Medication and Treatment Reviews

Clonazepam

Brand Name: Klonopin

Uses

Clonazepam is an anticonvulsant or antiepileptic drug in the benzodiazepine class used for short-term relief of symptoms of panic disorder with or without agoraphobia in adults. Clonazepam is also useful alone or in tandem with other medications to treat Lennox-Gastaut syndrome, plus akinetic and myoclonic seizures in adults and children. The safety and effectiveness of clonazepam for treating panic disorder have not been established for adolescents and children under age 18 or elderly patients over age 65.

How to Use Clonazepam

Before starting or refilling a clonazepam prescription, read the medication guide included with your pills, as it may be updated with new information.

This guide should not replace a conversation with your doctor, who has a holistic view of your or your child’s medical history, other diagnoses, and other prescriptions. If you have questions, ask your doctor or pharmacist before you begin taking the medication.

Dosage

As with all medications, follow your clonazepam prescription instructions exactly. Clonazepam is available in two formulations:

  • Clonazepam Tablet: Taken orally two to three times daily with water or another liquid. Tablets are available in 0.5mg, 1mg, and 2mg doses.
  • Clonazepam Quick-Dissolving Tablet: Taken with or without water or another liquid. Tablets are available in 0.125mg, 0.25mg, 0.5mg, 1mg, and 2mg dosages. To keep it from dissolving before you place the tablet in your mouth, leave it contained in its blister package until you are ready to take it. When opening the medication, make sure your hands are clean and dry so as not to accidentally trigger dissolution. Peel back the blister package backing to take out the tablet, instead of pushing it through the foil. Place the tablet on your tongue, where it will dissolve. Do not crush or chew the tablet.

Do not drink alcohol while taking this medication.

The maximum dosage is typically 4mg daily for treatment of panic disorders. Treatment of seizure disorders may require a higher dosage, up to 20mg per day. When taking a higher dosage, you should meet with your doctor regularly to consider dosage reduction and long-term usefulness. Doctors may recommend a lower starting dosage for elderly patients or patients with certain medical conditions who may be particularly sensitive to benzodiazepines.

The optimal dosage varies by patient and condition treated. Your doctor may increase your dosage by 0.5mg to 1mg every three days until symptoms are adequately controlled.

When discontinuing treatment, or decreasing dosage, patients should work with a doctor to gradually taper the level of medication by no more than .125mg every three days. Stopping clonazepam suddenly can create withdrawal symptoms, and seizures can occur. Some patients may need to decrease dosage at an even slower rate.

Do not increase the dosage without discussing it with your doctor. Your doctor should periodically reassess if the treatment is still useful. Long-term treatment with clonazepam increases the risk of dependence, and may cause difficulty when terminating treatment. After an extended period without attacks or symptoms, a patient may work with his or her doctor to taper off the medication gradually.

Side Effects

The most common side effects associated with clonazepam are: drowsiness, dizziness, fatigue, depression, memory problems, loss of coordination, and symptoms of dependence/withdrawal with long-term usage.

There is a chance that clonazepam used to treat a seizure disorder can make seizures happen more often, or get worse. Contact your healthcare provider immediately if this occurs.

If you stop taking clonazepam suddenly, it can cause seizures that will not stop, hallucinations, shaking, and cramps.

Taking clonazepam may impair your ability to drive, operate machinery, or perform other potentially dangerous tasks. This side effect usually wears off with time. If side effects are bothersome, or do not go away, talk to your doctor.

Most people taking this medication do not experience any of these side effects.

Disclose to your physician all mental health issues including any family history of suicide or depression. In a small number of people, clonazepam may cause suicidal thoughts or actions. Panic disorder is often comorbid with major depressive disorders, which can increase risk for suicide. Call your doctor immediately if you experience new or worsening mental health symptoms including hallucinations or sudden changes in mood.

Tell your doctor if you have liver, kidney, or lung problems before taking clonazepam. Clonazepam is processed by the liver and kidneys, and impaired function can lead to a build-up in the body. Clonazepam causes respiratory depression, which can cause breathing problems for patients with impaired function.

Benzodiazepines like clonazepam are “Schedule IV controlled substances,” a designation that the Drug Enforcement Agency uses for drugs with a potential for abuse. Other Schedule IV drugs include Valium, Ativan, and Ambien. Long-term treatment in higher dosages with clonazepam increases the risk of dependence, especially among people predisposed to addiction.

The above is not a complete list of potential side effects. If you notice any health changes not listed above, discuss them with your doctor or pharmacist.

Precautions and Safety

Store clonazepam in a secure place out of reach of children, and at room temperature. If you are taking the quick-dissolving tablet, keep the tablets in the blister packaging until you are ready to take them. Do not share your clonazepam prescription with anyone, even another person with the same condition. Sharing prescription medication is illegal, and can cause harm.

You should not take clonazepam if you are sensitive to benzodiazepines, have liver disease, or have acute narrow angle glaucoma.

If you are thinking of becoming pregnant, you should not take clonazepam, because there is a high potential for fetal harm, and increased risk of congenital abnormalities. If you become pregnant while taking clonazepam, talk to your healthcare provider about registering with the North American Antiepileptic Drug Pregnancy Registry. It is actively collecting information about the safety of anticonvulsants during pregnancy. Clonazepam is passed through breastmilk, so it is recommended that mothers do not nurse while taking it.

Interactions

Before taking clonazepam, discuss all other active prescription medications with your doctor.

Using benzodiazepines, like clonazepam, at the same time as opioid medications can cause severe drowsiness, breathing problems, coma, and even death.

Use caution taking clonazepam if you are taking drugs that inhibit metabolism via cytochrome P4503A, such as oral antifungal agents.

Share a list of all vitamin or herbal supplements, and prescription and non-prescription medications you take with the pharmacist when you fill your prescription, especially any drugs that cause drowsiness including alcohol, antihistamines, anti-anxiety drugs, sleep-inducing drugs, muscle relaxants, or narcotics.

Let all doctors and physicians know you are taking clonazepam before having any surgery or laboratory tests. The above is not a complete list of all possible drug interactions.

Sources:

https://www.accessdata.fda.gov/drugsatfda_docs/label/2010/017533s046s048,020813s006s007MedGuide.pdf
https://www.gene.com/download/pdf/klonopin_prescribing.pdf
https://www.accessdata.fda.gov/drugsatfda_docs/label/2009/017533s045,020813s005lbl.pdf
https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=1aef0069-80ea-483d-ac70-c8d485462c5b

 

3 reviews

  1. I suffer from Generalized Anxiety Disorder and ADHD and had the same challenges when the ADHD medication wears off. I have tried Xanax and other options but found that the best result was another dose of Adderall at that time. The anxiety was caused by my lack of focus.

    Xanax was a temporary solution but can cause the same anxiety when it wears off too. I have chosen to take Clonazepam because it lasts longer and I don’t always need it with the extra Adderall dose.

  2. Diagnosed 18 months ago BECAUSE of anxiety and severe panic attacks. Sought med management specifically as I needed something immediate and meditation, exercise, etc wasn’t working. AND I had just passed my third year as a recovering alcoholic, with a good recovery approach working really well. Then BAM panic and anxiety! It became panic about having panic attacks more anxiety that it would lead to relapse!

    I currently take 2 (15mg) dextroamphetamine extended release capsules 3x/day and 1mg clonazepam 2x/day.

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