Description and Brand Names

Drug information provided by: Merative, Micromedex®

US Brand Name

  1. KlonoPIN
  2. KlonoPIN Wafers

Canadian Brand Name

  1. Accel-clonazePAM
  2. APO-clonazePAM
  3. Clonapam
  4. CO-clonazePAM
  5. DOM-clonazePAM
  6. Mylan-clonazePAM
  7. PRO-clonazePAM
  8. Riva-clonazePAM
  9. Rivotril
  10. Sandoz-clonazePAM
  11. Teva-clonazePAM
  12. Zym-clonazePAM

Descriptions


Clonazepam is used alone or together with other medicines to treat certain seizure disorders (eg, Lennox-Gastaut syndrome, akinetic, myoclonic, and absence seizures). It is also used to treat panic disorder. Clonazepam is a benzodiazepine that works in the brain to prevent seizures. Benzodiazepines are 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
  • 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.

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 not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Flumazenil

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.

  • Acepromazine
  • Alfentanil
  • Alprazolam
  • Amobarbital
  • Anileridine
  • Aripiprazole
  • Aripiprazole Lauroxil
  • Asenapine
  • Baclofen
  • Benperidol
  • Benzhydrocodone
  • Bromazepam
  • Bromopride
  • Buprenorphine
  • Buspirone
  • Butabarbital
  • Butalbital
  • Butorphanol
  • Calcifediol
  • Calcium Oxybate
  • Cannabidiol
  • Cannabis
  • Carbamazepine
  • Carbinoxamine
  • Carisoprodol
  • Carphenazine
  • Ceritinib
  • Cetirizine
  • Chloral Hydrate
  • Chlordiazepoxide
  • Chlorpromazine
  • Chlorzoxazone
  • Clobazam
  • Clorazepate
  • Clozapine
  • Codeine
  • Cyclobenzaprine
  • Dantrolene
  • Daridorexant
  • Darunavir
  • Dexmedetomidine
  • Diacetylmorphine
  • Diazepam
  • Dichloralphenazone
  • Difenoxin
  • Dihydrocodeine
  • Diphenhydramine
  • Diphenoxylate
  • Doxylamine
  • Droperidol
  • Enflurane
  • Esketamine
  • Estazolam
  • Eszopiclone
  • Ethchlorvynol
  • Ethopropazine
  • Ethylmorphine
  • Fentanyl
  • Flibanserin
  • Flunitrazepam
  • Fluphenazine
  • Flurazepam
  • Fluspirilene
  • Fospropofol
  • Gabapentin
  • Gabapentin Enacarbil
  • Halazepam
  • Haloperidol
  • Halothane
  • Hexobarbital
  • Hydrocodone
  • Hydromorphone
  • Hydroxyzine
  • Isoflurane
  • Ivacaftor
  • Ketamine
  • Ketazolam
  • Ketobemidone
  • Ketoconazole
  • Lacosamide
  • Lemborexant
  • Levocetirizine
  • Levorphanol
  • Lofexidine
  • Lorazepam
  • Loxapine
  • Magnesium Oxybate
  • Meclizine
  • Melperone
  • Meperidine
  • Mephenesin
  • Mephobarbital
  • Meprobamate
  • Meptazinol
  • Mesoridazine
  • Metaxalone
  • Methadone
  • Methdilazine
  • Methocarbamol
  • Methohexital
  • Methotrimeprazine
  • Methylene Blue
  • Metoclopramide
  • Midazolam
  • Mirtazapine
  • Molindone
  • Moricizine
  • Morphine
  • Morphine Sulfate Liposome
  • Nalbuphine
  • Nicomorphine
  • Nitrazepam
  • Nitrous Oxide
  • Olanzapine
  • Opium
  • Opium Alkaloids
  • Orlistat
  • Orphenadrine
  • Oxazepam
  • Oxycodone
  • Oxymorphone
  • Papaveretum
  • Paregoric
  • Pentazocine
  • Pentobarbital
  • Perampanel
  • Perazine
  • Periciazine
  • Perphenazine
  • Phenobarbital
  • Pimozide
  • Piperacetazine
  • Pipotiazine
  • Piritramide
  • Potassium Oxybate
  • Prazepam
  • Pregabalin
  • Primidone
  • Prochlorperazine
  • Promazine
  • Promethazine
  • Propofol
  • Quazepam
  • Quetiapine
  • Ramelteon
  • Remifentanil
  • Remimazolam
  • Remoxipride
  • Ropeginterferon Alfa-2b-njft
  • Scopolamine
  • Secobarbital
  • Sertindole
  • Sodium Oxybate
  • Sufentanil
  • Sulpiride
  • Suvorexant
  • Tapentadol
  • Temazepam
  • Tenofovir Alafenamide
  • Thiethylperazine
  • Thiopental
  • Thiopropazate
  • Thioridazine
  • Tilidine
  • Tizanidine
  • Tolonium Chloride
  • Topiramate
  • Tramadol
  • Trazodone
  • Triazolam
  • Trifluoperazine
  • Trifluperidol
  • Triflupromazine
  • Trimeprazine
  • Valproic Acid
  • Zaleplon
  • Zolpidem
  • Zopiclone
  • Zotepine
  • Zuranolone

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
  • Rifapentine
  • 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:

  • Alcohol or drug abuse or dependence, or history of or
  • Depression, history of or
  • Lung or breathing problems or
  • Porphyria—Use with caution. May make these conditions worse.
  • Glaucoma, narrow angle, acute or
  • Liver disease—Should not be used in patients with these conditions.
  • Kidney 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 too much of this medicine is taken for a long time, it may become habit-forming (causing mental or physical dependence).

This medicine should come with a Medication Guide. Read and follow these instructions carefully. Ask your doctor if you have any questions.

Swallow the tablet whole with water.

If you are using the 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 and children 10 years and older—At first, 0.5 milligram (mg) 3 times per day. Your doctor may adjust your dose as needed. However, the dose is usually not more than 20 mg per day.
      • Children up to 10 years or 30 kilograms (kg) of body weight—Dose is based on body weight and must be determined by your doctor. The dose is usually 0.01 to 0.03 mg per kg of body weight per day, given in 2 or 3 divided doses. However, the dose is usually not more than 0.05 mg per kg of body weight. Your doctor may adjust your dose as needed.
    • For panic disorder:
      • Adults—At first, 0.25 milligram (mg) 2 times per day. Your doctor may adjust your dose as 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 your progress 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 unwanted effects.

Tell your doctor if you are pregnant or planning to become pregnant. Using this medicine during the later pregnancy may cause problems in your newborn baby (eg, sedation or withdrawal symptoms). Tell your doctor right away if your baby has an abnormal sleep pattern, diarrhea, feeding problems, a high-pitched cry, irritability, low muscle tone, restlessness, shakiness or tremors, sluggishness, trouble breathing, weight loss, vomiting, or fails to gain weight. If you think you have become pregnant while using the medicine, tell your doctor right away.

This medicine may be habit-forming. If you feel that the medicine is not working as well, do not use more than your prescribed dose. Call your doctor for instructions.

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.

If you develop any unusual and strange thoughts or behavior while you are taking clonazepam, be sure to discuss it with your doctor. Some changes that have occurred in people taking this medicine are like those seen in people who drink alcohol and then act in a manner that is not normal. Other changes may be more unusual and extreme, such as confusion, worsening of depression, hallucinations (seeing, hearing, or feeling things that are not there), suicidal thoughts, and unusual excitement, nervousness, or irritability.

If you have been taking this medicine 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 worsening of your condition and reduce the possibility of withdrawal symptoms, including actions that are out of control, anxiety, blurred vision, decreased awareness or responsiveness, discouragement, dizziness, environment seems unreal, feeling of unreality, feeling sad or empty, irritability, lack of appetite, loss of interest or pleasure, mimicry of speech or movements, mutism, negativism, nervousness, peculiar postures or movements, mannerisms or grimacing, seeing, hearing, or feeling things that are not there, sense of detachment from self or body, seizures, severe sleepiness, talking, feeling, and acting with excitement, trouble concentrating and sleeping.

Symptoms of an overdose include: change in consciousness, changes in patterns and rhythms of speech, hallucinations, lack of coordination, loss of consciousness, loss of strength or energy, mood or mental changes, muscle pain or weakness, nightmares, sleepiness or unusual drowsiness, shakiness and unsteady walk, slurred speech, trouble in speaking, trouble sleeping, unsteadiness, trembling, or other problems with muscle control or coordination, unusual drowsiness, dullness, tiredness, weakness or feeling of sluggishness, unusual excitement, nervousness, restlessness, or irritability, or unusual weak feeling. Call your doctor right away if you notice these symptoms.

This medicine will add to the effects of alcohol and other central nervous system (CNS) depressants. CNS depressants are medicines that slow down the nervous system, which may cause drowsiness or make you less alert. Some examples of CNS depressants are antihistamines or medicine for hay fever, allergies or colds, sedatives, tranquilizers, or sleeping medicine, prescription pain medicine or narcotics, barbiturates or seizure medicines, muscle relaxants, or anesthetics (numbing medicines), including some dental anesthetics. Check with your doctor before taking any of these products while you are using this medicine.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

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 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. poor coordination
  16. runny or stuffy nose
  17. shakiness and unsteady walk
  18. sleepiness or unusual drowsiness
  19. sneezing
  20. sore throat
  21. tiredness
  22. trouble concentrating
  23. trouble sleeping
  24. unsteadiness, trembling, or other problems with muscle control or coordination
  25. unusual tiredness or weakness

Less common

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

Rare

  1. Burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
  2. changes in skin color
  3. chest pain, discomfort, or tightness
  4. cold sweats
  5. colds
  6. confusion
  7. cough or hoarseness
  8. difficulty with sleeping
  9. dizziness, faintness, or lightheadedness when getting up suddenly 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, tension, or tightness
  22. nightmares
  23. pain, inflammation, or swelling in the calves, shoulders, or hands
  24. pain or swelling in the arms or legs without any injury
  25. pain, tenderness, or swelling of the foot or leg
  26. partial or slight paralysis
  27. scaling
  28. sense of detachment from self or body
  29. shakiness in the legs, arms, hands, or feet
  30. skin rash
  31. swelling around the eyes
  32. swelling of the face, ankle, foot, or knees
  33. thoughts of killing oneself changes in behavior
  34. trembling or shaking of the hands or feet
  35. uncaring
  36. vision changes

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 interest or pleasure
  18. loss of memory
  19. loss of strength or energy
  20. loss of voice
  21. muscle weakness
  22. pale or blue lips, fingernails, or skin
  23. pinpoint red spots on the skin
  24. problems with memory
  25. restlessness
  26. severe mood or mental changes
  27. sores, ulcers, or white spots on the lips or in the mouth
  28. stomach pain or fullness
  29. swollen glands
  30. trouble breathing
  31. uncontrolled eye movements
  32. unusual behavior
  33. unusual bleeding or bruising
  34. unusual weakness
  35. vivid dreams
  36. weight loss or gain

Get emergency help immediately if any of the following symptoms of overdose occur:

Symptoms of overdose

  1. Agitation
  2. change in consciousness
  3. changes in patterns and rhythms of speech
  4. confusion
  5. loss of consciousness
  6. loss of strength or energy
  7. mood or mental changes
  8. nightmares
  9. shakiness and unsteady walk
  10. sleepiness or unusual drowsiness
  11. slurred speech
  12. talkativeness
  13. trouble speaking
  14. unsteadiness, trembling, or other problems with muscle control or coordination
  15. unusual drowsiness, dullness, tiredness, weakness, or feeling of sluggishness
  16. unusual excitement, nervousness, restlessness, or irritability
  17. unusual weak feeling

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. change in color perception
  9. cracks in the skin at the corners of the mouth
  10. decrease or change in vision
  11. difficulty moving
  12. double vision
  13. dryness of the eyes
  14. earache
  15. excess air or gas in stomach or intestines
  16. feeling of constant movement of self or surroundings
  17. feeling of warmth
  18. frequent bowel movements
  19. full feeling
  20. hair loss or thinning of the hair
  21. halos around lights
  22. heartburn
  23. increased watering of the mouth
  24. indigestion
  25. irregularities in menstruation
  26. itching in the genital or other skin areas
  27. itching, scaling, severe redness, soreness, or swelling of the skin
  28. joint stiffness or swelling
  29. leg or muscle cramps
  30. loss of taste
  31. night blindness
  32. nosebleeds
  33. overbright appearance of lights
  34. pain in the breasts or pelvic area
  35. pain in the leg, nape, or back
  36. passing gas
  37. red, sore eyes
  38. redness of the face, neck, arms, and occasionally, upper chest
  39. redness or swelling in the ear
  40. sensation of spinning
  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.