Adult Dosing
Seizure disorders (Lennox-Gastaut syndrome, akinetic and myoclonic seizures, absence seizures)
- Initial dose: 0.5 mg PO tid
- Increase in increments of 0.5-1 mg q3 days until seizures are adequately controlled
- Max: 20 mg/day
Panic disorder
- Initial dose: 0.25 mg PO bid; may start on lower doses in geriatric patients
- Increase in increments of 0.125-0.25 mg bid q3 days to the target dose of 1 mg/day or until panic disorder is controlled
- Max: 4 mg/day
- Discontinue gradually by decreasing 0.125 mg bid q3 days, until completely withdrawn
Pediatric Dosing
Seizure disorders (Lennox-Gastaut syndrome, akinetic and myoclonic seizures, absence seizures, refractory seizures)
Children <10 yrs or <30 kgs
- Start 0.01-0.03 mg/kg/day PO divided bid-tid
- Increase 0.25-0.5 mg q3 days until seizures are adequately controlled
- Max: 0.1-0.2 mg/kg/day
Children >10 yrs or >30 kgs
- Start 0.5 mg PO tid
- Increase 0.5-1 mg q3 days until seizures are adequately controlled
- Max: 20 mg/day
Panic disorder
- Safety and effectiveness not established in pediatric patients below 18 yrs of age
[Outline]
See Supplemental Patient Information
- Clonazepam produces CNS depression, caution patients against engaging in activities requiring mental alertness eg. operating machinery and driving
- Antiepileptic drugs increase the risk of suicidal thoughts or behavior, monitor the patient for emergence/worsening of depression or the emergence of suicidal ideation, and/or unusual changes in mood or behavior. These changes are observed as early as one week after starting the drug
- Increases the risk of congenital malformations in the fetus, use during pregnancy should be considered only when the clinical situation warrants the risk to the fetus
- Taper dose gradually to discontinue (abrupt cessation may cause a withdrawal syndrome)
- May increase the incidence or precipitate the onset of generalized tonic-clonic seizures (grand mal) in patients with several different types of seizure disorders, consider addition of appropriate anticonvulsants or an increase in their dosages
- Monitor periodic CBC and LFTs during prolonged therapy
- Take precautions while administering in patients with chronic respiratory diseases because of the possibility of increased salivation and respiratory depression
Cautions: Use cautiously in
- Renal impairment
- Liver diseases
- History of depression
- Alcohol use
- History of alcohol or substance abuse
- History of porphyria
- Obstructive sleep apnea
- Pregnancy
- Geriatric population
- Debilitated patients
Supplemental Patient Information
- Advise patients to avoid alcohol while taking clonazepam
- Caution patients against operating hazardous machinery, including automobiles until they are reasonably certain that therapy does not affect them adversely
- Alert patients, their caregivers, and families about the increased risk of suicidal thoughts and behavior changes with the therapy
- Patients should be advised to inform their physician if they become pregnant or intend to become pregnant during therapy
- Instruct mothers receiving clonazepam to avoid breastfeeding their children if possible
Pregnancy Category:D
Breastfeeding: Limited number of cases of breastfeeding with clonazepam have been reported. If clonazepam is considered necessary for use in nursing women, monitor the infants for drowsiness, adequate weight gain, and developmental milestones. If excessive sedation occurs, monitor infant's serum concentration. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 4 Jan 2011). Manufacturer recommends mothers receiving this drug not to breastfeed their infants
Pricing data from www.DrugStore.com in U.S.A.
- KlonoPIN 2 MG TABS [Bottle] (GENENTECH)
30 mg = $89.99
90 mg = $257.98 - KlonoPIN 0.5 MG TABS [Bottle] (GENENTECH)
30 mg = $60.99
90 mg = $163.98 - ClonazePAM ODT 0.5 MG TBDP [Box] (PAR)
60 mg = $74.99
180 mg = $210.97 - ClonazePAM ODT 2 MG TBDP [Box] (PAR)
60 mg = $105.99
180 mg = $309.97 - ClonazePAM 1 MG TABS [Bottle] (ACTAVIS ELIZABETH)
30 mg = $11.99
90 mg = $26.99 - KlonoPIN 1 MG TABS [Bottle] (GENENTECH)
30 mg = $67.99
90 mg = $188.96 - ClonazePAM 0.5 MG TABS [Bottle] (ACTAVIS ELIZABETH)
30 mg = $13.99
90 mg = $26.99 - ClonazePAM ODT 0.125 MG TBDP [Box] (PAR)
60 mg = $69.99
180 mg = $189.98 - ClonazePAM ODT 0.25 MG TBDP [Box] (PAR)
60 mg = $76.99
180 mg = $218.97 - ClonazePAM 2 MG TABS [Bottle] (SANDOZ)
30 mg = $12.99
90 mg = $23.99 - ClonazePAM ODT 1 MG TBDP [Box] (PAR)
60 mg = $80.99
180 mg = $217.97
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.
