Adult Dosing
Lennox-Gastaut syndrome (LGS)
30 kg: 5 mg daily and titrate as tolerated up to 20 mg daily- >30 kg: 10 mg daily and titrate as tolerated up to 40 mg daily
Note: In elderly patients or CYP2C19 poor metabolizers, start 5 mg PO qd x1wk, then 5 mg PO bid x1wk, then 10 mg PO bid; taper dose by 5-10 mg/day qwk to D/C
Pediatric Dosing
Note: Use not recommended in children between the ages of 6 months and 3 yrs, other than in exceptional cases for anticonvulsant treatment. Below mentioned guidelines may be followed
Epilepsy, adjunctive
Child
- > 2 years, 30 kg: 5 mg daily and titrate as tolerated up to 20 mg daily
- > 2 years, >30 kg: 10 mg daily and titrate as tolerated up to 40 mg daily
- Max: 40 mg/day
- Clobazam may induce somnolence and sedation particularly with concomitant use of other central nervous system depressants
- Clobazam may potentiate sedation from concomitant use with central nervous system depressants
- Abrupt discontinuation of clobazam should be avoided.Dose should be tapered by decreasing the dose every week by 5-10 mg/day until discontinuation
- Clobazam should not be given with antiepileptic drugs to minimize the risk of precipitating seizures, seizure exacerbation, or status epilepticus
- Patients with a history of substance abuse should be under careful surveillance when receiving clobazam or other psychotropic agents because of the predisposition of such patients to habituation and dependence
- Clobazam increases the risk of suicidal thoughts thus such patients should be monitored for worsening of depression, suicidal thoughts or behavior, and/or any unusual changes in mood or behavior
- Serious skin reactions including Stevens-Johnson syndrome, toxic epidermal necrolysis reported in both children and adults; monitor carefully for signs or symptoms, especially during the first 8 weeks of treatment initiation or when re-introducing therapy; discontinue at the first sign of drug related rash and do not resume
Cautions: Use cautiously in
Pregnancy Category: c
Breastfeeding: Limited information indicates that maternal doses of clobazam up to 30 mg daily produce low levels in milk. Short-term use would not be expected to cause any adverse effects in breastfed infants, especially if the infant is older than 2 months. During long-term administration, monitor the infant for possible sedation and poor sucking.This information is based upon Lactmed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 24 June 2013)
