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Benzodiazepine

Clonazepam

Brand names: Rivotril

Adult dose

Dose: Epilepsy: 1mg nocte for 4 nights, increase over 2–4 weeks to maintenance 4–8mg/day. Status epilepticus: 1mg IV slow

Route: PO/IV

Frequency: OD or divided

Clinical pearls

Myoclonic seizures, atonic seizures, palliative seizure management
High dependence risk — keep duration as short as possible

Contraindications

Severe respiratory disease
Sleep apnoea
Acute pulmonary insufficiency
Severe hepatic impairment

Side effects

Sedation
Ataxia
Hypersalivation in children
Dependence
Withdrawal seizures

Interactions

CNS depressants
CYP3A4 inhibitors prolong effect

Reference: BNF; NICE NG217; https://bnf.nice.org.uk/drugs/clonazepam/. Verify against your local formulary and the latest BNF before prescribing.

Related

Curated clinical cross-links plus same-class fallbacks.

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