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    Clonazepam, 2 mg tablets

    Drug formTablets

    ATC categoryNeurology. Psychiatry

    ATC subcategoryAntiepileptics

    Brand nameClonazepam

    Generic nameClonazepam

    What Clonazepam is and what it is used for

    The active ingredient of drug Clonazepam is clonazepam. Clonazepam belongs to a group of medicines called benzodiazepines.

    It is used to treat epilepsy in infants, older children and in adults.

    It lowers the number of fits (seizures) that you have.

    Any fits that you do have will be less serious.

     

    What you need to know before you take Clonazepam

    Do not take Clonazepam if you are allergic to:

    • clonazepam or any of the other ingredients of this medicine
    • other benzodiazepine medicines. These include diazepam, flurazepam and temazepam.

     

    Do not take this medicine if any of the above apply to you. If you are not sure, talk to your doctor or pharmacist before taking Clonazepam.

    Do not take this medicine if:

    • you have breathing problems or lung disease,
    • you have severe liver problems,
    • your muscles become weak and get tired easily (myasthenia gravis),
    • your breathing stops when you are asleep (sleep apnoea),
    • you have problems with alcohol or drug (prescription or recreational) use.

     

    Do not take this medicine if any of the above apply to you. If you are not sure, talk to your doctor or pharmacist before taking Clonazepam.

     

    Warnings and precautions

    A small number of people being treated with epilepsy medicines such as Clonazepam have had thoughts of harming or killing themselves. If at any time you have these thoughts, contact your doctor immediately.

    Check with your doctor or pharmacist before taking this medicine if:

    • you have any liver, kidney or lung problems,
    • you have ever had depression,
    • you have ever tried to harm or kill yourself,
    • a close friend or relative has recently died,
    • you regularly drink alcohol or take recreational drugs or you have had problems with alcohol or drug use in the past. This is because you should not drink alcohol or take recreational drugs while you are taking Clonazepam,
    • you are shaky and unsteady, have slurred speech or have rapid eye movements (spinal or cerebellar ataxia)
    • you have a rare, inherited blood problem called porphyria,
    • you are elderly or debilitated (weak); your doctor may adjust your dose.

    If any of the above apply to you (or you are not sure), talk to your doctor or pharmacist before taking Clonazepam.

     

    Other medicines and Clonazepam

    Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines. This includes medicines obtained without a prescription, including herbal medicines. This is because clonazepam can affect the way some other medicines work. Also some other medicines can affect the way clonazepam works.

    In particular tell your doctor or pharmacist if you are taking any of the following medicines:

    • other medicines to treat epilepsy, such as carbamazepine, hydantoins, phenobarbital, phenytoin, primidone or sodium valproate,
    • cimetidine – for stomach problems and heartburn,
    • rifampicin – an antibiotic used to treat infections,
    • medicines used to make you sleep (hypnotics),
    • medicines that help with anxiety (tranquillisers),
    • pain killers (analgesics) or medicines to relax your muscles (muscle relaxants).

     

    Operations

    If you are going to have an anaesthetic for an operation or for dental treatment, it is important to tell your doctor or dentist that you are taking Clonazepam.

     

    Clonazepam with alcohol

    Do not drink alcohol while you are taking Clonazepam. This is because it may cause side effects or cause your fits to return.

     

    Pregnancy and breast-feeding

    It is not recommended to take Clonazepam, if you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, except the cases, when your doctor prescribed you that.

    Clonazepam may affect your baby.

     

    Driving and using machines

    Talk to your doctor about driving or using machines or tools while you are taking Clonazepam. This is because the medicine can slow down your reactions, particularly when you start taking it. If you are in any doubt about whether you can do a particular activity, talk to your doctor.

    This medicine can affect your ability to drive.

    • Do not drive whilst taking this medicine until you know how this medicine affects you.
    • It may be an offence to drive if your ability to drive safely is affected.
    • You will not be hold accountable, if
    • Clonazepam was prescribed for treatment of stomatological and medical problems
    • you took clonazepam according to doctor’s prescription or the information given in drug leaflet
    • Clonazepam doesn’t affect the ability to drive safely
    • if you have any doubts about ability to drive safely during taking clonazepam, consult with your doctor.

     

    Dependence

    When taking this medicine there is a risk of dependence which increases with the dose and duration of treatment and also in patients with a history of alcohol and/or drug abuse.

     

    Important information about ingredients

    Clonazepam talbets contain lactose.

    If you were warned that you have intolerance to some sugars, consult with your doctor before taking clonazepam.

     

    How to take Clonazepam

    Always take this medicine exactly as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are not sure.

    • Your doctor will start you on a low dose of Clonazepam and gradually increase it over 2 to 4 weeks until the right dose has been found for you.
    • Your doctor will usually tell you to split your daily dose into three equal amounts which you will take at evenly spaced times throughout the day.
    • If your daily dose cannot be split equally, take the largest dose at bedtime.
    • Once your doctor has found the right dose for you, they may tell you to take Clonazepam as a single dose in the evening.

     

    Adults and children over 12 years

    • The usual starting dose is 1mg a day or less.
    • This will be increased gradually, usually to between 4mg and 8mg a day. The maximum dose is 20 mg a day.

     

    The elderly

    • The usual starting dose is 0.5mg a day or less.
    • This will be increased gradually, usually to between 4mg and 8mg a day. The maximum dose is 20mg a day.

     

    Children under 1 year

    • The usual starting dose is 0.25mg a day or less.
    • This will be increased gradually, usually to between 0.5mg and 1mg a day.

     

    Children aged 1-5 years

    • The usual starting dose is 0.25mg a day or less.
    • This will be increased gradually, usually to between 1mg and 3mg a day.

     

    Children aged 5-12 years

    • The usual starting dose is 0.5mg a day or less.
    • This will be increased gradually, usually to between 3mg and 6mg a day.

     

    If you take more Clonazepam than you should

    • Talk to a doctor or go to your nearest hospital straight away. Take the medicine pack with you.
    • If you take too much Clonazepam you may feel drowsy, sleepy, light-headed, have a lack of coordination or be less responsive than normal.

    If you forget to take Clonazepam

    • If you forget a dose, take it as soon as you remember. However, if it is nearly time for the next dose, skip the missed dose.
    • Do not take a double dose (two doses at the same time) to make up for a forgotten dose.

    If you stop taking Clonazepam

    If you receive long term treatment with Clonazepam (are given the medicine for a long time) you may become dependent upon this medicine and get withdrawal symptoms.

    • Do not stop taking Clonazepam without talking to your doctor. If you do your fits may return and you may get withdrawal symptoms.
    • If the dose of Clonazepam you take has to be lowered, or stopped, this must be done gradually. Your doctor will let you know how to do this.

    If someone else has taken Clonazepam by mistake they should consult a doctor or to the nearest hospital immediately.

    If you have any further questions on the use of this medicine, ask your doctor or pharmacist.

     

    Possible side effects

    Like all medicines, this medicine can cause side effects, although not everybody gets them. The side effects below may sometimes happen.

     

    Important side effects to look out for

    See a doctor straight away if you notice any of the following serious side effects – you may need urgent medical treatment:

    • allergic reactions – the signs may include skin rash, flaking skin, boils, sore lips and mouth, swelling of the face, fever, sudden wheezing, fluttering or tightness of the chest or collapse.

     

    Effects on the heart

    If you notice any of the following effects, see a doctor straight away.

     

    The signs may include:

    • breathlessness, swelling of the ankles, cough, tiredness and a racing heart
    • chest pain which may spread to your neck and shoulders and down your left arm.

     

    Effects on behaviour

    If you notice any of the following effects, talk to your doctor as they may want you to stop taking Clonazepam. The signs may include:

    • being aggressive, excited, irritable, nervous, agitated, hostile or anxious
    • problems sleeping, nightmares or vivid dreams
    • mental problems such as seeing or hearing things that are not really there (hallucinations), believing in things that are not real (delusions) or problems with your speech
    • types of fits (seizures) that you have not had before.

     

    Children and infants

    • Take special control on clonazepam usage in children and infants, as it can bring to impaired airway function, caugh and choking feeling. It may be caused by excessive salivation.
    • Early puberty is possible. After clonazepam withdrawal this process stops.

     

    Other possible side effects

    When you start taking Clonazepam you may notice the following effects:

    • feeling drowsy and tired
    • feeling dizzy and light-headed
    • weak or floppy muscles or jerky movements (poor coordination)
    • feeling unsteady when walking.

    If you notice any of these effects, talk to your doctor. Your doctor may be able to help you by giving you a lower dose of Clonazepam and then increasing it slowly.

     

    The following may occur at any time during your treatment:

    Mind and nervous system

    • poor concentration, confusion or a feeling of being lost (disorientation)
    • feeling restless
    • difficulty remembering new things
    • headache
    • depression
    • slowing or slurring of speech
    • poor coordination, including feeling unsteady when walking
    • an increase in how often you have fits.

     

    Liver, kidney and blood

    • changes in how well your liver is working (shown by blood tests)
    • loss of bladder control
    • blood problems – the signs may include feeling tired, bruising easily, being short of breath and nose bleeds.

    Your doctor may want to give you blood tests from time to time.

     

    Stomach and gut

    • feeling sick (nausea)
    • stomach upset.

     

    Eyes

    • double vision
    • jerky movements of the eyes (nystagmus).

     

    Breathing

    • breathing problems (respiratory depression). Early signs include suddenly noisy, difficult and uneven breathing. Your skin may become blue.

     

    Skin and hair

    • skin rashes, hives (lumpy rash) and itchy skin
    • changes to the colour of your skin
    • hair loss (the hair usually grows back).

     

    Sexual

    • loss of sex drive
    • difficulty getting or keeping an erection (erectile dysfunction).

     

    Withdrawal symptoms

    Using benzodiazepines like Clonazepam may make you dependent on the medicine. This means that if you stop treatment quickly, or reduce the dose too quickly, you may get withdrawal symptoms. The most common symptoms can include:

    • sleeping problems
    • muscle pain, shaking (tremor) or feeling restless
    • feeling very anxious, tense, confused, irritable or agitated, or changes in your mood
    • increased sweating
    • headache

     

    Less common withdrawal symptoms can include:

    • feeling sensitive to light, noise or physical contact
    • seeing or hearing things that are not really there (hallucinations)
    • tingling and feeling numb in your arms and legs
    • a feeling of losing contact with reality.

     

    Injury

    Patients taking benzodiazepine medicines are at risk of falling and breaking bones. This risk is increased in the elderly and those taking other sedatives (including alcohol).

     

    How to store Clonazepam
    • Store at temperature not higher than 25°C, in a dry place, out of the reach of children. Protect from light.
    • Shelf life – 3 years. Do not take after the expiry date on the packaging. The expiry date refers to the last day of the month.
    • Do not throw away the tablets you no longer use. Ask your pharmacist what to do with the drug you no longer use. Keep the drug with you if your doctor has told you to do so.
    • If the tablets show signs of ‘going off’ such as discolouration ask the pharmacist what to do with them.

     

    Contents of the pack and other information

    What Clonazepam Tablets contain

    One tablet contains:

    active substance – clonazepam 2 mg;

    other ingredients – microcrystalline cellulose, lactose monohydrate, maize (corn) starch, povidone, sodium starch glycolate, magnesium stearate, talc purified.

     

    What Clonazepam Tablets look like and contents of the pack

    White scored cylindrical tablets, the end surface of which are flat.

     

    1 blister packet with 24 tablets with leaflet in the cardboard box.

     

    Prescription status

    Prescription drug.