Clonazepam

Administration

• Type: Benzodiazepine
• Dosage Forms:
• Routes of Administration: PO (tablet or ODT)
• Common Trade Names: Klonopin

Adult Dosing

• 0.25-6mg PO q8-24h

Pediatric Dosing

• 6-10yo or <30kg: 0.01-0.2 mg/kg/day PO divided q8h
• >10yo: 1.5-20mg/day PO divided q8h

Special Populations

Pregnancy Rating

• D

Lactation risk

• Excreted in breastmilk- avoid use or monitor infant closely for sedation

Renal Dosing

• No adjustment

Hepatic Dosing

• Do not use in significant hepatic impairment

==Contraindications==

• Allergy to class/drug
• Significant hepatic impairment
• Acute narrow angle glaucoma
• Caution with:
  • Compromised respiratory function (e.g. COPD, sleep apnea, myasthenia gravis)
  • Concomitant CNS depressants
  • History of ETOH/substance abuse
  • Depression, psychosis, suicidal ideation
  • Porphyria
  • Elderly

Adverse Reactions

Serious

• Respiratory depression
• CNS depression, coma
• Paradoxical agitation, anxiety, psychosis
• Suicidal ideation
• Abuse/dependence
• Withdrawal seizures

Common

• Somnolence/fatigue
• Confusion, memory impairment, abnormal coordination, dysarthria, dizziness
• Depression
• Impotence, decreased libido
• URI, cough
• Urinary frequency

Pharmacology

• Half-life: 17-60h (adults); 22-33h (children)
• Metabolism: Hepatic
• Excretion: Urinary

Mechanism of Action

• Long-acting benzodiazepine

See Also

• Benzodiazepine toxicity
• Benzodiazepine withdrawal