Clonazepam (Rivotril, Klonopin) - Drug informtion

Clonazepam (Rivotril, Klonopin) is a benzodiazepine drug that enhances the GABA activity in the brain.

It is used to treat the following conditions:

  • Treatment of panic disorder, with or without agoraphobia.

  • Seizure disorders:

    • Monotherapy or adjunctive therapy in the treatment of the Lennox-Gastaut syndrome (petit mal variant)

    • akinetic seizures

    • Myoclonic seizures

    • Absence seizures (petit mal) unresponsive to succinimides.

  • Off Label Use of Clonazepam in Adults:

    • Bipolar disorder, manic or mixed episodes

    • Burning mouth syndrome

    • Essential tremor

    • Rapid eye movement (REM) sleep behavior disorder

    • Restless legs syndrome

    • Tardive dyskinesia

    • Tic disorders

Clonazepam (Rivotril, Klonopin) Dose in Adults

Clonazepam (Rivotril, Klonopin) dose in the treatment of Panic disorder:

  • 0.25 mg orally twice daily; increase in increments of 0.125 to 0.25 mg two times a day every 3 days to a target dose of 1 mg orally once a day (maximum: 4 mg/day).

  • Discontinuation of treatment:

    • To discontinue, treatment should be withdrawn gradually.
    • Decrease dose by 0.125 mg twice daily every 3 days until the medication is completely withdrawn.

Dose in the treatment of Seizure disorders:

  • Initial daily dose not to exceed 1.5 mg orally given in 3 divided doses.
  • The dose may be increased by 0.5 to 1 mg every third day until seizures are controlled or adverse effects seen (maximum: 20 mg/day).
  • Usual maintenance dose: 2 to 8 mg daily in 1 to 2 divided doses; do not exceed 20 mg/day.

Dose in the treatment of mixed or manic episodes of Bipolar disorder (off-label):

  • 2 to 8 mg orally daily, in 2 to 4 divided doses; total daily doses as high as 16 mg have been studied.

Dose in the treatment of Burning mouth syndrome (off-label):

  • Initial: 0.25 orally at bedtime for 1 week and increase the dose by ≤0.25 mg every week to a maximum dose of 3 mg daily in 3 divided doses.

Note: Use should be limited.

  • Topical: May administer topically with 1 mg 3 times daily (after each meal).

Note: Patient should be instructed to suck on the tablet, retain saliva in the mouth near the pain sites without swallowing for 3 minutes, and then expectorate saliva.

Essential tremor (off-label use):

  • Initial: 0.5 mg at bedtime and increase the dose by 0.5 mg every 3 to 4 days to a maximum dose of 6 mg daily.

Dose in the treatment of REM sleep behavior disorder (off-label):

  • 0.25 to 2 mg 30 minutes before bed, to a maximum dose of  4 mg 30 minutes before bed.

Note: Use with caution in patients with dementia, gait disorders, or obstructive sleep apnea.

Dose in the treatment of Restless leg syndrome (off-label):

  • Initial: 1 mg 30 minutes before bed and increase the dose by 0.5 to 1 mg at weekly intervals (Max dose is 2mg/day)
  • Additional data may be necessary to further define the role of clonazepam in the treatment of this condition.

Rivotril dose in the treatment of Tardive dyskinesia (off-label):

  • Initial: 1 mg/day orally and adjust the dose based on response and tolerability by 1 mg/day every 3 to 4 days up to a maximum dose of 4.5 mg/day.

Tic disorders (off-label use):

  • Initial: 0.5 mg orally at bedtime and adjust the dose by 0.5 mg every 2 weeks based on response and tolerability.
  • Dosing range in clinical studies was 1 to 12 mg/day

Clonazepam (Rivotril, Klonopin) Dose in Children

Clonazepam (Rivotril) dose in the treatment of Neuroirritability agitation (palliative care):

  • Infants, Children, and Adolescents:

    • <30 kg:

      • Initial: 0.01 to 0.03 mg/kg/day in divided doses up to 3 to 4 times daily.
      • Increase the dose to the desired effect up to a maximum daily dose: 0.2 mg/kg/day in 3 divided doses.

    • ≥30 kg:

      • Initial: ≤0.25 mg/dose 3 times daily.
      • The dose may be increased by 0.5 to 1 mg/day every 3 days up to maintenance dose range: 0.05 to 0.2 mg/kg/day up to maximum daily dose: 20 mg/day.

Clonazepam (Rivotril, Klonopin) dose in the treatment of Seizure disorders:

  • Infants and Children <10 years or ≤30 kg:

    • Initial: 0.01 to 0.03 mg/kg/day orally in 2 to 3 divided doses.
    • The maximum initial daily dose: 0.05 mg/kg/day.
    • Increase the dose by ≤0.25 to 0.5 mg every third day until seizures are controlled or adverse effects observed
    • Maintenance dose: 0.1 to 0.2 mg/kg/day orally in 3 divided doses.
    • The maximum daily dose: 0.2 mg/kg/day

  • Children ≥10 years or >30 kg and Adolescents: 

    • Initial: 0.01 to 0.05 mg/kg/day orally in 2 or 3 divided doses.
    • The maximum initial dose: 0.5 mg/dose 3 times daily.
    • The dose may be increased by 25% or by 0.5 to 1 mg every 3 to 7 days until seizures are controlled or adverse effects observed.
    • Maintenance dose range: 0.05 to 0.2 mg/kg/day in 2 to 3 divided doses.
    • The maximum daily dose: 20 mg/day.

Clonazepam (Rivotril) dose in the treatment of Panic disorder:

  • Adolescents ≥18 years:
    • Initial: 0.25 mg orally twice daily.
    • Increase in increments of 0.125 to 0.25 mg twice daily every 3 days.
    • The target dose is 1 mg/day in divided doses.
    • Some patients may require higher doses up to a maximum daily dose: 4 mg/day.
    • To discontinue, treatment should be withdrawn gradually.
    • Decrease dose by 0.125 mg twice daily every 3 days until medication is completely withdrawn.

Clonazepam pregnancy risk factor: D

  • Clonazepam crosses over the placenta
  • Some BZDs may have caused teratogenic events.
  • Low birth weights and preterm births may increase in mothers who use BZD.
  • Hypoglycemia or respiratory problems can also occur.
  • The "floppy infant syndrome", which can occur days or weeks after birth, is a common cause.

Use of Clonazepam while breastfeeding

 

  • Breast milk contains Clonazepam.
  • When the RID of medication for breastfeeding is less than 10%, it is generally acceptable.
  • It is preferable to use shorter-acting agents if benzodiazepine use is necessary for breastfeeding women.

Dose in renal disease:

No data. Use with caution.

Dose in Liver disease:

Take care. Clonazepam is subject to hepatic metabolism. Patients with severe hepatic impairment should not take it.

Common Side Effects of Clonazepam (Rivotril, Klonopin) Include:

  • Central nervous system:

Less Common Side Effects of Clonazepam Include:

  • Central Nervous System:

    • Fatigue
    • Depression
    • Memory Impairment
    • Nervousness
    • Dysarthria
    • Reduced Intellectual Ability
    • Emotional Lability
    • Confusion
    • Delayed Ejaculation

  • Endocrine & Metabolic:

    • Decreased Libido

  • Gastrointestinal:

    • Constipation
    • Decreased Appetite
    • Abdominal Pain

  • Genitourinary:

    • Dysmenorrhea
    • Vaginitis
    • Impotence
    • Urinary Tract Infection
    • Urinary Frequency

  • Hypersensitivity:

    • Hypersensitivity

  • Neuromuscular & Skeletal:

    • Myalgia

  • Ophthalmic:

    • Blurred Vision

  • Respiratory:

    • Upper Respiratory Tract Infection
    • Sinusitis
    • Influenza
    • Cough
    • Rhinitis
    • Pharyngitis
    • Bronchitis

Rare side effects of Rivotril (clonazepam):

  • Cardiovascular:

    • Edema (Ankle Or Facial)
    • Palpitations

  • Central Nervous System:

    • Amnesia
    • Aphonia
    • Choreiform Movements
    • Coma
    • Glassy-Eyed Appearance
    • Hallucination
    • Headache
    • Hemiparesis
    • Hypotonia
    • Hysteria
    • Insomnia
    • Myasthenia
    • Psychosis
    • Slurred Speech
    • Vertigo

  • Dermatologic:

    • Alopecia
    • Skin Rash

  • Endocrine & Metabolic:

    • Dehydration
    • Hirsutism
    • Increased Libido
    • Weight Gain
    • Weight Loss

  • Gastrointestinal:

    • Anorexia
    • Coated Tongue
    • Diarrhea
    • Encopresis
    • Gastritis
    • Gingival Pain
    • Increased Appetite
    • Nausea
    • Xerostomia

  • Genitourinary:

    • Dysuria
    • Nocturia
    • Urinary Incontinence
    • Urinary Retention

  • Hematologic & Oncologic:

    • Anemia
    • Eosinophilia
    • Leukopenia
    • Lymphadenopathy
    • Thrombocytopenia

  • Hepatic:

    • Hepatomegaly
    • Increased Serum Alkaline Phosphatase (Transient)
    • Increased Serum Transaminases (Transient)

  • Neuromuscular & Skeletal:

    • Dysdiadochokinesia
    • Tremor

  • Ophthalmic:

    • Abnormal Eye Movements
    • Diplopia
    • Nystagmus

  • Respiratory:

    • Chest Congestion
    • Dyspnea
    • Respiratory Depression
    • Rhinorrhea
    • Upper Respiratory Complaint (Hypersecretion)

  • Miscellaneous:

    • Fever
    • Paradoxical Reactions
      • Aggressive Behavior
      • Agitation
      • Anxiety Excitability
      • Hostility
      • Irritability
      • Nervousness
      • Nightmares
      • Sleep Disturbance
      • Vivid Dreams
    • Physical Health Deterioration

Contraindication to Clonazepam (Rivotril, Klonopin) Include: 

  • Allergy reactions to clonazepam or other benzodiazepines or any component of this formulation
  • Significant liver disease
  • Glaucoma with acute narrow-angle vision
  • Grave respiratory insufficiency
  • Sleep apnea Syndrome
  • Myasthenia gravis

Warnings and precautions

  • Depression in the CNS:

    • It can impair mental or physical abilities.
    • Refrain from driving or operating machinery on the patient's behalf.
    • Multiple anticonvulsants may increase the risk.

  • Paradoxical reactions

    • Hyperactive or aggressive behavior can occur in patients who are adolescent/pediatric, elderly, or have a history of alcohol abuse disorder or psychiatric/personality disorder.

  • Activities that are sleep-related:

    • Dangerous sleep-related activities include driving, cooking, eating, and calling while you're asleep.

  • Suicidal thoughts:

    • Suicidal thoughts and behavior are more common in patients who received a placebo than in patients who were treated with a placebo.

  • Depression

    • Suicide risk increases

  • Use of drugs:

    • If used for a prolonged period, tolerance and psychological dependence can occur.

  • Glaucoma

    • Patients with open-angle or severe glaucoma may use this product.

  • Hepatic impairment

    • Patients with hepatic impairment should be cautious; accumulation is possible
    • Patients with severe hepatic impairment are advised to avoid this medication.

  • Porphyria

    • Patients with porphyria need to be cautious.

  • Renal impairment

    • Patients with impaired renal function should be cautious.
    • The kidneys eliminate clonazepam metabolites.

  • Respiratory disease

    • It can cause respiratory depression.

Clonazepam: Drug Interaction

Note: Drug Interaction Categories:

  • Risk Factor C: Monitor When Using Combination
  • Risk Factor D: Consider Treatment Modification
  • Risk Factor X: Avoid Concomitant Use

Risk Factor C (Monitor therapy).
Alcohol (Ethyl). CNS Depressants can increase the CNS depressant effects of Alcohol (Ethyl).
Alizapride CNS Depressants may increase the CNS depressant effects.
Aprepitant High risk of Inhibitors causing an increase in serum CYP3A4 Substrates concentrations
Bosentan Could lower serum concentrations of CYP3A4 substrates (High Risk with Inducers).
Brexanolone CNS Depressants can increase the CNS depressant effects of Brexanolone.
Brimonidine CNS Depressants may increase the CNS depressant effects.
Bromopride CNS Depressants may increase the CNS depressant effects.
Cannabidiol CNS Depressants may increase the CNS depressant effects.
Cannabis CNS Depressants may increase the CNS depressant effects.
Chlorphenesin Carbamate CNS Depressants may have an adverse/toxic effect that can be exacerbated by them.
Clofazimine High risk of Inhibitors causing an increase in serum CYP3A4 Substrates concentrations
CNS Depressants Can increase the toxic/adverse effects of CNS Depressants.
Cobicistat ClonazePAM serum concentration may be increased
Cosyntropin ClonazePAM may increase the hepatotoxic effects.
Moderate CYP3A4 Inducers Could lower serum concentrations of CYP3A4 substrates (High Risk with Inducers).
Moderate CYP3A4 inhibitors Might decrease metabolism of CYP3A4 substrates (High Risk with Inhibitors).
Deferasirox Could lower serum concentrations of CYP3A4 substrates (High Risk with Inducers).
Dimethindene (Topical). CNS Depressants may increase the CNS depressant effects.
Doxylamine CNS Depressants may have a greater CNS depressant effect if taken with other CNS Depressants. Management: Diclegis (doxylamine/pyridoxine), which is intended for pregnancy, has specifically stated that it should not be used with any other CNS depressants.
Dronabinol CNS Depressants may increase the CNS depressant effects.
Duvelisib High risk of Inhibitors causing an increase in serum CYP3A4 Substrates concentrations
Esketamine CNS Depressants may increase the CNS depressant effects.
Fosaprepitant High risk of Inhibitors causing an increase in serum CYP3A4 Substrates concentrations
Fosnetupitant High risk of Inhibitors causing an increase in serum CYP3A4 Substrates concentrations
Fosphenytoin ClonazePAM serum concentration may be decreased. Clonazepam can also affect the concentration of Phenytoin, an active metabolite fosphenytoin.
HydrOXYzine CNS Depressants may increase the CNS depressant effects.
Ivosidenib Could lower serum concentrations of CYP3A4 substrates (High Risk with Inducers).
Kava Kava CNS Depressants may have an adverse/toxic effect that can be exacerbated by them.
Larotrectinib High risk of Inhibitors causing an increase in serum CYP3A4 Substrates concentrations
Lofexidine CNS Depressants may have a greater depressant effect on the brain. Management: Separate drug interaction monographs are available for drugs listed as an exception to this monograph.
Magnesium Sulfate CNS Depressants may increase the CNS depressant effects.
Melatonin May increase the sedative effects of Benzodiazepines.
MetyroSINE MetyroSINE may have a sedative effect that can be enhanced by CNS depressants.
Minocycline CNS Depressants may increase the CNS depressant effects.
Mirtazapine CNS Depressants can increase the CNS depressant effects of Mirtazapine.
Nabilone CNS Depressants may increase the CNS depressant effects.
Netupitant High risk of Inhibitors causing an increase in serum CYP3A4 Substrates concentrations
Palbociclib High risk of Inhibitors causing an increase in serum CYP3A4 Substrates concentrations
Phenytoin ClonazePAM serum concentration may be decreased. Clonazepam can also alter Phenytoin concentrations.
Piribedil CNS Depressants could increase the CNS depressant effects of Piribedil.
Pramipexole Pramipexole may have a greater sedative effect if it is combined with CNS depressants.
ROPINIRole CNS Depressants can increase the sedative effects of ROPINIRole.
Rotigotine CNS Depressants can increase the sedative effects of Rotigotine.
Rufinamide CNS Depressants may have an adverse/toxic effect that can be exacerbated by this. Particularly, dizziness and sleepiness may be increased.
Sarilumab Could lower serum concentrations of CYP3A4 substrates (High Risk with Inducers).
Selective Serotonin Reuptake inhibitors CNS Depressants can increase the toxic/adverse effects of Selective Serotonin Resuptake Inhibitors. Particularly, psychomotor impairment could be increased.
Siltuximab Could lower serum concentrations of CYP3A4 substrates (High Risk with Inducers).
Simeprevir High risk of Inhibitors causing an increase in serum CYP3A4 Substrates concentrations
Teduglutide May increase serum concentrations of Benzodiazepines.
Tetrahydrocannabinol CNS Depressants may increase the CNS depressant effects.
Tetrahydrocannabinol, and Cannabidiol CNS Depressants may increase the CNS depressant effects.
Tocilizumab Could lower serum concentrations of CYP3A4 substrates (High Risk with Inducers).
Trimeprazine CNS Depressants may increase the CNS depressant effects.
Vigabatrin ClonazePAM may increase the CNS depressant effects. ClonazePAM serum concentration may be increased by Vigabatrin
Yohimbine Antianxiety agents may have a less therapeutic effect.

Risk Factor D (Consider therapy modifications)

  
Blonanserin CNS Depressants can increase the CNS depressant effects of Blonanserin.
Buprenorphine CNS Depressants can increase the CNS depressant effects of buprenorphine. Management: Reduced doses of CNS depressants should be considered and avoidance of such drugs for patients at high risk of buprenorphine self-injection/overuse. Buprenorphine patches (Butrans) should be initiated at 5 mg/hr for adults who are taking other CNS depressants.
Chlormethiazole CNS Depressants may increase the CNS depressant effects. Monitoring: Look out for signs of CNS depression. If a combination of chlormethiazole and other drugs is required, a reduced dose should be used.
CloZAPine CloZAPine's toxic/adverse effects may be exacerbated by benzodiazepines. Management: Before starting clozapine, reduce or discontinue your benzodiazepines.
Strong CYP3A4 Inducers May increase metabolism of CYP3A4 substrates (High Risk with Inducers). Management: You may consider a different drug to replace one of the interacting drugs. Some combinations might be contraindicated. Refer to the manufacturer's label.
Strong CYP3A4 inhibitors Might decrease metabolism of CYP3A4 substrates (High Risk with Inhibitors).
Dabrafenib High risk of Inducers causing a decrease in serum CYP3A4 substrates. Management: If possible, seek alternatives to the CYP3A4 substrate. Concomitant therapy should be avoided if possible. Monitor the clinical effects of the substrate carefully (especially therapeutic effects).
Droperidol CNS Depressants may increase the CNS depressant effects. Management: Droperidol and other CNS agents, such as opioids, may be reduced or used in combination with droperidol. Separate drug interaction monographs provide more detail on exceptions to this monograph.
Enzalutamide High risk of Inducers causing a decrease in serum concentrations of CYP3A4 substrates. Management: Avoid concurrent use of enzalutamide and CYP3A4 substrates with a narrow therapeutic index. You should exercise caution when using enzalutamide or any other CYP3A4 sub-substance.
Flunitrazepam CNS Depressants can increase the CNS depressant effects of Flunitrazepam.
HYDROcodone CNS Depressants can increase the CNS depressant effects of HYDROcodone. When possible, avoid concomitant use with hydrocodone and other CNS depressants. Combining these agents is not recommended unless there are other options. Limit the amount and duration of each drug when combined.
Lorlatinib High risk of Inducers causing a decrease in serum concentrations of CYP3A4 substrates. Management: Do not use lorlatinib concurrently with any CYP3A4 Substrates. Even a slight decrease in serum concentrations could cause therapeutic failure or serious clinical consequences.
Methadone Methadone's CNS depressant effects may be exacerbated by benzodiazepines. Methadone and benzodiazepines should not be used in combination by doctors. Any such combination should be done with extreme caution.
Methotrimeprazine Methotrimeprazine may have a higher CNS depressant activity than CNS Depressants. Methotrimeprazine can increase the CNS depressant effects of CNS Depressants. Management: Lower the adult dose of CNS Depressants by 50% and start concomitant methotrimeprazine treatment. After clinically proven efficacy of methotrimeprazine, further CNS depressant dose adjustments should only be made.
MiFEPRIStone High risk of Inhibitors causing an increase in serum concentrations of CYP3A4 substrates. Management: Reduce CYP3A4 Substrates and monitor for elevated concentrations/toxicity during and after treatment with mifepristone. Avoid dihydroergotamine and ergotamine.
Mitotane High risk of Inducers causing a decrease in serum concentrations of CYP3A4 substrates. Treatment: Patients receiving mitotane may require significant adjustments in the dosage of CYP3A4 Substrates.
Opioid Agonists CNS Depressants can increase the CNS depressant effects of Opioid Aggonists. Management: When possible, avoid concomitant use opioid agonists and other CNS depressants. Combining these agents is not recommended unless there are other options. Limit the amount and duration of each drug when combined.
OxyCODONE CNS Depressants can increase OxyCODONE's CNS depressant effects. When possible, avoid the simultaneous use of oxycodone and other CNS depressants. Combining these agents is not recommended unless there are other options. Limit the amount and duration of each drug when combined.
Perampanel CNS Depressants may have a greater CNS depressant effect. Perampanel and any other CNS depressant drug should be used in combination. Patients who take perampanel together with other drugs that have CNS depressant activity should not engage in complex or high-risk activities until they are familiar with the combination.
Pitolisant High risk of Inducers causing a decrease in serum concentrations of CYP3A4 substrates Management: Avoid combining pitolisant and a CYP3A4 substrat with a low therapeutic index. Pitolisant should not be combined with other CYP3A4 sub-substances.
St John's Wort High risk of Inducers causing a decrease in serum CYP3A4 Substrates. Management: You may consider a different drug to replace one of the interacting drugs. Some combinations might be contraindicated. Refer to the manufacturer's label.
Stiripentol High risk of Inhibitors causing an increase in serum concentrations of CYP3A4 substrates. Management: Avoid stiripentol use with CYP3A4 Substrates that have a narrow therapeutic Index. This is to avoid adverse effects and toxicities. Monitoring of any CYP3A4 substrate that is used with stiripentol should be closely done.
Suvorexant CNS Depressants can increase the CNS depressant effects of Suvorexant. Management: Suvorexant or any other CNS depressionant can be reduced in doses. Suvorexant should not be taken with alcohol. It is also not recommended to take suvorexant along with any other drugs for insomnia.
Tapentadol CNS Depressants may increase the CNS depressant effects. Tapentadol, benzodiazepines and other CNS depressants should be avoided when possible. Combining these agents is not recommended unless there are other options. Limit the amount and duration of each drug when combined.
Theophylline Derivatives This may reduce the therapeutic effects of Benzodiazepines.
Zolpidem CNS Depressants can increase the CNS depressant effects of Zolpidem. Management: For men who also take CNS depressants, reduce the adult Intermezzo brand sublingual Zolpidem dose to 1.75mg. For women, no dose adjustment is advised. Avoid using CNS depressants at night; do not use alcohol.

Risk Factor X (Avoid Combination)

  
Azelastine - Nasal CNS Depressants could increase the CNS depressant effects of Azelastine.
Bromperidol CNS Depressants may increase the CNS depressant effects.
Conivaptan High risk of Inhibitors causing an increase in serum CYP3A4 Substrates concentrations
Fusidic Acid (Systemic). High risk of Inhibitors causing an increase in serum CYP3A4 Substrates concentrations
Idelalisib High risk of Inhibitors causing an increase in serum CYP3A4 Substrates concentrations
OLANZapine May increase the toxic/adverse effects of Benzodiazepines. Management: Avoid the concurrent use of parenteral benzodiazepines or IM olanzapine. There are risks of additional adverse events, such as cardiorespiratory depression. The prescribing information for Olanzapine does not include any recommendations regarding oral administration.
Orphenadrine Orphenadrine may be more effective against CNS depression than other drugs.
Oxomemazine CNS Depressants may increase the CNS depressant effects.
Paraldehyde Paraldehyde may be enhanced by CNS Depressants.
Sodium Oxybate Benzodiazepines can increase the CNS depressant effects of Sodium Oxybate.
Thalidomide CNS Depressants can increase Thalidomide's CNS depressant effects.

 

  •  

Monitoring Parameters:

  • CBC
  • liver function tests
  • renal function tests
  • suicidality (eg, suicidal thoughts, depression, and behavioral changes)

How to take Clonazepam (rivotril, Klonopin)?

To reduce somnolence, administration of one dose at bedtime may be desirable. Tablet: Swallow whole with water.

Mechanism of action of Clonazepam:

  • It is not known what the exact mechanism might be. 
  • It is thought to increase GABA activity and suppress spike-and-wave discharges in absence seizures by reducing nerve transmission in motor cortex.

The onset of action:

  • ~20 to 40 minutes.

Duration:

  • Infants and young children: 6 to 8 hours
  • Adults: ≤12 hours.

Absorption:

  • Rapidly and completely absorbed

Distribution:

  • Children: V : 1.5 to 3 L/kg
  • Adults: V : 1.5 to 6.4 L/kg.

Protein binding:

  • ~85%

Metabolism:

  • Extensively hepatic.

Bioavailability:

  • ~90%

Half-life elimination:

  • Children: 22 to 33 hours
  • Adults: 17 to 60 hours

Time to peak, serum:

  • 1 to 4 hours

Excretion:

  • Urine

International brands of Clonazepam:

  • APO-ClonazePAM
  • Clonapam
  • CO ClonazePAM
  • DOM-ClonazePAM
  • DOM-ClonazePAM-R
  • MYLAN-ClonazePAM
  • PHL-ClonazePAM
  • PMS-ClonazePAM
  • PMS-ClonazePAM-R
  • PRO-ClonazePAM
  • RATIO-ClonazePAM
  • RIVA-ClonazePAM
  • Rivotril
  • SANDOZ ClonazePAM
  • TEVA-ClonazePAM
  • Aklonil
  • Amotril
  • Antaspan
  • Anzatax
  • Apetryl
  • Clonapilep
  • Clonaril
  • Clonatril
  • Clonatryl
  • Clonazepamum
  • Clonex
  • Clonium
  • Clonofax
  • Clonotril
  • Clozapam
  • Clozer
  • Convolsil
  • Iktorivil
  • Jing Kang
  • Kenoket
  • Klozepam
  • Kriadex
  • Leptic
  • Naza
  • Neuryl
  • Paxam
  • Povanil
  • Ravotril
  • Riklona
  • Rivopam
  • Rivoram
  • Rivotril
  • Ronatril
  • Valpax
  • Xetril
  • Zepanc
  • Zymanta

Clonazepam (Rivotril, Klonopin) in Pakistan:

Clonazepam [Drops 0.25 %W/V]
Epizep Zafa Pharmaceutical Laboratories (Pvt) Ltd.
Naze Schazoo Laboratories Ltd.
Rivotril Roche Pakistan Ltd.

Clonazepam [Tabs 1 Mg]
Curo Wilshire Laboratories (Pvt) Ltd.

Clonazepam (rivotril) [Tabs 2 Mg]
Clonatril Polyfine Chempharma (Pvt) Ltd.
Clonazil English Pharmaceuticals Industries
Curo Wilshire Laboratories (Pvt) Ltd.
Epitril Geofman Pharmaceuticals
Epizep Zafa Pharmaceutical Laboratories (Pvt) Ltd.
Eppam Z-Jans Pharmaceutical (Pvt) Ltd.
Klozepam Usawa Pharmaceuticals
Magura Sami Pharmaceuticals (Pvt) Ltd.
Medyo Jinnah Pharmaceuticals
Naze The Schazoo Laboratories Ltd.
Retril Tagma Pharma (Pvt) Ltd.
Rivotril Roche Pakistan Ltd.
Rospam Lowitt Pharmaceuticals (Pvt) Ltd
Setril Saydon Pharmaceutical Industries (Pvt) Ltd.
Zaron Raazee Theraputics (Pvt) Ltd.

Clonazepam [Tabs 0.5 Mg]
Clonatril Polyfine Chempharma (Pvt) Ltd.
Clonazil English Pharmaceuticals Industries
Epifits Gray`S Pharmaceuticals
Epizep Zafa Pharmaceutical Laboratories (Pvt) Ltd.
Magura Sami Pharmaceuticals (Pvt) Ltd.
Medyo Jinnah Pharmaceuticals
Naze The Schazoo Laboratories Ltd.
Rivotril Roche Pakistan Ltd.
Setril Saydon Pharmaceutical Industries (Pvt) Ltd.
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