Clobazam

Indications
Oral
Short-term management of anxiety, Adjunct in epilepsy
Adult: 20-30 mg as a single dose at night or as daily divided doses, increased to 60 mg/day in severe conditions.
Child: 3-12 yr: 125 mcg/kg bid increased every 5 days. Usual maintenance dose: 250 mcg/kg bid. Max: 500 mcg/kg bid.
Elderly: or debilitated patients: 10-20 mg daily.
Renal impairment: Dose adjustment may be needed.
Hepatic impairment: Dose adjustment may be needed.

Special Populations: Debilitated patients: 10-20 mg daily.
Contraindications
Hypersensitivity; history of drug dependence; myasthaenia gravis; pregnancy (1st trimester), lactation; serious liver damage; sleep apnoea syndrome; impaired respiratory function.
Warnings / Precautions
May impair ability to perform skilled tasks and hazardous activities; elderly; renal or hepatic impairment; alcoholics; obesity; withdrawal should be gradual.
Adverse Reactions
Constipation, anorexia, nausea; dizziness, fine tremors; worsening of respiratory symptoms in predisposed individuals; ataxia, drowsiness, headache, confusion; loss of libido, motor dysfunction; dependence; visual disturbances and weight gain.
Potentially Fatal: Respiratory depression.
Overdose Reactions
Drowsiness, mental confusion, lethargy, ataxia, hypotonia, hypotension, respiratory depression, coma and very rarely death. Treatment includes emptying stomach by inducing vomiting (if within 1 hr) or gastric lavage. Activated charcoal may be used to reduce absorption. Monitor respiratory and CV functions. Flumazenil may be given if necessary. Forced diuresis or haemodialysis unlikely to be effective.
Drug Interactions
Increased hepatic clearance of clobazam when administered with phenytoin, phenobarbital or carbamazepine. Cimetidine may increase levels of clobazam.
Potentially Fatal: Concurrent alcohol, hypnotics and sedative antidepressants can potentiate CNS side effects of clobazam.
See Below for More clobazam Drug Interactions
Mechanism of Actions
Clobazam binds to one or more specific GABA receptors at several sites within the CNS including the limbic system and reticular formation. Increased permeability of neuronal membrane to chloride ions results in GABA's inhibitory effect leading to hyperpolarisation and stabilisation.
Absorption: Well absorbed from the GI tract (oral); peak plasma concentrations after 1-4 hr.
Distribution: Rapidly crosses the blood-brain barrier. Protein-binding: 85%.
Metabolism: Hepatic by demethylation and hydroxylation.
Excretion: Urine (as unchanged drug and metabolites); 18-42 hr (elimination half-life).
Administration
May be taken with or without food.
Storage Conditions
Oral: Store at 15-30°C.
ATC Classification
N05BA09 - clobazam ; Belongs to the class of benzodiazepine derivatives anxiolytics. Used in the management of anxiety, agitation or tension.
Storage
Oral: Store at 15-30°C.
Available As
  • Clobazam 10 mg
  • Clobazam 20 mg
  • Clobazam 5 mg
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