Clonazepam

DEA Class;  Rx

Common Brand Names; Klonopin

Significant hepatic impairment

Documented hypersensitivity

Acute narrow angle glaucoma

• Somnolence (37%)
• Abnormal coordination (5-10%)
• Ataxia (5-10%)
• Depression (5-10%)
• Dizziness (5-10%)
• Fatigue (5-10%)
• Memory impairment (5-10%)
• Upper respiratory infection (5-10%)
• Confusion (1-5%)
• Dysarthria (1-5%)
• Rhinitis (1-5%)
• Coughing (1-5%)
• Urinary frequency (1-5%)
• Impotence (1-5%)
• Decreased libido (1-5%)
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• Increased salivation
• Worsening tonic-clonic seizures

Withdraw gradually when used for panic disorder

Use caution in COPD, sleep apnea, renal/hepatic disease, open-angle glaucoma (questionable), depression, suicidal ideation

Not recommended in patients with depressed neuroses, psychotic reactions, severe respiratory depression, myasthenia gravis (allowable in limited circumstances), acute alcohol intoxication

Anterograde amnesia reported benzodiazepine use

May cause CNS depression and impairs ability to perform hazardous tasks

Hyperactive or aggressive behavior reported with benzodiazepines in pediatric/adolescent patients and in psychiatric patients

Increased risk of suicidal thoughts/behavior reported with antiepileptic agents; monitor patient for suicidal behavior and notify health-care provider immediately

Use with caution in patients with a history of drug abuse or acute alcoholism; drug dependency possible; prolonged use may result in psychological and physical dependence

Use with caution in patients with compromised respiratory function

May have porphyrogenic effect; use with caution in patients with porphyria

Not for concomitant administration with alcohol or other CNS-depressant drugs

When used in patients in whom several different types of seizure disorders coexist, clonazepam may increase incidence or precipitate onset of generalized tonic-clonic seizures (grand mal); may require addition of appropriate anticonvulsants or increase in dosages; concomitant use of valproic acid and clonazepam may produce absence status

There are no adequate and well-controlled studies of Klonopin in pregnant women; available human data on risk of teratogenicity are inconclusive; there is insufficient evidence in humans to assess effect of benzodiazepine exposure during pregnancy on neurodevelopment

Effects on breastfed infant and on milk production are unknown; developmental and health benefits of breastfeeding should be considered along with mother’s clinical need for therapy and any potential adverse effects on breastfed infant from drug or from underlying maternal condition