About Klonopin
Klonopin is an anticonvulsant, sedative, and antipanic medication
used in the treatment of several types of seizure, to prevent seizures
while taking cyclosporin A, and panic disorder. It may also be used
to treat Tourette's syndrome, trigeminal (cranial nerve that runs
between the brain and face) neuralgia (pain), drug resistant depression
(may be combined with another antidepressant), restless legs syndrome
or periodic limb movement (see Sleep
Disorders), drug-induced mania, tremors, and Xanax (alprazolam)
withdrawal. For individuals with multiple seizure disorders, this
drug may increase the risk of grand mal seizures, and will likely
be prescribed along with an additional anticonvulsant medication.
This medication works by increasing the activity of a neurotransmitter
called GABA (gamma-aminobutyric acid), which controls convulsion
and seizure. It is a member of the benzodiazepine group of drugs,
a class of antidepressants, anti-panic agents, sleep medications,
and muscle relaxants.
Klonopin is only available by prescription. Do not use this
medication with alcohol, narcotic pain medication, or other
drugs with a sedative effect.
Klonopin Side Effects
Klonopin is generally regarded as a safe drug, but there is some
risk of side effects. Speak to your doctor if any of the following
effects persists or is severe. Elderly patients and children are
much more likely to experience undesirable side effects, and are
generally prescribed much lower doses to compensate for this.
Common Klonopin Side Effects: drowsiness (most likely at
the beginning of treatment), increased salivation, weight gain.
Less Common Side Effects: ataxia (lack of muscle coordination),
blurry or double vision, confusion, depression, dizziness, headache,
impaired memory, muscle weakness, slurred speech.
Rare Klonopin Side Effects: breathing problems (esp. in
patients with lung disease), constipation or diarrhea, dependence,
difficulty urinating or incontinence, hair loss, hallucinations,
heart palpitations, low platelet counts, nausea or vomiting, paradoxical
agitation or anger, porphyria, seizures, shuffling gait, yellowing
of skin or eyes. Any of these effects should be reported to your
doctor immediately, most of these are more likely in elderly
patients who should be carefully monitored for side effects.
Allergic Reactions (Infrequent to Rare): hives, rash, fever,
itching. If you have an allergic reaction to this medication, you
will have to stop taking it, and should not take other benzodiazepines.
Cautions: Do not stop taking Klonopin suddenly if you have
a seizure disorder, or have been taking it for more than 4 weeks.
This could increase the risk of, or cause, seizures. Other undesirable
side effects, such as anxiety, insomnia, or irritability are also
possible. For maximum safety, all individuals who wish to stop taking
Klonopin should step off their dose slowly according to their doctor's
recommendations.
Because some conditions are contraindications for Klonopin treatment,
and others may require careful monitoring or a dosage adjustment,
inform your doctor if you have any of the following conditions or
a history of them.
- Alcohol or drug abuse - may increase likelihood of Klonopin
dependence
- Allergic reaction to Klonopin, or other benzodiazepine. Always
tell your doctor about any allergies before starting a medication.
- Borderline personality disorder or a history of violent behavior.
- Brain disease - may increase likelihood of side effects from
Klonopin
- Breathing difficulties such as asthma, bronchitis, emphysema,
or any other chronic lung disease - Klonopin may worsen this condition.
- Difficulty swallowing - This condition may become more pronounced
in children.
- Epilepsy or seizures - Abruptly starting or stopping treatment
with Klonopin may increase seizures. Although Klonopin can be
used to treat seizures, it should be used cautiously and strictly
according to a doctor's instructions in these cases.
- Glaucoma - Klonopin should not be prescribed to patients with
acute narrow-angle glaucoma. Patients receiving treatment for
open angle glaucoma should consult their doctor, as Klonopin may
be an acceptable treatment for them.
- Hyperactivity
- Kidney or liver problems - In isolated cases, Klonopin has been
reported to cause jaundice. If you experience yellowing of the
skin or eyes, seek medical treatment immediately. More Klonopin
may end up in your bloodstream if you have a pre-existing kidney
or liver condition, increasing the likelihood of side effects.
- Major Depression
- Myasthenia gravis - This autoimmune disorder characterized by
muscle weakness may be aggravated by Klonopin treatment.
- Porphyria - Klonopin (clonazepam) is listed as an unsafe drug
for porphyria, an enzyme deficiency that can cause fragile skin
that is sensitive to sunlight, digestive difficulties, anxiety,
and reddish-brown urine.
- Psychosis or other serious mental illness - Klonopin has not
proved to be an effective treatment for these conditions, and
is not recommended.
- Sleep apnea (temporary suspension of breathing during sleep)
- Klonopin may worsen this condition. Individuals with sleep apnea
should not generally use sedatives as sleep aids. (See Sleep Disorders)
Klonopin Interactions
Klonopin slows the central nervous system, and should be taken with
care with medications that do the same thing. When Klonopin is taken
with certain other medications, the rate of side effects may increase,
and the action of either medication may be increased or altered.
Certain medications can cause an undesirable build-up of Klonopin in
the body. Ask your doctor's advice about combining Klonopin with any
of the following:
- Alcohol - Klonopin should not be mixed with alcohol, individuals
are advised to avoid it completely during treatment.
- Any medication which may cause drowsiness
- Antibiotics (macrolide antibiotics) like azithromycin,
biaxin, clarythromycin, or erythromycin
- Antihistamines like Tavist or Benadryl
- Antabuse (disulfiram)
- Antiseizure medication like Cerebyx (fosphenytoin), Dilantin
(phenytoin), or Tegretol
(carbamazepine) - these medications may decrease each
other's effectiveness.
- Benzodiazepines of any other type, such as Valium
(diazepam), Halcion
(triazolam), Restoril
(temazepam), Librium(chlordiazepoxide),
Tranxene-SD (clorazepate), Paxipam (halazepam), Ativan
(lorazepam), ProSom (estazolam), or Xanax
(alprazolam).
- Bronchodilators of the xanthine (thioxanthine) class (Aminophylline,
Dyphylline, Oxtriphylline, Somophyllin, Theo-Dur,
etc...) - May increase the effects of Klonopin.
- BuSpar (buspirone)
- Can result in oversedation.
- Cordarone (amiodarone) - May cause buildup of Klonopin
in the body.
- Desyrel (trazodone) - Risk
of additive CNS depression.
- Diflucan (fluconazole)
- Kava kava - Do not use this herb while taking Klonopin.
- Lopressor (metoprolol) -Can result in oversedation.
- MAO inhibitors - Klonopin should not be mixed with MAO
(monoamine oxidase) inhibitors, a class of antidepressants
and antisenility drugs, such as Eldepryl (selegiline), Furoxone
(furazolidone), Nardil (phenelzine), Marplan (isocarboxazid),
or Parnate (tranylcypromine).
- Muscle relaxants such as Flexeril
(cyclobenzaprine), Skelaxin
(metaxalone), Soma
(carisoprodol), or Robaxin
(methocarbamol) may cause oversedation in combination
with this medication.
- Mysoline (primidone) - May cause oversedation.
- Narcotic analgesics of any kind, like Darvon (propoxyphene),
Darvocet (propoxyphene, acetaminophen), Demerol
(meperidine), Codeine, Percocet
(oxycodone, acetaminophen), Vicodin
(hydrocodone, acetaminophen), Vicoprofen
(hydrocodone and ibuprofen) or OxyContin
(oxycodone) should likely be taken in much lower doses
when taken with Klonopin.
- Neoral, Sandimmune (cyclosporine)
- Nizoral (ketoconazole)
- Klonopin should not be mixed with this antifungal medication.
- Norflex (orphenadrine)
- Risk of oversedation.
- Oral contraceptives - May increase the effects of Klonopin.
- Phenobarbitol, Fioricet
(butalbital, acetaminophen, and caffeine), Fiorinal,
Seconal, or other barbiturates may cause oversedation.
- Prilosec (omeprazole) - May increase the effects of Klonopin.
- Protease inhibitors like Agenerase (amprenavir) or Norvir
(ritonavir) may cause a toxic buildup of Klonopin in the
body.
- Rifamate (isoniazid), Rifater (rifampin), or Mycobutin
(rifabutin)
- Selective serotonin reuptake inhibitors (SSRIs) like Celexa
(citalopram), Paxil
(paroxetine), Prozac
(fluoxetine), Luvox (fluvoxamine), or Zoloft
(sertraline).
- Serzone (nefazodone)
- Sinemet (carbidopa, levadopa) can cause oversedation.
- Sleep medication like Ambien
(zolpidem), Sonata
(zaleplon), or over the counter sleeping pills should
be used with Klonopin only as, and if, advised by your doctor.
- Sporanox (itraconazole)
- Klonopin should not be mixed with this antifungal medication.
- Street drugs - Marijuana may increase sedative effects
from Klonopin. You should refrain from using any illegal
drugs while taking prescription medication, as it greatly
increases the risk of adverse side effects and overdose.
- St. John's Wort - Do not take this herb while taking Klonopin.
- Tagamet (cimetidine)
- Tranquilizers such as Haldol (haloperidol), Mellaril (thioridazine),
or Thorazine (chlorpromazine) may cause oversedation.
- Tricyclic antidepressants such as Elavil
(amitriptyline), Asendin (amoxapine), Anafranil (clomipramine),
Pertofrane or Norpramin (desipramine), Sinequan
(doxepin), Tofranil (imipramine), Aventyl or Pamelor
(nortriptyline),
Vivactil (protriptyline), and Surmontil (trimipramine),
may be less effective in combination with Klonopin.
- Ultram (tramadol) -
May increase the risk of oversedation, and lower the threshold
for seizure.
- Valerian - Do not take this herb while taking Klonopin.
- Valproic acid, also Depakote, Depakene, divalproex, increases
the risk of continuous absence seizures in combination with
Klonopin.
Talk with your doctor if you are considering mixing an antidepressant
and anxiety medication like Klonopin with any other antidepressant,
or any medication that may cause drowsiness. Anxiety medication
can have increased, unexpected, or severe side effects when mixed
with other medications that affect the central nervous system. Stimulants
of any type may blunt the effectiveness of Klonopin.
Klonopin Dosages
For seizure disorders the recommended starting dose is 0.5 mg,
3 times daily. The dose may be increased by 0.5 mg to 1 mg every
3 days as needed, up to a maximum of 20 mg daily. For panic disorder
the usual starting dose is 0.25 mg, 2 times daily, up to a maximum
of 4 mg per day.
Klonopin is available in the following dosages:
- Tablets: 0.125 mg, 0.25 mg, 0.5 mg, 1 mg, 2 mg
Klonopin Directions
Do not increase your dose of Klonopin without instructions from
your doctor. If you miss a dose, take it as soon as you remember,
unless it is almost time for your next dose. Skip the missed dose
of Klonopin and resume your regular schedule. Do not take double
doses of this medication.
Inform your doctor, dentist, or anesthesiologist that you are taking
Klonopin before any kind of surgery or medical test. This medication
may interfere with certain test results. Klonopin should not be
combined with certain medications given during surgery.
Store Klonopin away from direct light and heat. Store in a dry
location; avoid storing it in the bathroom, near sinks, or other
areas where it may become damp. Do not use after the expiration
date.
Keep Klonopin away from children; both when storing it, and when
discarding any unused medication.
Klonopin may cause drowsiness or disorientation. Be cautious if
you plan to drive or operate heavy machinery, avoid these activities
if you find yourself feeling tired or experience slowed reactions.
Klonopin and Pregnancy
Klonopin may cause withdrawal, muscle weakness, or breathing difficulty
in newborns if taken during late pregnancy. It may cause similar
problems in nursing infants, as Klonopin does pass into breast milk.
Animal studies indicated some possibility of birth defects. This
medication should not generally be prescribed for pregnant or nursing
women, and should especially not be taken during the first trimester
of pregnancy.
Klonopin and Children
Klonopin is considered safe for all age groups, but is more likely to cause unwanted side effects in children. Your doctor will need to determine an individual dose carefully.
Klonopin and Seniors
Seniors generally require smaller doses of Klonopin, spaced farther apart. Watch more carefully for symptoms of oversedation or paradoxical agitation.
Klonopin is a trademark of Roche Pharmaceuticals
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This document is provided for information only. It is not a substitute
for consultation with a physician, either to diagnose symptoms
or prescribe treatment. Any dosages mentioned are general
guidelines only, please follow the directions of your doctor
or pharmacist exactly when taking medication. We have made
every effort to ensure that this information is accurate,
but only your doctor can say if a medication, or drug combination,
is safe for you. Information intended for US residents only.
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