Indications of Clonatril 2 Tablet

It is suitable for the treatment of panic disorder with or without agoraphobia. Panic disorder is characterized by the appearance of an unexpected panic attack and concerns related to a recurrence, fear of impact, or the consequences of the attack.

It can also be used alone or as an adjunctive treatment for Lennox-Gastaut syndrome (minor variant), dyskinesias, and myoclonic seizures. It may be suitable for patients with absence seizures (mild illnesses) that do not respond to succinimide.

The efficacy of clonazepam for long-term use, that is, more than 9 weeks, has not been systematically studied in controlled clinical trials. Clinicians who choose to use clonazepam for a prolonged period should periodically re-evaluate the long-term effectiveness of the drug for individual patients.

Pharmacology of Clonatril 2 Tablet

Clonazepam has common pharmacological properties of benzodiazepines, including anticonvulsant, sedative, muscle relaxation, and anxiolytic effects. The central effects of benzodiazepines are mediated by increased GABAergic neurotransmission at inhibitory synapses. In the presence of benzodiazepines, the affinity of GABA receptors for neurotransmitters increases through positive allosteric regulation, increasing the effect of released GABA on postsynaptic transmembrane chloride flux.

There are also data in animals showing the effect of clonazepam on serotonin. Animal data and human EEG studies have shown that clonazepam can rapidly inhibit many types of paroxysmal activities, including spikes and wave discharges in absence seizures (small seizures), slow spikes, systemic spikes, and spikes over time. or other locations and irregular peaks and waves. Systemic EEG abnormalities are suppressed more often than focal abnormalities. Based on these findings, clonazepam has a beneficial effect on generalized and focal epilepsy.

Dosage & Administration of Clonatril 2 Tablet

Oral:

• Adults: The initial dose for adults with seizure disorders should not exceed 1.5 mg/day divided into three doses. Dosage may be increased in increments of 0.5 to 1 mg every 3 days until seizures are adequately controlled or until side effects preclude any further increase. Maintenance dosage must be individualized for each patient depending upon response. Maximum recommended daily dose is 20 mg.
• The initial dose for adults with panic disorder is 0.25 mg given in two divided dose. An increase to the target dose for most patients of 1 mg/day may be made after 3 days.

Pediatric Patients: In order to minimize drowsiness, the initial dose for infants and children (up to 10 years of age or 30 kg of body weight) should be between 0.01 and 0.03 mg/kg/day but not to exceed 0.05 mg/kg/day given in two or three divided doses.

Injection:

• Infants and children: half of a vial (0.5 mg) by slow IV injection or by IV infusion.
• Adults: 1 vial (1 mg) by slow IV injection or by IV infusion. This dose can be repeated as required (1-4 mg are usually sufficient to reverse the status). In adults, the rate of injection must not exceed 0.25 – 0.5 mg per minute (0.5-1.0 ml of the prepared solution) and a total dose of 10 mg should not be exceeded.

Interaction of Clonatril 2 Tablet

Phenytoin, carbamazepine, and phenobarbital pharmacokinetics do not appear to be affected by clonazepam. Clonazepam’s impact on the metabolism of other medications has not been studied.

Contraindications

It should not be used in patients who have a history of benzodiazepine hypersensitivity, as well as those who have clinical or biochemical signs of substantial liver disease. It can be utilized in people with open angle glaucoma who are on the right medication, but it’s not recommended for acute narrow angle glaucoma.

Side Effects of Clonatril 2 Tablet

Clonazepam’s most common adverse effects are depression of the central nervous system (CNS). Drowsiness has been reported in roughly 50 percent of patients treated for seizures, with ataxia occurring in approximately 30 percent. These may improve with time in some situations; behavior issues have been reported in about 25% of patients. Aphonia, coma, tremor, vertigo, disorientation, sadness, amnesia, hallucinations, hysteria, increased libido, sleeplessness, psychosis, and palpitations are some of the symptoms that can arise.

Pregnancy & Lactation

Pregnancy: It cannot be ruled out from preclinical studies that clonazepam has the possibility of birth defects. From epidemiological evaluation, there is evidence that anticonvulsants can be used as teratogens. However, it is difficult to determine from published epidemiological reports which drug or drug combination is the cause of neonatal defects. There is also the possibility that other factors, such as genetic factors or epilepsy itself, are more important than drugs in causing birth defects. In these cases, the drug should be used for pregnant women only when the potential benefits outweigh the risks to the fetus. During pregnancy, clonazepam should be used only when there are compelling indications. The use of high doses in the last trimester of pregnancy or during delivery can cause irregular heartbeats in the fetus, hypothermia, hypotonia, mild respiratory depression and poor diet. It should be remembered that both pregnancy itself and sudden withdrawal from the drug can cause seizures. Benzodiazepines occasionally cause withdrawal symptoms in newborns.

Nursing Mothers: Although only a small amount of the active ingredient in clonazepam has been found to pass into breast milk, mothers receiving this drug should not breastfeed. If there are convincing indications for clonazepam, breastfeeding should be stopped.

Precautions & Warnings

Clonazepam may increase the incidence or hasten the beginning of generalized tonic-clonic seizures in patients who have multiple distinct forms of seizure disorders. This may necessitate the addition of or an increase in the dosage of anticonvulsants. The use of valproic acid and Clonazepam at the same time can cause absent status.

Therapeutic Class

Adjunct anti-epileptic drugs, Benzodiazepine hypnotics

Storage Conditions

Keep in a dry place away from light and heat. Keep out of the reach of children.

Pharmaceutical Name of Clonatril 2 Tablet

Healthcare Pharmaceuticals Ltd

Generic of Clonatril 2 Tablet

Clonazepam