clonazepam (Rx)

Brand and Other Names: Klonopin

Classes: Antianxiety Agents; Anxiolytics, Benzodiazepines; Anticonvulsants, Benzodiazepine

Category:
Description

Description

Panic Disorder

0.25 mg PO q12hr initially; may increase to 1 mg/day after 3 days (up to 4 mg/day in some patients)

Seizure Disorders

1.5 mg/day PO divided q8hr; increase by 0.5-1 mg q3Days until desired effect achieved; not to exceed 20 mg/day

Maintenance: 2-8 mg PO; not to exceed 20 mg/day  

Essential Tremor (Off-label)

0.5 mg PO at bedtime; increase dose by 0.5 mg q3-4days; not to exceed 6 mg/day

REM Sleep Behavior Disorder (Off-label)

0.25-2 mg PO 30 min prior to bedtime; not to exceed 4 mg

Burning Mouth Syndrome (Off-label)

0.25 mg PO at bedtime for 1 week; increase dose by up to 0.25 mg qweek; not to exceed 3 mg daily in 3 divided doses

Alternatively, 1 mg topirally three times daily after each meal; suck on the tablet, retain salive in mouth near pain sites without swallowing for 3 min, then expectorate saliva

Tardive Dyskinesia (Off-label)

The American Academy of Neurology guidelines includes use of clonazepam for short-term treatment (~3 mo) to decrease tardive dyskinesia symptoms

Initial: 1 mg/day PO; adjust dose based on response and tolerability by 1 mg/day increments q3-4 days; not to exceed 4.5 mg/day

Dosage Modifications

Renal impairment: Supplemental dose in hemodialysis not necessary

Dosing Considerations

Discontinuation of treatment: Withdraw treatment gradually; decrease the dose q3Days by 0.125 mg PO q12hr until completely withdrawn

Hyperekplexia (Orphan)

Orphan indication sponsor

  • Hoffmann-La Roche, Inc; 340 Kingsland Street; Nutley, NJ 07110

Recurrent, Acute, Repetitive Seizures (Orphan)

Administration: Intranasal spray

Orphan indication sponsor

  • Jazz Pharmaceuticals, Inc; 3180 Porter Drive; Palo Alto, CA 94304

Tardive Dyskinesia (Off-label)

The American Academy of Neurology guidelines includes use of clonazepam for short-term treatment (~3 mo) to decrease tardive dyskinesia symptoms

Initial: 1 mg/day PO; adjust dose based on response and tolerability by 1 mg/day increments q3-4 days; not to exceed 4.5 mg/day

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