Clorazepate
Tranquilizer, Sedative/Hypnotic · Benzodiazepine
Indications
Short-term treatment of anxiety that is severe or disabling occurring alone or with insomnia. Acute alcohol withdrawal. Night terrors and somnambulism in children.
Dosage
Adults: Elderly, 5 mg daily; over 16 yr, 5 mg-25 mg daily in single or divided doses. Max: 60 mg/day. Alcohol withdrawal: Adults: Max 90 mg daily. Day 1: Initially 30 mg, followed by 30-60 mg in divided doses. Day 2: 45-90 mg in divided doses. Day 3: 22.5-45 mg in divided doses. Day 4: 15-30 mg in divided doses. Beyond day 4: Gradually reduce the daily dose to 7.5-15 mg. Children: Not recommended.
Adverse Effects
Drowsiness and light headedness, which may continue into the following day. Muscle weakness, ataxia, confusion, vertigo, GI upset, hypotension, visual disturbance, rash, impaired alertness and dexterity, headache, urinary retention, changes in libido, Rarely blood disorder, jaundice, respiratory depression, abnormal psychological reactions. Paradoxical reactions, anterograde amnesia. Dependence. Injection: rarely, thrombophlebitis.
Risk Factor (Pregnancy/Lactation)
Pregnancy: Positive evidence of risk: Use only when no safer alternative exists for a serious problem. Lactation: Caution advised or effect undetermined. Contraindications: Acute pulmonary insufficiency, respiratory depression, sleep apnoea, phobic or obsessional state, chronic psychosis, unstable Myasthaenia gravis. Severe hepatic impairment. As monotherapy to treat depression or anxiety associated with depression. Precautions: Chronic pulmonary insufficiency, Myasthaenia gravis, renal impairment, mild to moderate hepatic impairment, history of drugs or alcohol abuse, personality disorders, Elderly, avoid long-term use. Withdraw gradually.
Interactions
Alcohol, CNS depressants, anticonvulsants, CYP3A4 inhibitors or inducers (e.g. cimetidine, rifampicin).
Advice to Patient
Take with or without meals. To reduce GI upset, take with meals. Contact prescriber if you experience abdominal cramps, vomiting, constipation, loss of appetite, change in personality, change in memory, change in urinary pattern, muscle cramps/weakness/tremors/rigidity, change in vision, ringing in ears, increased sweating, chest pain, palpitations, fast heartbeat, increased sleepiness, confusion, depression, headache, excitation, agitation, dizziness, lack of sleep, nightmares, fatigue or if there is worsening of condition. Do not take any new medication especially antihistamines, pain medications, sedatives or hypnotics without consulting prescriber. Avoid alcohol during therapy. Take sufficient amount of fluids (2-3 litres per day) to maintain hydration, unless restricted by the prescriber. Avoid direct sunlight, use sunscreen, wear proper clothing and eyewear to prevent…
Pharmacokinetics
Onset: 1-2 hrs. Duration: 8-24 hrs (variable). Absorption: Decarboxylated rapidly at the low pH in the stomach to form desmethyldiazepam, which is quickly absorbed. Metabolism: Hepatic. Bioavailability: 91%. Half-life elimination: Desmethyldiazepam: 30-100 hrs. Time to peak, plasma: 1-2 hrs. Excretion: Urine.
Brands with this active ingredient
Compiled by Healify Pharmacy from published drug references. How we compile it →
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