Prophylaxis of petit mal, petit mal variant (Lennox-Gastaut), akinetic, and myoclonic seizures

Use with caution in patients with chronic respiratory disease or impaired renal function; abrupt discontinuance may precipitate withdrawal symptoms, status epilepticus or seizures, in patients with a history of substance abuse; clonazepam-induced behavioral disturbances may be more frequent in mentally handicapped patients

Hypersensitivity to clonazepam, any component, or other benzodiazepines; severe liver disease, acute narrow-angle glaucoma

>10%: Cardiovascular: Tachycardia, chest pain Central nervous system: Drowsiness, fatigue, ataxia, lightheadedness, memory impairment, insomnia, anxiety, depression, headache Dermatologic: Rash Endocrine & metabolic: Decreased libido Gastrointestinal: Xerostomia, constipation, diarrhea, nausea, increased or decreased appetite, vomiting, decreased salivation Neuromuscular & skeletal: Dysarthria Ocular: Blurred vision Miscellaneous: Diaphoresis .

1% to 10%: Cardiovascular: Syncope, hypotension Central nervous system: Confusion, nervousness, dizziness, akathisia Dermatologic: Dermatitis Gastrointestinal: Weight gain or loss, increased salivation Neuromuscular & skeletal: Rigidity, tremor, muscle cramps Otic: Tinnitus Respiratory: Nasal congestion, hyperventilation
<1%: Menstrual irregularities, blood dyscrasias, reflex slowing, drug dependence

CYP3A3/4 enzyme substrate Decreased effect: Phenytoin, barbiturates may increase clonazepam clearance
Increased toxicity: CNS depressants may increase sedation

May produce somnolence, confusion, ataxia, diminished reflexes, or coma Treatment for benzodiazepine overdose is supportive. Rarely is mechanical ventilation required. Flumazenil has been shown to selectively block the binding of benzodiazepines to CNS receptors, resulting in a reversal of benzodiazepine-induced CNS depression, but not respiratory depression.

Take exactly as directed (do not increase dose or frequency); may cause physical and/or psychological dependence. While using this medication, do not use alcohol and other prescription or OTC medications (especially pain medications, sedatives, antihistamines, or hypnotics) without consulting prescriber.

Maintain adequate hydration (2-3 L/day of fluids unless instructed to restrict fluid intake). You may experience drowsiness, dizziness, or blurred vision (use caution when driving or engaging in tasks requiring alertness until response to drug is known); nausea, vomiting, loss of appetite, or dry mouth (small frequent meals, frequent mouth care, chewing gum, or sucking lozenges may help); constipation (increased exercise, fluids, or dietary fruit and fiber may help). If medication is used to control seizures, wear identification that you are taking an antiepileptic medication. Report excessive drowsiness, dizziness, fatigue, or impaired coordination; CNS changes (confusion, depression, increased sedation, excitation, headache, agitation, insomnia, or nightmares) or changes in cognition; difficulty breathing or shortness of breath; changes in urinary pattern, changes in sexual activity; muscle cramping, weakness, tremors, or rigidity; ringing in ears or visual disturbances, excessive perspiration, or excessive GI symptoms (cramping, constipation, vomiting, anorexia); worsening of seizure activity, or loss of seizure control. Pregnancy/breast-feeding precautions: Inform prescriber if you are or intend to be pregnant. Breast-feeding is not recommended.