What is Clonazepam (Klonopin, Rivotril)?
Clonazepam is a benzodiazepine. It affects chemicals in the brain that may be unbalanced. Clonazepam is also a seizure medicine, also called an anti-epileptic drug.
Clonazepam is used to treat certain seizure disorders (including absence seizures or Lennox-Gastaut syndrome) in adults and children.
Clonazepam is also used to treat panic disorder (including agoraphobia) in adults.
You should not use clonazepam if you have narrow-angle glaucoma or severe liver disease, or if you are allergic to Valium or a similar medicine.
Call your doctor if you have any new or worsening symptoms of depression, unusual changes in behavior, or thoughts about suicide or hurting yourself.
Do not drink alcohol while taking this medicine. Clonazepam may be habit-forming. Never share clonazepam with another person. Keep the medication in a place where others cannot get to it. Selling or giving away clonazepam is against the law.
Before taking this medicine
You should not take clonazepam if you have:
- narrow-angle glaucoma;
- severe liver disease; or
- a history of allergic reaction to any benzodiazepine, such as diazepam (Valium), alprazolam (Xanax), lorazepam (Ativan), chlordiazepoxide, flurazepam, and others.
To make sure clonazepam is safe for you, tell your doctor if you have:
- kidney or liver disease;
- porphyria (a genetic enzyme disorder that causes symptoms affecting the skin or nervous system);
- asthma, emphysema, bronchitis, chronic obstructive pulmonary disorder (COPD), or other breathing problems;
- a history of depression or suicidal thoughts or behavior;
- a history of mental illness, psychosis, or addiction to drugs or alcohol; or
- if you use a narcotic (opioid) medication.
Some people have thoughts about suicide when taking seizure medication. Your doctor should check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms.
Follow your doctor’s instructions about taking seizure medication if you are pregnant. Do not start or stop taking this medicine without your doctor’s advice, and tell your doctor right away if you become pregnant. Clonazepam may cause harm to an unborn baby, and may cause breathing or feeding problems in a newborn. But having seizures during pregnancy could harm both mother and baby.
If you are pregnant, your name may be listed on a pregnancy registry. This is to track the outcome of the pregnancy and to evaluate any effects of clonazepam on the baby.
Clonazepam can pass into breast milk and may harm a nursing baby. You should not breast-feed while using this medicine.
Do not give this medicine to a child without medical advice. Clonazepam is not approved to treat panic disorder in anyone younger than 18 years old.
The sedative effects of clonazepam may last longer in older adults. Accidental falls are common in elderly patients who take benzodiazepines. Use caution to avoid falling or accidental injury while you are taking clonazepam.
How should I take clonazepam?
Take clonazepam exactly as prescribed by your doctor. Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not use this medicine in larger or smaller amounts or for longer than recommended.
Clonazepam may be habit-forming. Never share this medicine with another person, especially someone with a history of drug abuse or addiction. Keep the medication in a place where others cannot get to it.
Misuse of habit-forming medicine can cause addiction, overdose, or death. Selling or giving away this medicine is against the law.
Clonazepam should be used for only a short time. Do not take this medication for longer than 9 weeks without your doctor’s advice.
Swallow the tablet whole, with a full glass of water.
If you use this medicine long-term, you may need frequent medical tests.
Do not stop using clonazepam suddenly or you could have unpleasant withdrawal symptoms, including a seizure (convulsions). Ask your doctor how to safely stop using this medicine.
Call your doctor if this medicine seems to stop working as well in treating your seizures or anxiety symptoms.
Seizures are often treated with a combination of drugs. Use all medications as directed by your doctor. Read the medication guide or patient instructions provided with each medication. Do not change your doses or medication schedule without your doctor’s advice.
Store clonazepam at room temperature away from moisture, heat, and light.
Keep track of the amount of medicine used from each new bottle. Clonazepam is a drug of abuse and you should be aware if anyone is using your medicine improperly or without a prescription.
What happens if I miss a dose?
Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
Overdose symptoms may include extreme drowsiness, confusion, muscle weakness, fainting, or coma.
What should I avoid while taking clonazepam?
Avoid drinking alcohol. Dangerous side effects could occur.
Clonazepam may impair your thinking or reactions. Avoid driving or operating machinery until you know how this medicine will affect you. Dizziness or severe drowsiness can cause falls or other accidents.
Clonazepam side effects
Get emergency medical help if you have signs of an allergic reaction to clonazepam: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.
Call your doctor at once if you have:
- new or worsening seizures;
- severe drowsiness;
- unusual changes in mood or behavior;
- confusion, aggression, hallucinations;
- thoughts of suicide or hurting yourself;
- weak or shallow breathing;
- pounding heartbeats or fluttering in your chest; or
- unusual or involuntary eye movements.
Common clonazepam side effects may include:
- feeling tired or depressed;
- drowsiness, dizziness;
- memory problems; or
- problems with balance or coordination.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Clonazepam dosing information
Usual Adult Dose of Clonazepam for Seizure Prophylaxis:
1.5 mg orally per day divided into 3 doses; this may be increased in increments of 0.5 mg to 1 mg every 3 days until seizures are adequately controlled or until side effects preclude any further increase.
Maximum dose: 20 mg orally per day
-The use of multiple anticonvulsants may result in an increase of depressant adverse effects.
-Alone or as an adjunct in the treatment of the Lennox-Gastaut syndrome (petit mal variant), akinetic and myoclonic seizures
Usual Adult Dose for Panic Disorder:
Initial dose: 0.25 mg orally 2 times per day
Maintenance dose: 1 mg orally per day
Maximum dose: 4 mg orally per day
-An increase to the target dose for most patients of 1 mg/day may be made after 3 days.
-The dose may be increased in increments of 0.125 mg to 0.25 mg 2 times per day every 3 days until panic disorder is controlled or until side effects make further increases undesired.
-Administration of one dose at bedtime may be desired, to reduce the inconvenience of somnolence.
-Treatment should be discontinued gradually, with a decrease of 0.125 mg 2 times per day every 3 days, until the drug is completely withdrawn.
-Treatment of panic disorder, with or without agoraphobia
Usual Pediatric Dose of Clonazepam for Seizure Prophylaxis:
Up to 10 years of age or 30 kg of body weight:
0.01 mg/kg/day to 0.05 mg/kg/day orally administered in 2 or 3 divided doses
10 years or older or 30 kg and over:
See adult dosing
-Dosage should be increased by no more than 0.25 mg to 0.5 mg every third day until the daily maintenance dose has been reached, unless seizures are controlled or side effects preclude further increase.
-Whenever possible, the daily dose should be divided into three equal doses.
-If doses are not equally divided, the largest dose should be given before retiring.
-Alone or as an adjunct in the treatment of the Lennox-Gastaut syndrome (petit mal variant), akinetic and myoclonic seizures.