while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant. If you think you have become pregnant while using the medicine, tell your doctor right away. Your doctor may want you to join a pregnancy registry for patients taking a seizure medicine.

This medicine may cause drowsiness, trouble with thinking, trouble with controlling movements, or trouble with seeing clearly. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are not alert or able to think or see well.

This medicine may cause some people to be agitated, irritable, or display other abnormal behaviors. It may also cause some people to have suicidal thoughts and tendencies or to become more depressed. If you, your child, or your caregiver notice any of these side effects, tell your doctor or your child's doctor right away.

If you or your child have been taking this medicine in large doses or for a long time, do not stop taking it without checking first with your doctor. Your doctor may want you to gradually reduce the amount you are using before stopping it completely. This may help prevent a worsening of your condition and reduce the possibility of withdrawal symptoms, such as convulsions (seizures), hallucinations, stomach or muscle cramps, tremors, or unusual behavior.

This medicine will add to the effects of alcohol and other central nervous system (CNS) depressants (medicines that make you drowsy or less alert). Some examples of CNS depressants are antihistamines or medicine for allergies or colds; sedatives, tranquilizers, or sleeping medicine; prescription pain medicine or narcotics; barbiturates (used for seizures); muscle relaxants; or anesthetics (numbing medicines), including some dental anesthetics. Check with your doctor before taking any of the above while you are using this medicine.

Side Effects of This Medicine:

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common
Body aches or pain
chills
cough
difficulty with breathing
discouragement
dizziness
ear congestion
feeling sad or empty
fever
headache
irritability
lack of appetite
loss of interest or pleasure
loss of voice
nasal congestion
poor coordination
runny nose
shakiness and unsteady walk
sleepiness or unusual drowsiness
sneezing
sore throat
tiredness
trouble with concentrating
trouble with sleeping
unsteadiness, trembling, or other problems with muscle control or coordination
unusual tiredness or weakness
Less common
Being forgetful
bladder pain
bloody or cloudy urine
changes in patterns and rhythms of speech
diarrhea
difficult, burning, or painful urination
frequent urge to urinate
general feeling of discomfort or illness
joint pain
loss of appetite
lower back or side pain
mood or mental changes
muscle aches and pains
nausea
nervousness
problems in urination or increase in the amount of urine
shivering
slurred speech
sore throat
sweating
trouble with speaking
vomiting
Rare
Burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
changes in skin color
chest pain or discomfort
cold sweats
colds
confusion
cough or hoarseness
difficulty with sleeping
dizziness, faintness, or lightheadedness when getting up from a lying or sitting position
excessive dreaming
excessive muscle tone
excitement
falling
fast, irregular, pounding, or racing heartbeat or pulse
feeling mad
feeling of unreality
flu-like symptoms
headache, severe and throbbing
lack of feeling or emotion
lack or loss of self-control
muscle stiffness
muscle tension or tightness
nightmares
pain, inflammation, or swelling in the calves, shoulders, or hands
pain or swelling in the arms or legs without any injury
pain, tenderness, or swelling of the foot or leg
partial or slight paralysis
scaling
sense of detachment from self or body
shakiness in the legs, arms, hands, or feet
shortness of breath
skin rash
sleeplessness
swelling around the eyes
swelling of the face, ankle, foot, or knees
thoughts of killing oneself changes in behavior
tightness in the chest
trembling or shaking of the hands or feet
troubled breathing
unable to sleep
uncaring
vision changes
wheezing
Incidence not known
Anxiety
black, tarry stools
bleeding gums
blood in the urine or stools
change in consciousness
chest congestion
difficulty with coordination
double vision
drowsiness
dry mouth
feeling that others are watching you or controlling your behavior
feeling that others can hear your thoughts
feeling, seeing, or hearing things that are not there
hyperventilation
irregular, fast, slow, or shallow breathing
irregular, twisting uncontrolled movement of the face, hands, arms, or legs
loss of consciousness
loss of interest or pleasure
loss of memory
loss of strength or energy
loss of voice
muscle weakness
pale or blue lips, fingernails, or skin
pinpoint red spots on the skin
problems with memory
restlessness
right upper abdominal pain and fullness
severe mood or mental changes
sores, ulcers, or white spots on the lips or in the mouth
swollen glands
troubled breathing with exertion
uncontrolled eye movements
unusual behavior
unusual bleeding or bruising
unusual weak feeling
vivid dreams
weight loss or gain

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Less common
Decreased interest in sexual intercourse
difficulty with swallowing
dryness or soreness of the throat
heavy bleeding
hives
inability to have or keep an erection
longer than usual time to ejaculation of semen
loss in sexual ability, desire, drive, or performance
pain or tenderness around the eyes and cheekbones
puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
voice changes
Rare
Acid or sour stomach
ankle, knee, or great toe joint pain
belching
bleeding after defecation
blistering, burning, crusting, dryness, or flaking of the skin
bloated
blurred or loss of vision
decrease or change in vision
difficulty with moving
disturbed color perception
double vision
dryness of the eyes
earache
excess air or gas in stomach or intestines
feeling of constant movement of self or surroundings
feeling of warmth
frequent bowel movements
full feeling
hair loss or thinning of the hair
halos around lights
heartburn
increased watering of the mouth
indigestion
irregularities in menstruation
itching in genital or other skin areas
itching, scaling, severe redness, soreness, or swelling of the skin
joint stiffness or swelling
leg or muscle cramps
loss of taste
night blindness
nosebleeds
overbright appearance of lights
pain in the breasts or pelvic area
pain in the leg, nape, or back
passing gas
red, sore eyes
redness of the face, neck, arms, and occasionally, upper chest
redness or swelling in the ear
sensation of spinning
skin rash cracks in the skin at the corners of the mouth
smaller amount of semen ejaculated than usual
sore on the edge of the eyelid
soreness or redness around the fingernails and toenails
stomach discomfort, upset, or pain
thickening of the tongue
thirst
tooth disorder
toothache
tunnel vision
twitching of the eyes
uncomfortable swelling around the anus
worsening of acne
Incidence not known
Burning feeling in the chest or stomach
difficulty having a bowel movement (stool)
increased appetite
increased hair growth, especially on the face
increased in sexual ability, desire, drive, or performance
increased interest in sexual intercourse
sore gums
tenderness in the stomach area

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.


Last Updated: 11/4/2014

Copyright © 1984- Thomson Micromedex. All rights reserved.

Thomson & A.D.A.M