Description and Brand Names

Drug information provided by: Micromedex

US Brand Name

  1. Klonopin
  2. Klonopin Wafers

Descriptions


Clonazepam is used alone or together with other medicines to treat certain seizure (convulsive) disorders (e.g., Lennox-Gastaut syndrome, akinetic or myoclonic seizures). It is also used to treat panic disorder in some patients. Clonazepam is a benzodiazepine. Benzodiazepines belong to the group of medicines called central nervous system (CNS) depressants, which are medicines that slow down the nervous system.

This medicine is available only with your doctor's prescription.

This product is available in the following dosage forms:

  • Tablet, Disintegrating
  • Solution
  • Tablet

Before Using

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of clonazepam in children with seizure disorders. However, safety and efficacy in children with panic disorder have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of clonazepam in the elderly. However, elderly patients are more likely to have confusion and severe drowsiness, or age-related heart, liver, or kidney problems, which may require caution and an adjustment in the dose for patients receiving clonazepam.

Pregnancy

Information about this clonazepam-oral-route
Pregnancy Category Explanation
All Trimesters D Studies in pregnant women have demonstrated a risk to the fetus. However, the benefits of therapy in a life threatening situation or a serious disease, may outweigh the potential risk.

Breastfeeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Drug Interactions

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Alfentanil
  • Amobarbital
  • Anileridine
  • Aprobarbital
  • Butabarbital
  • Butalbital
  • Carbamazepine
  • Carbinoxamine
  • Carisoprodol
  • Ceritinib
  • Chloral Hydrate
  • Chlorzoxazone
  • Codeine
  • Dantrolene
  • Ethchlorvynol
  • Fentanyl
  • Fospropofol
  • Hydrocodone
  • Hydromorphone
  • Ketoconazole
  • Levorphanol
  • Meclizine
  • Meperidine
  • Mephenesin
  • Mephobarbital
  • Meprobamate
  • Metaxalone
  • Methocarbamol
  • Methohexital
  • Morphine
  • Morphine Sulfate Liposome
  • Orlistat
  • Oxycodone
  • Oxymorphone
  • Pentobarbital
  • Phenobarbital
  • Primidone
  • Propoxyphene
  • Remifentanil
  • Secobarbital
  • Siltuximab
  • Sodium Oxybate
  • Sufentanil
  • Tapentadol
  • Thiopental
  • Zolpidem

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Amiodarone
  • Desipramine
  • Ginkgo
  • Nevirapine
  • Perampanel
  • Ritonavir
  • St John's Wort
  • Theophylline

Other Interactions

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following is usually not recommended, but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.

  • Ethanol

Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Depression, history of or
  • Lung or breathing problems—Use with caution. May make these conditions worse.
  • Glaucoma, acute narrow angle or untreated open-angle or
  • Liver disease, severe—Should not be used in patients with these conditions.
  • Kidney disease or
  • Liver disease—Use with caution. The effects may be increased because of slower removal of the medicine from the body.

Proper Use

Take this medicine only as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered.

If you or your child are using the orally disintegrating tablet (wafer), make sure your hands are dry before you handle the tablet. Do not open the blister pack that contains the tablet until you are ready to take it. Remove the tablet from the blister pack by peeling back the foil. Do not push the tablet through the foil. Do not break or split the tablet. Place the tablet in your mouth. It should melt quickly. After the tablet has melted, you may take a sip of water.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage forms (tablets or disintegrating tablets):
    • For seizures:
      • Adults, teenagers, and children 10 years of age and older—At first, 0.5 milligram (mg) three times a day. Your doctor may adjust your dose if needed. However, the dose is usually not more than 20 mg per day.
      • Infants and children younger than 10 years of age and weighing 30 kilograms (kg)—Dose is based on body weight and must be determined by your doctor.
    • For panic disorder:
      • Adults—At first, 0.25 milligram (mg) two times a day. Your doctor may adjust your dose if needed. However, the dose is usually not more than 4 mg per day.
      • Children—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions

It is very important that your doctor check the progress of you or your child at regular visits to see if the medicine is working properly and to allow for changes in the dose. Blood tests may be needed to check for any unwanted effects.

Using this medicine while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant. If you think you have become pregnant while using the medicine, tell your doctor right away. Your doctor may want you to join a pregnancy registry for patients taking a seizure medicine.

This medicine may cause drowsiness, trouble with thinking, trouble with controlling movements, or trouble with seeing clearly. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are not alert or able to think or see well.

This medicine may cause some people to be agitated, irritable, or display other abnormal behaviors. It may also cause some people to have suicidal thoughts and tendencies or to become more depressed. If you, your child, or your caregiver notice any of these side effects, tell your doctor or your child's doctor right away.

If you or your child have been taking this medicine in large doses or for a long time, do not stop taking it without checking first with your doctor. Your doctor may want you to gradually reduce the amount you are using before stopping it completely. This may help prevent a worsening of your condition and reduce the possibility of withdrawal symptoms, such as convulsions (seizures), hallucinations, stomach or muscle cramps, tremors, or unusual behavior.

This medicine will add to the effects of alcohol and other central nervous system (CNS) depressants (medicines that make you drowsy or less alert). Some examples of CNS depressants are antihistamines or medicine for allergies or colds; sedatives, tranquilizers, or sleeping medicine; prescription pain medicine or narcotics; barbiturates (used for seizures); muscle relaxants; or anesthetics (numbing medicines), including some dental anesthetics. Check with your doctor before taking any of the above while you are using this medicine.

Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common

  1. Body aches or pain
  2. chills
  3. cough
  4. difficulty with breathing
  5. discouragement
  6. dizziness
  7. ear congestion
  8. feeling sad or empty
  9. fever
  10. headache
  11. irritability
  12. lack of appetite
  13. loss of interest or pleasure
  14. loss of voice
  15. nasal congestion
  16. poor coordination
  17. runny nose
  18. shakiness and unsteady walk
  19. sleepiness or unusual drowsiness
  20. sneezing
  21. sore throat
  22. tiredness
  23. trouble with concentrating
  24. trouble with sleeping
  25. unsteadiness, trembling, or other problems with muscle control or coordination
  26. unusual tiredness or weakness

Less common

  1. Being forgetful
  2. bladder pain
  3. bloody or cloudy urine
  4. changes in patterns and rhythms of speech
  5. diarrhea
  6. difficult, burning, or painful urination
  7. frequent urge to urinate
  8. general feeling of discomfort or illness
  9. joint pain
  10. loss of appetite
  11. lower back or side pain
  12. mood or mental changes
  13. muscle aches and pains
  14. nausea
  15. nervousness
  16. problems in urination or increase in the amount of urine
  17. shivering
  18. slurred speech
  19. sore throat
  20. sweating
  21. trouble with speaking
  22. vomiting

Rare

  1. Burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
  2. changes in skin color
  3. chest pain or discomfort
  4. cold sweats
  5. colds
  6. confusion
  7. cough or hoarseness
  8. difficulty with sleeping
  9. dizziness, faintness, or lightheadedness when getting up from a lying or sitting position
  10. excessive dreaming
  11. excessive muscle tone
  12. excitement
  13. falling
  14. fast, irregular, pounding, or racing heartbeat or pulse
  15. feeling mad
  16. feeling of unreality
  17. flu-like symptoms
  18. headache, severe and throbbing
  19. lack of feeling or emotion
  20. lack or loss of self-control
  21. muscle stiffness
  22. muscle tension or tightness
  23. nightmares
  24. pain, inflammation, or swelling in the calves, shoulders, or hands
  25. pain or swelling in the arms or legs without any injury
  26. pain, tenderness, or swelling of the foot or leg
  27. partial or slight paralysis
  28. scaling
  29. sense of detachment from self or body
  30. shakiness in the legs, arms, hands, or feet
  31. shortness of breath
  32. skin rash
  33. sleeplessness
  34. swelling around the eyes
  35. swelling of the face, ankle, foot, or knees
  36. thoughts of killing oneself changes in behavior
  37. tightness in the chest
  38. trembling or shaking of the hands or feet
  39. troubled breathing
  40. unable to sleep
  41. uncaring
  42. vision changes
  43. wheezing

Incidence not known

  1. Anxiety
  2. black, tarry stools
  3. bleeding gums
  4. blood in the urine or stools
  5. change in consciousness
  6. chest congestion
  7. difficulty with coordination
  8. double vision
  9. drowsiness
  10. dry mouth
  11. feeling that others are watching you or controlling your behavior
  12. feeling that others can hear your thoughts
  13. feeling, seeing, or hearing things that are not there
  14. hyperventilation
  15. irregular, fast, slow, or shallow breathing
  16. irregular, twisting uncontrolled movement of the face, hands, arms, or legs
  17. loss of consciousness
  18. loss of interest or pleasure
  19. loss of memory
  20. loss of strength or energy
  21. loss of voice
  22. muscle weakness
  23. pale or blue lips, fingernails, or skin
  24. pinpoint red spots on the skin
  25. problems with memory
  26. restlessness
  27. right upper abdominal pain and fullness
  28. severe mood or mental changes
  29. sores, ulcers, or white spots on the lips or in the mouth
  30. swollen glands
  31. troubled breathing with exertion
  32. uncontrolled eye movements
  33. unusual behavior
  34. unusual bleeding or bruising
  35. unusual weak feeling
  36. vivid dreams
  37. weight loss or gain

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Less common

  1. Decreased interest in sexual intercourse
  2. difficulty with swallowing
  3. dryness or soreness of the throat
  4. heavy bleeding
  5. hives
  6. inability to have or keep an erection
  7. longer than usual time to ejaculation of semen
  8. loss in sexual ability, desire, drive, or performance
  9. pain or tenderness around the eyes and cheekbones
  10. puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
  11. voice changes

Rare

  1. Acid or sour stomach
  2. ankle, knee, or great toe joint pain
  3. belching
  4. bleeding after defecation
  5. blistering, burning, crusting, dryness, or flaking of the skin
  6. bloated
  7. blurred or loss of vision
  8. decrease or change in vision
  9. difficulty with moving
  10. disturbed color perception
  11. double vision
  12. dryness of the eyes
  13. earache
  14. excess air or gas in stomach or intestines
  15. feeling of constant movement of self or surroundings
  16. feeling of warmth
  17. frequent bowel movements
  18. full feeling
  19. hair loss or thinning of the hair
  20. halos around lights
  21. heartburn
  22. increased watering of the mouth
  23. indigestion
  24. irregularities in menstruation
  25. itching in genital or other skin areas
  26. itching, scaling, severe redness, soreness, or swelling of the skin
  27. joint stiffness or swelling
  28. leg or muscle cramps
  29. loss of taste
  30. night blindness
  31. nosebleeds
  32. overbright appearance of lights
  33. pain in the breasts or pelvic area
  34. pain in the leg, nape, or back
  35. passing gas
  36. red, sore eyes
  37. redness of the face, neck, arms, and occasionally, upper chest
  38. redness or swelling in the ear
  39. sensation of spinning
  40. skin rash cracks in the skin at the corners of the mouth
  41. smaller amount of semen ejaculated than usual
  42. sore on the edge of the eyelid
  43. soreness or redness around the fingernails and toenails
  44. stomach discomfort, upset, or pain
  45. thickening of the tongue
  46. thirst
  47. tooth disorder
  48. toothache
  49. tunnel vision
  50. twitching of the eyes
  51. uncomfortable swelling around the anus
  52. worsening of acne

Incidence not known

  1. Burning feeling in the chest or stomach
  2. difficulty having a bowel movement (stool)
  3. increased appetite
  4. increased hair growth, especially on the face
  5. increased in sexual ability, desire, drive, or performance
  6. increased interest in sexual intercourse
  7. sore gums
  8. tenderness in the stomach area

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.