Description and indication for use
Clonazepam is a benzodiazepine and anti-convulsant. Benzodiazepines enhance the polysynaptic
inhibitory processes at all levels of the CNS, producing anxiolytic, sedative,
hypnotic, skeletal muscle relaxant and anti-convulsant effects.
Clonazepam is indicated for use as an
anti-convulsant but should not be used as first line treatment.
Dose
Oral and IV:
Prolonged seizures:
|
Term (if
ventilated):
|
0.25 mg (NOTE: Not
per kg)
|
|
Preterm (or
infants not on ventilator):
|
0.1 - 0.2 mg (NOTE: Not per kg )
|
Dose may be repeated.
Reconstitution/Dilution
Ampoule 1
mg in 1 mL; Diluent. 1 mL of Water for
Injection.
Diluted with diluent provided = 1 mg in 2 mL
(0.5 mg/mL).
Withdraw required dose.
Note: This injection contains 30 mg/2 mL of Benzyl Alcohol, plus Ethanol
and Propylene Glycol.
Route and method of administration
IV:
Give slowly over 5 minutes.
Side effects
CNS depression, drowsiness, significant
risk of hypoventilation/apnoea.
Hypotension.
Tachycardia.
GI tract disturbances.
Increased salivation.
Hypersecretion in upper respiratory
passages, congestion, rhinorrhea.
Thrombocytopenia.
Transient elevation of serum transaminases
and alkaline phosphatase.
Special precautions
CAUTION in patients with impaired renal and hepatic function.
There are no absolute contraindications to
the use of Clonazepam in neonates.
Rapid IV injection may cause respiratory
depression - consider reducing dose for unventilated patients.
Compatibilities
Glucose 5%.
Glucose 10%.
Sodium Chloride 0.9%.
Incompatibilities
No information available.
Drug interactions
| Amiodarone | Clonzaepam toxicity may occur after long periods of concomitant use. |
| Phenytoin | Serum levels of both drugs may be altered. Monitor levels. |
| Phenobarbitone | Serum levels of Clonazepam may be reduced. This may reduce efficacy of Clonazepam. |
Nursing responsibilities
Monitor with cardiorespiratory monitor.
Ventilation equipment should be available.
Monitor blood pressure and urinary output.
Levels if ordered, are done halfway between
doses.
Therapeutic range 60-150 nanomols/L.