Indications
Epitra Tablet is used for:
Epilepsy, Anxiety disorders, Panic disorder, Status epilepticus, Social phobia, Migraines, Parasomnia, Restless legs syndrome, Rapid eye movement, Behavior disorder, Spasticity, Resistant depression, Trigeminal neuralgia, Nocturnal myoclonus, Post traumatic stress disorder, Insomnia and sleep disturbances, Burning Mouth Syndrome
Adult Dose
Oral
Epilepsy
Adult: Initially, 1 mg given at night for 4 days, gradually increased over 2-4 wk. Maintenance: 4-8 mg/day. Max: 20 mg/day.
Elderly: Initially, 0.5 mg at night for 4 days.
Panic disorder
Adult: Initially, 0.25 mg bid, increased after 3 days up to 1 mg/day. Max: 4 mg/day.
Intravenous
Emergency management of status epilepticus
Adult: 1 mg by slow IV inj over at least 2 min or by infusion, repeated if necessary. Max: 20 mg.
Hepatic impairment: Dosage adjustment may be needed.
Child Dose
Oral
Epilepsy
Child: <10 yr or <30 kg: Initially, 0.01-0.03 mg/kg/day but not to exceed 0.05 mg/kg/day given in 2 or 3 divided doses. May be increased by no more than 0.25-0.5 mg every 3rd day until seizure control is achieved.
Maintenance: 0.1-0.2 mg/kg/day divided 3 times daily. Max: 0.2 mg/kg/day.
Intravenous
Emergency management of status epilepticus
Child: 500 mcg by slow IV inj or by infusion.
Renal Dose
Administration
May be taken with or without food.
Contra Indications
Hypersensitivity to benzodiazepines, acute pulmonary insufficiency, acute narrow angle glaucoma.
Precautions
Neonates, chronic pulmonary insufficiency, hepatic/renal dysfunction, porphyria, elderly; pregnancy and lactation.
Lactation: Excreted in breast milk; not recommended
Pregnancy-Lactation
Pregnancy
There are no adequate and well-controlled studies of Klonopin in pregnant women; available human data on risk of teratogenicity are inconclusive; there is insufficient evidence in humans to assess effect of benzodiazepine exposure during pregnancy on neurodevelopment; administration of benzodiazepines immediately prior to or during childbirth can result in a syndrome of hypothermia, hypotonia, respiratory depression, and difficulty feeding; in addition, infants born to mothers who have taken benzodiazepines during later stages of pregnancy can develop dependence, and subsequently withdrawal, during the postnatal period
Data for other benzodiazepines suggest possibility of adverse developmental effects (long-term effects on neurobehavioral and immunological function) in animals following prenatal exposure to benzodiazepines
Lactation
Effects on breastfed infant and on milk production are unknown; developmental and health benefits of breastfeeding should be considered along with mother's clinical need for therapy and any potential adverse effects on breastfed infant from drug or from underlying maternal condition
Interactions
Additive depressant effect w/ TCAs, MAOIs, sedative and hypnotics, barbiturates, anxiolytics, antipsychotics, opiate agonists. May increase serum phenytoin levels.
Side Effects
Side effects of Clonazepam :
>10%
Somnolence (37%)
1-10%
Abnormal coordination (5-10%), Ataxia (5-10%), Depression (5-10%), Dizziness (5-10%), Fatigue (5-10%), Memory impairment (5-10%), Upper respiratory infection (5-10%), Confusion (1-5%), Dysarthria (1-5%), Rhinitis (1-5%), Coughing (1-5%), Urinary frequency (1-5%), Impotence (1-5%), Decreased libido (1-5%)
Frequency Not Defined
Increased salivation, Worsening tonic-clonic seizures
Potentially Fatal: Salivary or bronchial hypersecretion leading to respiratory problems (children). May produce diminished reflexes or coma. Rarely, blood dyscrasias.
Mode of Action
Clonazepam reduces the nerve transmission in the motor cortex which suppresses the spike and wave discharge in absence seizures. Its mechanism is believed to be related to its ability to enhance the activity of GABA. Clinically, it improves focal epilepsy and generalised seizures.
Note
Epitra 1mg Tablet generic name is Clonazepam. Epitra 1mg Tablet is manufactured by Square Pharmaceuticals Ltd.Epitra is availble in all over Bangladesh.
Mes BD drug index information on Epitra Tablet is not intended for diagnosis, medical advice or treatment; neither intended to be a substitute for the exercise of professional judgment.