Clonazepam

Actions

• Increases frequency of GABA-mediated chloride channel opening.

Metabolism

Hepatic

Enzymes involved

CYP3A4

Elimination

Renal

Half-life

19-60 hours

Plasma protein binding

85%

Important side-effects

Suicidal behaviour and ideation.

CNS depression. Concomitant use of opioid analgesics and benzodiazepines increases the risk of drug-related mortality.

Indications

Myoclonic seizures.

Absence seizures.

Generalized seizures.

Focal seizures with or without generalization.

Adjunctive treatment of status epilepticus.

Dosing recommendation

Start with 1.5 mg/day divided into three doses

Increase in increments of 0.5 mg to 1 mg every 3 days

Target dose: 4-8 mg divided in three to four doses. Maximum recommended daily dose is 20 mg

Renal impairment

Dose adjustment might be necessary in patients with impaired renal function.

Hepatic impairment

Dose adjustment might be necessary in patients with impaired hepatic function.