PMS-Clonazepam

Brand Names: PMS-Clonazepam

Common Name: clonazepam

What is this drug used for?

Clonazepam belongs to the class of medications called benzodiazepines. In general, benzodiazepines are used as a sedative or to decrease seizures or anxiety.

Clonazepam is used to treat seizure disorders. It helps by slowing the activity of the nerves in the brain (i.e., the central nervous system).

Your doctor may choose to use this medication for conditions other than the ones listed in these drug information articles. If you are unsure why you are taking this medication, contact your doctor.

Is there any reason not to take this drug?

Clonazepam should not be taken by anyone with:

• an allergy to clonazepam, any other benzodiazepine, or any ingredient of this medication
• severe breathing problems
• myasthenia gravis
• significant liver disease
• acute narrow or closed angle glaucoma

Clonazepam may be used by people with open angle glaucoma who are receiving appropriate treatment.

What about possible side effects?

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your health professional. They may be able to help you to deal with some of the effects.

The following side effects may go away as your body becomes used to the medicine; check with your doctor if they continue or become bothersome.

More common

• clumsiness or unsteadiness
• dizziness or lightheadedness
• drowsiness
• slurred speech

  Less common or rare

• abdominal or stomach cramps or pain
• blurred vision or other changes in vision
• changes in sexual desire or ability
• constipation
• diarrhea
• dryness of mouth or increased thirst
• false sense of well-being
• headache
• increased watering of mouth
• muscle spasm
• nausea or vomiting
• problems urinating
• trembling or shaking
• unusual tiredness or weakness

Check with your doctor as soon as possible if any of the following side effects occur:

Less common

• anxiety
• confusion
• depression
• fast, pounding, or irregular heartbeat
• lack of memory

  Rare

• abnormal thinking (disorientation, delusions, or loss of sense of reality)
• agitation
• behavioural changes, including:
  • aggressiveness
  • bizarre conduct
  • decreased inhibition
  • angry outbursts
• convulsions (seizures)
• hallucinations
• hypotension (low blood pressure)
• muscle weakness
• skin rash or itching
• sore throat, fever, and chills
• trouble sleeping
• ulcers or sores in mouth or throat
• uncontrolled movements of body, including the eyes
• unusual bleeding or bruising
• unusual excitement, nervousness, or irritability
• unusual tiredness or weakness (severe)
• yellow eyes or skin

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

What if I am taking other drugs?

The following medications may affect how clonazepam works or increase the risk of side effects:

• alcohol
• barbiturates (e.g., phenobarbital)
• narcotic-containing medications (e.g., codeine)
• phenothiazines (e.g., chlorpromazine)
• tricyclic antidepressants (e.g., amitriptyline)
• carbamazepine
• valproic acid

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. In many cases, interactions are intended or are managed by close monitoring. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications that you are taking. Also tell them about any supplements you take. Since caffeine, the nicotine from cigarettes, or street drugs can affect the action of many medications; you should let your prescriber know if you use them.

Other information:

Dependence and withdrawal: Physical dependence (a need to take regular doses to prevent physical symptoms) has been associated with benzodiazepines such as clonazepam. Severe withdrawal symptoms may occur if the dose is significantly reduced or suddenly discontinued. These symptoms include seizures, irritability, nervousness, sleep problems, agitation, tremors, diarrhea, abdominal cramps, vomiting, memory impairment, headache, muscle pain, extreme anxiety, tension, restlessness, and confusion. Reducing the dose gradually under medical supervision can help prevent or decrease these withdrawal symptoms.

Medical conditions: Clonazepam is not recommended for use by people with depression or psychosis. People who have an addiction to alcohol or other drugs should not take clonazepam except in rare situations under medical supervision.

Occupational hazards: Because clonazepam causes drowsiness and sedation, do not engage in activities requiring mental alertness, judgment, and physical coordination (such as driving or operating machinery) while taking it. This is particularly true when first taking the medication and until you have established that clonazepam does not affect you this way. Alcohol can increase the drowsiness effects and should be avoided.

Pregnancy: If clonazepam is used to prevent major seizures, its use should not be discontinued. If it is taken for minor seizures, the risks posed by seizures need to be weighed against the risks posed by the medication. Women who have epilepsy should notify their doctor promptly if they become pregnant.

Breast-feeding: Clonazepam may pass into breast milk and is not recommended for use by nursing mothers. Mothers who take clonazepam should not breast-feed their infants.

Children: If long-term use of clonazepam is being considered for a child, the benefits needs to be weighed against the risks.

Seniors: Seniors may be at increased risk for the sedative and impaired coordination effects of this medication. They need to use extra caution, for example, when getting up during the night.

Special Instructions:

The recommended adult starting dose of clonazepam ranges from 0.5 mg to 2 mg daily in divided doses, with or without food. It is important that the dose be individualized to your specific needs to avoid excessive sedation or motor impairment. Your doctor may increase this dose to as high as 20 mg per day in two to four divided doses. The dose is usually started low and increased if necessary by your doctor.

Children who are more than 10 years old or who weigh more than 30 kg have their doses based on weight (0.01 mg per kg of body weight per day - 0.03 mg per kg of body weight per day) and need to be monitored carefully.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones given here, do not change the way that you are taking the medication without consulting your doctor.

Clonazepam may be habit forming when taken for long periods of time. If you have been taking this medication regularly for a long period of time (i.e., more than one month), do not stop taking the medication without speaking with your doctor. To avoid withdrawal effects, a gradual reduction in dose is recommended when stopping this medication.

It is important that this medication be taken exactly as prescribed by the doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If your next dose is in less than 4 hours, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

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