"Clonazepam": reviews. "Clonazepam": instructions for use, side effects. Detailed instructions for the use of clonazepam

Elderly patients (over 65 years): dose reduction is recommended. The initial dose should not exceed 0.5 mg / day. Pa In patients with impaired renal function, it may be necessary to reduce the dose of the drug.

From the side of the central nervous system: at the beginning of treatment - severe lethargy, a feeling of fatigue, drowsiness, lethargy, dizziness, a state of numbness, headaches; rarely - confusion, ataxia. When used in high doses, especially with long-term treatment - articulation disorders, diplopia, nystagmus; paradoxical reactions (incl. acute conditions excitation); anterograde amnesia. Rarely - hyperergic reactions, muscle weakness - depression. Long-term treatment of some forms of epilepsy may increase the frequency of seizures.

From the side digestive system: rarely - dry mouth, nausea, diarrhea, heartburn, nausea, vomiting, decreased appetite, constipation or diarrhea, liver dysfunction, increased activity of hepatic transaminases and alkaline phosphatase, jaundice. In infants and children early age possibly increased salivation.

From the side of cardio-vascular system: lowering blood pressure, tachycardia.

From the side endocrine system: change in libido, dysmenorrhea, reversible premature sexual development in children (incomplete premature puberty).

From the side respiratory system: with intravenous administration, respiratory depression is possible, especially against the background of treatment with other drugs that cause respiratory depression; in infants and young children, bronchial hypersecretion is possible.

From the hematopoietic system: leukopenia, neutropenia, agranulocytosis, anemia, thrombocytopenia.

From the urinary system: urinary incontinence, urinary retention, impaired renal function.

Allergic reactions: hives, skin rash, itching, extremely rarely - anaphylactic shock.

Dermatological reactions: transient alopecia, pigmentation changes.

Influence on the fetus: teratogenicity (especially the first trimester), inhibition of the CNS, impaired respiration and suppression of the sucking reflex in newborns whose mothers used the drug.

Others: addiction, drug dependence (both physical and mental - the risk of developing dependence increases with increasing dose and duration of treatment; predisposition is observed especially in patients with alcoholism or other types of addictions in history); decrease in blood pressure; rarely - weight loss, tachycardia, transient alopecia, changes in pigmentation.

At a sharp decline dose or discontinuation - withdrawal syndrome (tremor, increased sweating, agitation, irritability, nervousness, sleep disturbances, severe anxiety, dysphoria, smooth muscle spasm internal organs and skeletal muscles, myalgia, depression, nausea, vomiting, tachycardia, convulsions and epileptic seizures, which may be a manifestation of the underlying disease; in severe cases, derealization, hyperacusis, paresthesia, photophobia, hyperesthesia, hallucinations may develop). Withdrawal symptoms are usually seen when treatment is discontinued abruptly. Therefore, if it is necessary to stop treatment, the dose of the drug must be reduced gradually under the supervision of a physician. With prolonged use, it is possible to develop drug dependence and weaken the effect of the drug as a result of the development of tolerance.

Symptoms: drowsiness, confusion, paradoxical agitation, decreased reflexes, dysarthria, ataxia, nystagmus, tremor, bradycardia, shortness of breath or shortness of breath, severe weakness, decreased blood pressure, depression of cardiac and respiratory activity, coma.

Treatment: gastric lavage, intake activated carbon. Symptomatic therapy(maintaining breathing and blood pressure). Hemodialysis is ineffective. The benzodiazepine antagonist flumazenil is not indicated for patients with epilepsy who have been treated with benzodiazepines. In these patients, the benzodiazepine antagonistic effect can provoke epileptic seizures.

Mutual enhancement of the effects of antipsychotic drugs (neuroleptics), tricyclic antidepressants, other antiepileptic and hypnotic drugs, general anesthetics, narcotic analgesics, drugs that reduce blood pressure blood central action, muscle relaxants and ethanol. Drinking alcohol during clonazepam treatment, except provoke paradoxical reactions: psychomotor agitation, aggressive behavior or a state of pathological intoxication.

Pathological intoxication does not depend on the type and amount of alcohol consumed.

Reduces the effectiveness of levodopa in patients with parkinsonism.

Potentially increased toxicity of zidovudine with joint application.

When used simultaneously with valproic acid, it can lead to the development of status epilepticus in minor seizures.

Inhibitors of microsomal oxidation, lengthening T1 / 2, increase the risk of developing toxic effects.

Inducers of microsomal liver enzymes (barbiturates, or) accelerate the metabolism of clonazepam without affecting its binding to proteins (does not induce enzymes involved in its metabolism), reduce the effectiveness of the drug.

Narcotic analgesics increase euphoria, leading to an increase in psychological dependence.

Antihypertensive drugs can increase the severity of blood pressure lowering.

Against the background of the simultaneous administration of clozapine, an increase in respiratory depression is possible.

With the simultaneous use of phenytoin or primidone, an increase in the concentration of these drugs in the blood serum. lengthens the action.

An antiepileptic agent from the group of benzodiazepine derivatives. It has a pronounced anticonvulsant, as well as central muscle relaxant, anxiolytic, sedative and hypnotic effects.

Strengthens the inhibitory effect of GABA on the transmission of nerve impulses. Stimulates benzodiazepine receptors located in the allosteric center of postsynaptic GABA receptors of the ascending activating reticular formation of the brainstem and interneurons of the lateral horns of the spinal cord. Reduces the excitability of the subcortical structures of the brain (limbic system, thalamus, hypothalamus), inhibits postsynaptic spinal reflexes.

Anxiolytic action is due to the influence on the amygdala complex of the limbic system and is manifested in a decrease in emotional stress, weakening anxiety, fear, anxiety.

Sedation is due to the effect on the reticular formation of the brain stem and nonspecific nuclei of the thalamus and is manifested by a decrease in neurotic symptoms (anxiety, fear).

The anticonvulsant action is realized by enhancing presynaptic inhibition. In this case, the spread of epileptogenic activity that occurs in epileptogenic foci in the cortex, thalamus and limbic structures is suppressed, but the excited state of the focus is not removed.

It has been shown that clonazepam in humans rapidly suppresses paroxysmal activity of various types, incl. complexes "spike-wave" with absences (petit mal), slow and generalized complexes "spike-wave", "adhesions" of temporal and other localization, as well as irregular "adhesions" and waves.

Generalized EEG changes are suppressed to a greater extent than focal ones. In accordance with these data, clonazepam has a beneficial effect in generalized and focal forms of epilepsy.

The central muscle relaxant effect is due to inhibition of polysynaptic spinal afferent inhibitory pathways (to a lesser extent and monosynaptic). Direct inhibition of motor nerves and muscle function is also possible.

Pharmacokinetics

Release form

30 pcs. - contour cell packaging (1) - cardboard packs.

Dosage

Individual. For oral administration, an initial dose of no more than 1 mg / day is recommended for adults. The maintenance dose is 4-8 mg / day.

For infants and children aged 1-5 years, the initial dose should be no more than 250 mcg / day, for children aged 5-12 years - 500 mcg / day. Maintenance daily doses for children under 1 year old - 0.5-1 mg, 1-5 years old - 1-3 mg, 5-12 years old - 3-6 mg.

The daily dose should be divided into 3-4 equal doses. Maintenance doses are prescribed after 2-3 weeks of treatment.

IV (slowly) adults - 1 mg, children under 12 years old - 500 mcg.

Interaction

When used simultaneously with medicines, having a depressing effect on the central nervous system, ethanol, ethanol-containing drugs, it is possible to increase the inhibitory effect on the central nervous system.

With the simultaneous use of clonazepam enhances the effect of muscle relaxants; with sodium valproate - weakening the action of sodium valproate and provocation seizures.

With simultaneous use, a case is described of a decrease in the concentration of desipramine in blood plasma by 2 times and its increase after discontinuation of clonazepam.

With simultaneous use with carbamazepine, which causes the induction of microsomal liver enzymes, an increase in metabolism is possible and, as a result, a decrease in the concentration of clonazepam in blood plasma, a decrease in its T 1/2.

With simultaneous use with caffeine, it is possible to reduce the sedative and anxiolytic effect of clonazepam; with lamotrigine - a decrease in the concentration of clonazepam in blood plasma is possible; with lithium carbonate - the development of neurotoxicity.

With simultaneous use with primidone, the concentration of primidone in the blood plasma increases; with tiapride - the development of ZNS is possible.

With simultaneous use with toremifene, a significant decrease in AUC and T1 / 2 of toremifene is possible due to the induction of microsomal liver enzymes under the influence of clonazepam, which leads to an acceleration of toremifene metabolism.

A case of headache with localization in the occipital region with simultaneous use with phenelzine is described.

With simultaneous use, it is possible to increase the concentration of phenytoin in the blood plasma and develop toxic reactions, a decrease in its concentration or the absence of these changes.

With simultaneous use with cimetidine, side effects from the central nervous system increase, however, the frequency of seizures in some patients decreased.

Side effects

From the side of the central nervous system: at the beginning of treatment - severe lethargy, fatigue, drowsiness, lethargy, dizziness, numbness, headaches; rarely - confusion, ataxia. When used in high doses, especially with long-term treatment - articulation disorders, diplopia, nystagmus; paradoxical reactions (including acute states of excitement); anterograde amnesia. Rarely - hyperergic reactions, muscle weakness - depression. Long-term treatment of some forms of epilepsy may increase the frequency of seizures.

From the digestive system: rarely - dry mouth, nausea, diarrhea, heartburn, nausea, vomiting, loss of appetite, constipation or diarrhea, liver dysfunction, increased activity of hepatic transaminases and alkaline phosphatase, jaundice. In infants and young children, increased salivation is possible.

From the side of the cardiovascular system: lowering blood pressure, tachycardia.

From the endocrine system: changes in libido, dysmenorrhea, reversible premature sexual development in children (incomplete premature puberty).

On the part of the respiratory system: with intravenous administration, respiratory depression is possible, especially against the background of treatment with other drugs that cause respiratory depression; in infants and young children, bronchial hypersecretion is possible.

From the hematopoietic system: leukopenia, neutropenia, agranulocytosis, anemia, thrombocytopenia.

From the urinary system: urinary incontinence, urinary retention, impaired renal function.

Allergic reactions: urticaria, skin rash, itching, extremely rarely - anaphylactic shock.

Dermatological reactions: transient alopecia, pigmentation changes.

Others: addiction, drug dependence; with a sharp decrease in dose or termination of admission - withdrawal syndrome.

Indications

Means of the first row - epilepsy (adults, infants and young children): typical absences (petit mal), atypical absences (Lennox-Gastaut syndrome), nodding seizures, atonic seizures ("fall" or "drop-attack" syndrome).

The second row remedy is infantile spasms (West syndrome).

Remedy of the third row - tonic-clonic seizures (grand mal), simple and complex partial seizures and secondary generalized tonic-clonic seizures.

Status epilepticus (IV injection).

Somnambulism, muscle hypertonia, insomnia (especially in patients with organic brain lesions), psychomotor agitation, alcohol withdrawal syndrome (acute agitation, tremors, threatening or acute alcoholic delirium and hallucinations), panic disorder.

Contraindications

Depression of the respiratory center, severe COPD (progression of the degree of respiratory failure), acute respiratory failure, myasthenia gravis, coma, shock, angle-closure glaucoma (acute attack or predisposition), acute alcohol intoxication with weakening of vital functions, acute poisoning with narcotic analgesics and hypnotics, severe depression (suicidal tendencies may occur), pregnancy, lactation, hypersensitivity to clonazepam.

Application features

Application during pregnancy and lactation

Application for violations of liver function

Application in children

Use in elderly patients

special instructions

Use with extreme caution in patients with ataxia, severe liver disease, severe chronic respiratory failure, especially in the stage of acute deterioration, with episodes of sleep apnea.

Use with caution in elderly patients, because they may have a slower elimination of clonazepam and reduced tolerance, especially in the presence of cardiopulmonary insufficiency.

With prolonged use, drug dependence may develop. When clonazepam is abruptly canceled after long-term treatment possible development of withdrawal syndrome.

With prolonged use of clonazepam in children, one should bear in mind the possibility of side effects on the physical and mental development that may not show up for many years.

Avoid drinking alcohol during treatment.

Influence on the ability to drive vehicles and control mechanisms

During the period of treatment, a slowdown in the speed of psychomotor reactions is observed. This must be taken into account by persons involved in potentially dangerous species activities requiring increased attention and the speed of psychomotor reactions.

Clonazepam tablets belong to pharmacological group derivatives of benzodiazepine. The group is serious, not meant for self-choice... All medicines included in it are dispensed only by prescription and require strict prescriptions. have a depressing effect on nervous system.

For ordinary people, we recall that a depressing effect on the central nervous system is not at all synonymous with a calming effect. Therefore, if you are nervous after talking with your superiors or you simply cannot sleep, taking clonazepam is not an option at all. Beware if someone with good intentions offers you a "good" pill.

To confirm our warnings, consider how the instructions for use characterize clonazepam.

The pharmaceutical industry produces clonazepam tablets in two dosages - 0.5 and 2 mg each. This form is very convenient because Recommendations for the use of the drug suggest a gradual increase in dosage and gradual withdrawal, if necessary.

0.5 mg tablets have a bright orange color, 2 gram tablets are colored in White color.

1. potato starch or rice starch;
2. sodium carboxymethyl starch;
3. gelatin;
4. dye E 110 - only in a small dosage;
5. talc;
6. magnesium stearate;
7. lactose monohydrate.

Both small and big pill are round, provided with a notch to help separate the tablet if necessary.

How does the drug work?

The instruction describes clonazepam as a drug that regulates emotional activity by inhibiting many structures of the central nervous system. The tablets reduce muscle tone, have a mild hypnotic and sedative effect. Regular use of clonazepam prevents generalized or focal seizures associated with epilepsy.

• Epilepsy in children.
• Epilepsy in adults.

Prohibitions and direct contraindications

The medicine is not used to treat pregnant and lactating women, it is also not prescribed for severe renal and liver failure... Clonazepam should not be taken by people with respiratory failure, with attacks of apnea at night. Porphyria, myasthenia gravis, alcohol poisoning- also categorical prohibitions for the appointment of this medication.

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Where to buy the medicine

The concept of a deficiency is not associated with this drug - you can buy clonazepam at any state pharmacy, but strictly according to the prescription and in the exact amount and dosage indicated by the doctor. Even if the drug is prescribed for long time, to buy it every time you need a new recipe.

Despite the fact that the drug is manufactured in Poland, and not in Russia, the price for clonazepam is low. A pack of 30 tablets in a dosage of 0.5 mg costs 91-97 rubles, for 30 tablets of 2 mg you will pay from 134 to 151 rubles. For any budget, the drug is quite affordable.

Features of reception

The drug is prescribed with a gradual increase in dose. For adults, at the beginning of admission, the maximum daily dosage is 1.5 mg. The daily dose is taken not at once, but at regular intervals, three times a day. Depending on how the drug is tolerated, the dose is increased. Usually an increase is recommended every 3 days, adding to daily dosage 0.5 mg each.

The addition continues until the daily dose reaches the recommended dose of 4 or 8 mg. During a gradual increase in the dose of clonazepam, patient reviews are good, no side effects have been identified. But in situations of abrupt withdrawal of the drug, convulsive seizures, anxiety, and insomnia were noted.

Drug compatibility

If you are planning to prescribe clonazepam, you should tell your doctor about all medications you are using without exception.

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• Anesthetics.
• Opium pain relievers.
• Psychotropic drugs.
• Antidepressants.
• Antihistamines.
• Certain antihypertensive medications.

Clonazepam is prescribed with caution if the patient is constantly taking antiarrhythmic drugs, in particular cordarone, amiodarone. When used together, unwanted side effects can increase, for example, movement coordination is impaired.

Pills are categorically incompatible with alcohol. Joint intake of alcohol and clonazepam can cause paradoxical reactions - aggression, agitation, in some cases - loss of consciousness. In people who smoke, the effect of clonazepam may be reduced.

Unwanted side effects

Clonazepam is not a drug that has ever been discontinued due to pronounced adverse effects. However, like all other medicines, it has some undesirable effects that arise from improper use or overdose.

It can be chest pain, bradycardia, abnormalities in the composition of morphological blood cells. At the beginning of treatment, temporary neurological disorders are possible - drowsiness, ataxia, delayed reactions, visual impairment, headache... Adjusting the dose helps relieve these symptoms, but more often they go away on their own. Sometimes there are dyspeptic symptoms, abdominal discomfort, loss of appetite. Mental disorders are rare, and mainly when the drug is used together with alcoholic beverages... If the dose is exceeded, gastric lavage is necessary, which is best done in a hospital.

The person taking clonazepam must be under constant medical supervision.

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Which belongs to benzodiazepine derivatives. After taking the drug "Clonazepam" reviews are mostly positive. The medicine has a muscle relaxant and hypnotic effect, and also has a sedative effect.

Composition, release form of the drug "Clonazepam"

The drug can be purchased in tablets with different contents of the main component:

• 0.5 mg. In addition to clonazepam, the composition includes lactose monohydrate. Sodium carboxymethyl starch also belongs to the constituent components of the tablets. Clonazepam tablets contain gelatin. Talc and potato starch are also excipients. The color of the tablets is given by the dye E110.

• 2 mg. Among the auxiliary ingredients are polysorbate 80, lactose monohydrate. The composition of the drug contains sodium carboxymethyl starch and sodium lauryl sulfate. Talc and gelatin are also additional ingredients. Other substances belong to auxiliary components - magnesium stearate, rice, potato starch.

Pharmacological action of the drug "Clonazepam"

"Clonazepam" has a depressing effect on a large number of structures that make up the central nervous system, mainly those related to emotional activity. The action of the drug "Clonazepam" instructions for use, reviews are displayed as sedative, anti-anxiety and hypnotic (the latter is expressed moderately). The drug helps to reduce the tone of skeletal muscles, prevents the appearance of generalized convulsive seizures. Observed positive influence on the course epileptic seizures(focal, generalized).

Pharmacokinetics

The drug is almost completely absorbed from the gastrointestinal tract, excreted mainly by the kidneys (metabolites), a small part of it (2%) is excreted unchanged. The half-life process takes 20 to 40 hours. The bioavailability of the drug taken orally is 90%, the connection with blood proteins is 85%, highest concentration achieved on average after 2.5 hours. When treated with Clonazepam, its components pass into breast milk.

Indications for the use of the drug

Clonazepam tablets are suitable for treating patients of different ages with epilepsy, regardless of its manifestation:

• partial (local, focal) seizures of any severity;
• convulsive states (tonic, clonic);
• seizures of a simple secondary generalized nature;
• atypical absences (Lennox-Gastaut syndrome);
• myoclonic convulsions;
• typical absences;
• tonic-clonic seizures of primary and secondary severity.

"Clonazepam" is prescribed to reduce muscle tone, as well as during the treatment of psychomotor crises.

The use of the drug "Clonazepam"

The required dosage is determined taking into account many factors. At the initial stage of therapy, a small dose of "Clonazepam" (0.5 mg) is used, the dosage is gradually changed until the desired effect is obtained. In this case, it is prohibited to exceed the permissible dosage. As the reviews show, "Clonazepam" cannot be abruptly canceled, even when the treatment was short-lived. A sharp refusal from the drug threatens the development of an epileptic seizure.

Reception for epilepsy:

• Adults. Initial therapy is performed using no more than 1 mg of medication. The daily dose is divided into 3 or 4 doses, which should be taken at equal intervals. In the absence of an opportunity to use the drug in equal doses, most of the "Clonazepam" is drunk before going to bed. Usually, a sufficient daily dose is in the range of 4 to 8 mg of the drug. The maintenance dose should be no more than 20 mg (achieved over a period of 2-4 weeks of therapy). When the effective daily dose has been determined to maintain normal condition organism, it is allowed a single dose before bedtime.
• Children (weight not less than 30 kg). As the reviews show, "Clonazepam" is initially prescribed to children at 0.5 mg to determine the optimal dose.

Reception for a syndrome accompanied by paroxysmal fear:

• Adults. First, patients are prescribed 1-2 doses of the drug per day (0.5 mg at a time). For most patients, a therapeutic dose of 1 mg / day is sufficient. Do not consume more than 1 mg of Clonazepam per day. Reviews, however, show that in some cases, doctors may increase the dose to 4 mg. In such cases, the dosage is changed gradually (interval - 3 days, possibly adding 0.5 mg). When it is required to reduce the severity of drowsiness in daytime, the dose, calculated to be taken during the day, can be taken before bedtime.
• Children. For patients under 18 years of age, if the syndrome is detected, the drug may be ineffective and unsafe.

To avoid complications, the drug "Clonazepam" reviews of doctors are recommended to be taken strictly according to the recommendations of the specialist who conducts the treatment.

Contraindications to taking the drug "Clonazepam"

The tablets are not used for hypersensitivity to those substances of which they are composed. The drug is contraindicated in the following conditions:

• myasthenia gravis;
• disturbances of consciousness;
• carrying a child, breastfeeding;
• glaucoma (angle-closure);
• respiratory disorders of central origin, severe respiratory failure;
• severe renal and hepatic failure;
• manifestations of sleep apnea syndrome;
• poisoning with alcoholic beverages;
• acute porphyria.

Side effects of the drug "Clonazepam"

Consider side effects, which can cause "Clonazepam". The use of the drug may be accompanied by negative reactions of the body. The appearance of apathy, nausea, irritability is possible. With a negative reaction of the body, a person quickly gets tired, he has a violation of the coordination of movements. To reduce the intensity of manifestation, you must first apply a small dose, gradually increasing until it becomes optimal.

It is known that during the period of treatment with "Clonazepam" its use in violation of the recommendations can cause an overdose. In such cases, stunning is observed, which can lead to confusion, stupor, which can result in a coma. Other symptoms include - vascular collapse, breathing disorder, sleepy state... It is necessary to rinse the stomach (effectively immediately after taking the pills), to carry out appropriate therapy. It is important to regularly monitor changes in indicators such as blood pressure, pulse, respiration. In some cases, implementation is required artificial ventilation lungs. There is an antidote - "Flumazenil", but it is not suitable for administration to patients who have been treated with "Clonazepam" for a long time.

Do not combine "Clonazepam" and alcohol. Reviews allow us to make sure that such a combination can be life-threatening. The same applies to all drugs that act on the central nervous system, inhibiting its functioning.

Drug interaction of the drug "Clonazepam"

The effect of using the medication is enhanced by anticonvulsants. The same result is observed when it is used together with antidepressants, neuroleptics, barbiturates, as well as when combined with alcohol and substances that reduce skeletal muscle tone. The effectiveness of treatment decreases when nicotine enters the body.

Cost, reviews of the drug "Clonazepam"

You can buy Clonazepam tablets in Moscow for 97-150 rubles. (30 pcs.). The drug is effective for epilepsy if the doctor's recommendations are followed. With atonic seizures, therapy for two months may be sufficient, during which time you can switch to supportive treatment. Side effects are sometimes observed, but mostly only at the initial stage of treatment, weakness is often present.

Judging by what information the reviews contain, "Clonazepam" allows you to get rid of increased tone muscles in about three weeks. Doctors can prescribe medicine for anxiety, fear, VSD, which is accompanied by panic attacks... The drug is effective, acts quickly.

Trade name of the drug:

International non-proprietary name:

Dosage form:

Composition:

Composition 1 ml:
active substance: clonazepam 0.5 mg
Excipients: potato starch, gelatin, orange yellow dye E-110, talc, magnesium stearate, sodium starch glycolate, lactose.
active substance: clonazepam 2 mg
Excipients: potato starch, gelatin, sodium lauryl sulfate, talc, magnesium stearate, sodium starch glycolate, tween, rice starch, lactose

Description:

0.5 mg tablets :
Round biplanar tablets with solid edges, without cracks, light orange in color with a cross-shaped line dividing the tablet into 4 parts.
2 mg tablets :
Tablets from white to light cream color, practically odorless, round, bilaterally flat, with solid edges, without cracks, with a cross-shaped line dividing the tablet into 4 parts.

Pharmacotherapeutic group:

anticonvulsant benzodiazepines.

ATX code:

Indications for use

• epilepsy in children and adults (mainly akinetic, myoclonic, generalized submaximal seizures, temporal and focal seizures).
• paroxysmal fear syndromes, fear states with phobias, for example. agoraphobia (do not use in patients under 18 years of age).
• states of psychomotor agitation against the background of reactive psychoses.

Contraindications

• hypersensitivity to benzodiazepines;
• respiratory impairment of central origin and serious conditions respiratory failure, regardless of the cause;
• angle-closure glaucoma;
• myasthenia gravis;
• violation of consciousness;
• significant impairment of liver function.

Application during pregnancy and lactation

The use of the drug during pregnancy is allowed only in a situation where its use in the mother has absolute readings, and the use of a safer alternative drug impossible or contraindicated.
During treatment with clonazepam, you must refrain from breastfeeding.

Method of administration and dosage

The dose and duration of therapy is strictly according to the doctor's prescription.
Treatment should be started with low doses, increasing gradually until an appropriate therapeutic effect is obtained.
For epilepsy
Adults: The starting dose is 1.5 mg / day, divided into three doses. The dose should be gradually increased by 0.5-1 mg every 3 days. The maintenance dose is set individually for each patient, depending on the therapeutic effect (usually 4-8 mg / day in 3-4 doses). The maximum daily dose is 20 mg.
Children: initial dose - 1 mg / day (2 times 0.5 mg). The dose can be gradually increased by 0.5 mg every 3 days until a satisfactory therapeutic effect is obtained. The maintenance daily dose is:
in infants under 1 year old - 0.5-1mg
in children from 1 to 5 years old - 1-3 mg
in children from 5-12 years old -3-6 mg
The maximum daily dose for children is 0.2 mg / kg of body weight / day.
With paroxysmal fear syndrome
Adults: The average dose used is 1 mg / day. The maximum daily dose is 4 mg / day.
Children: the safety and efficacy of clonazepam in children under 18 years of age with paroxysmal fear syndrome has not been established.
Elderly patients (over 65 years old): care must be taken when using clonazepam. A dose reduction is recommended, especially in patients with imbalance and reduced motor abilities.
Patients with impaired renal and hepatic function: care must be taken when using clonazepam. It may be necessary to reduce the dose of the drug.
Patients with chronic diseases respiratory tract : clonazepam may cause increased salivary secretion. For this reason, and also because of the depressing effect on respiratory function, care must be taken when using the drug.
You can not abruptly cancel the drug, you always need a gradual, controlled by a doctor, dose reduction. Abrupt withdrawal of the drug can cause disturbances in sleep, mood, and even mental disorders... Especially dangerous abrupt termination long-term therapy or therapy requiring large doses of the drug. Withdrawal symptoms are then more pronounced. Long-term use leads to a gradual weakening of the drug's effect as a result of the development of tolerance. During long-term therapy with clonazepam, periodic studies are recommended: blood and liver function tests.
During treatment with clonazepam and 3 days after its completion, no alcohol should be consumed.

Interaction with other medicinal products
The depressing effect of clonazepam on the central nervous system is enhanced by all drugs with a similar effect: hypnotics (eg barbiturates), drugs that lower blood pressure of the central action, antipsychotics, antidepressants, anticonvulsants, narcotic analgesics. A similar effect has ethanol... Alcohol consumption during treatment with clonazepam, in addition to the cumulative depressing effect on the central nervous system, can provoke paradoxical reactions: psychomotor agitation, aggressive behavior or a state of pathological intoxication. Pathological intoxication does not depend on the type and amount of alcohol consumed.
The drug potentiates the effect of drugs that reduce skeletal muscle tone.
Smoking tobacco can weaken the effects of clonazepam.

Side effect

• Frequent undesirable actions of clonazepam during treatment can be: drowsiness, dizziness, impaired coordination of movements, feeling tired, fatigue.
• May also appear: memory impairment, increased nervous excitability, depression, symptoms of catarrhal inflammation of the upper respiratory tract, increased salivary secretion
• Rarely may occur: speech disorders, weakening of the ability to assimilate knowledge, emotional lability, decreased libido, disorientation, constipation, abdominal pain, loss of appetite, skin allergic reactions, muscle pain, violations menstrual cycle among women, frequent urination, visual impairment, a decrease in the number of erythrocytes, leukocytes and platelets in the blood, a transient increase in the blood concentration of transaminases (AlAT, AspAT), and alkaline phosphatase; paradoxical reactions: psychomotor agitation, insomnia. In the event of a paradoxical reaction, it is necessary to immediately interrupt the treatment.

The systematic use of the drug for many weeks can lead to the development of drug dependence and the appearance of withdrawal symptoms in the event of a sudden withdrawal of the drug.
During treatment with clonazepam and for 3 days after its end, you must not drive vehicles and service moving mechanical devices.

Overdose

Overdose with clonazepam may result in following symptoms: drowsiness, disorientation, slurred speech, and in severe cases loss of consciousness and coma. The use of clonazepam along with other drugs that have depressant properties on the central nervous system or alcohol can be life-threatening.
When acute poisoning it is necessary to induce vomiting, rinse the stomach. Treatment for clonazepam overdose is primarily symptomatic. It consists primarily of monitoring the main vital functions organism (respiration, pulse, blood pressure). A specific antidote is flumazenil (benzodiazepine receptor antagonist).

Release form

0.5 mg tablets:
30 tablets in a blister made of orange PVC / Al film. One blister, together with instructions for use, is placed in a cardboard box.
2 mg tablets:
30 tablets in a blister made of polyvinyl chloride film and aluminum foil. The blister, together with the instructions for use, is placed in a cardboard box.

Storage conditions

Store at temperatures up to 25 ° C. Protect from light and moisture.
Keep out of reach of children.

Shelf life

3 years.
Do not use the drug after the expiration date.

Vacation conditions

Prescribed by a doctor.

Manufacturer

Tarkhominsk pharmaceutical plant "POL FA" Joint-stock company
st. A. Fleming 2 03-176 Warsaw Poland

Consumer claims should be sent to the address of the Representative Office

Representative office in the Russian Federation:

121248, Moscow, Kutuzov Avenue, house 13, office 141.