Clonazepam: Difference between revisions
| [unchecked revision] | [checked revision] |
MDElliottMD (talk | contribs) Auto-created stub |
MDElliottMD (talk | contribs) parser-claude: Clonazepam MedTemplate refill, Top 300 stub upgrade |
||
| (9 intermediate revisions by 2 users not shown) | |||
| Line 2: | Line 2: | ||
| generic = Clonazepam | | generic = Clonazepam | ||
| brand = Klonopin | | brand = Klonopin | ||
| classes = Benzodiazepine, Anticonvulsant, | | structure = | ||
| mechanism = | | classes = [[:Category:Benzodiazepines|Benzodiazepine]], [[:Category:Anxiolytics|Anxiolytic]], [[:Category:Anticonvulsants|Anticonvulsant]], [[:Category:Schedule IV controlled substances|Schedule IV controlled substance]] | ||
| uses = <vote slug="panic-disorder-use">Panic disorder (FDA)</vote>, <vote slug="lennox-gastaut-use">Lennox-Gastaut syndrome (FDA)</vote>, <vote slug="myoclonic-seizures-use">Akinetic and myoclonic seizures (FDA)</vote>, <vote slug="social-anxiety-disorder-use">Social anxiety disorder (off-label)</vote>, <vote slug="rem-sleep-behavior-disorder-use">REM sleep behavior disorder (off-label, evidence-supported)</vote>, <vote slug="restless-legs-syndrome-use">Restless legs syndrome (off-label, second-line)</vote>, <vote slug="acute-mania-adjunct-use">Acute mania adjunct (off-label)</vote> | |||
| starting_dose = Anxiety: 0.25 mg PO BID, titrate by 0.125-0.25 mg every 3 days to target 1-4 mg/day divided. Seizures: 1.5 mg/day divided TID, titrate by 0.5-1 mg every 3 days | |||
| preparations = Tablets 0.5, 1, 2 mg; orally disintegrating tablets 0.125, 0.25, 0.5, 1, 2 mg | |||
| fda_max = 20 mg/day (seizures); commonly limited to 4 mg/day for anxiety in current practice | |||
| pill_id = | |||
| routes = Oral | |||
| onset = 20-60 minutes | |||
| duration = 6-12 hours (long-acting among benzodiazepines) | |||
| halflife = 30-40 hours (long; accumulates with chronic dosing)<ref name="klonopin-label">FDA Prescribing Information, Klonopin (clonazepam), Genentech/Roche, current revision. https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/017533s055lbl.pdf</ref> | |||
| bioavailability = ~90% (oral)<ref name="klonopin-label" /> | |||
| pregnancy = Limited human data; some signal for cleft palate with first-trimester exposure (debated); neonatal sedation and withdrawal with third-trimester exposure.{{citation needed}} | |||
| legal = [[USLegal:Schedule IV|Schedule IV controlled substance]] in US. Carries the benzodiazepine class '''Boxed Warning''' for risk of fatal respiratory depression, coma, and death when combined with opioids<ref name="klonopin-label" /> | |||
| mechanism = <vote slug="clonazepam-mech-claim">Positive allosteric modulator of the GABA-A receptor at the benzodiazepine binding site (α-γ subunit interface), enhancing chloride ion conductance and consequent neuronal inhibition. The long elimination half-life is the clinical signature: smoother symptom coverage than short-acting alternatives but greater accumulation, longer next-day sedation, and longer protracted withdrawal.</vote> Strong CYP3A4 substrate; CYP3A4 inhibitors (ketoconazole, clarithromycin, ritonavir, grapefruit juice) substantially raise plasma exposure. Tolerance to anxiolytic effect, dependence, and significant withdrawal syndrome on abrupt discontinuation; slow taper essential after extended use<ref name="klonopin-label" />. | |||
}} | }} | ||
== References == | |||
<references /> | |||
[[Category:Benzodiazepines]] | |||
[[Category:Anxiolytics]] | [[Category:Anxiolytics]] | ||
[[Category:Anticonvulsants]] | |||
[[Category:Schedule IV controlled substances]] | |||
Latest revision as of 06:43, 23 May 2026
Clonazepam
Klonopin
Experience
No personal reports yet
No clinical reports yet
Log in to add your own experience.
Problems
No problems yet. Be the first to suggest one.
+ Add a problemTitration strategies
No titration strategies yet. Be the first to suggest one.
Effects
No effects listed yet. Be the first to suggest one.
Relevant anecdote
No anecdotes yet. Share a relevant one.
Relevant Literature
No literature entries yet.
Log in to submit relevant literature.
Summary
Common uses
Panic disorder (FDA)0, Lennox-Gastaut syndrome (FDA)0, Akinetic and myoclonic seizures (FDA)0, Social anxiety disorder (off-label)0, REM sleep behavior disorder (off-label, evidence-supported)0, Restless legs syndrome (off-label, second-line)0, Acute mania adjunct (off-label)0
Pharmacy
Starting dose
Anxiety: 0.25 mg PO BID, titrate by 0.125-0.25 mg every 3 days to target 1-4 mg/day divided. Seizures: 1.5 mg/day divided TID, titrate by 0.5-1 mg every 3 days
Preparations
Tablets 0.5, 1, 2 mg; orally disintegrating tablets 0.125, 0.25, 0.5, 1, 2 mg
US FDA Max
20 mg/day (seizures); commonly limited to 4 mg/day for anxiety in current practice
Pharmacology
Routes
Oral
Onset
20-60 minutes
Duration
6-12 hours (long-acting among benzodiazepines)
Half-life
30-40 hours (long; accumulates with chronic dosing)[1]
Bioavailability
~90% (oral)[1]
Pregnancy
Limited human data; some signal for cleft palate with first-trimester exposure (debated); neonatal sedation and withdrawal with third-trimester exposure.[citation needed]
Legal status
Schedule IV controlled substance in US. Carries the benzodiazepine class Boxed Warning for risk of fatal respiratory depression, coma, and death when combined with opioids[1]
Purported mechanism
Positive allosteric modulator of the GABA-A receptor at the benzodiazepine binding site (α-γ subunit interface), enhancing chloride ion conductance and consequent neuronal inhibition. The long elimination half-life is the clinical signature: smoother symptom coverage than short-acting alternatives but greater accumulation, longer next-day sedation, and longer protracted withdrawal.0 Strong CYP3A4 substrate; CYP3A4 inhibitors (ketoconazole, clarithromycin, ritonavir, grapefruit juice) substantially raise plasma exposure. Tolerance to anxiolytic effect, dependence, and significant withdrawal syndrome on abrupt discontinuation; slow taper essential after extended use[1].
References
- ↑ 1.0 1.1 1.2 1.3 FDA Prescribing Information, Klonopin (clonazepam), Genentech/Roche, current revision. https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/017533s055lbl.pdf