Clorazepate
Commercial names and formulations:
Brand name: Tranxene, Gen-xene
Formulations: Tablet
Years on the market:
In the US since 1972
How to store it?
Store at room temperature
What does the body do to the medication?
Can I take it with food?
Yes
How long does it take to get to the blood after I take it?
30 minutes to 2 hours
How long does it take to start having a steady effect?
2 days
Can this medication be started at a high dose or it has to be started gradually?
Gradually
How long does it stay in the body?
2 to 5 days
How is it eliminated?
Liver
What does the medication do to the body?
Type of epilepsy that helps:
Partial and generalized Epilepsy
FDA approved for:
Add-on therapy for the treatment of partial seizures
Common side effects:
• Skin: transient skin rashes
• Bones: none
• Blood: abnormal liver and kidney function tests, decreased hematocrit
• Liver: none
• Kidneys: none
• Stomach and intestines: various gastrointestinal complaints
• Heart: none
• Brain: drowsiness, dizziness, headache, mental confusion, tremor, slurred speech
• Mood: irritability, nervousness
• Others: blurred vision, dry mouth, difficulty sleeping, fatigue
Serious side effects:
Risk of suicidal thoughts or behavior, excessive sleepiness leading to breathing difficulty
What happens if I get too much of it (intoxication)?
Symptoms may include drowsiness, confusion, slurred speech, tiredness, weakness and in severe cases lack of coordination, decrease in blood pressure, heart problems, difficulty breathing, and coma.
Could be fatal if combined with alcohol or barbiturates.
What happens if I stop it suddenly (withdrawal)?
Abrupt withdrawal symptoms include convulsions or status epilepticus, delirium, abdominal and muscle cramps, vomiting, sweating, nervousness, insomnia, irritability, diarrhea, and memory impairment.
Who should not take this medication?
You should not take clorazepate if you are allergic to any of the ingredients or if you have acute narrow angle glaucoma. Caution should be used when combining with barbiturates. Use in the elderly may increase risk of falls.
What is the average dose and how many times a day should be given?
Children: initial 7.5 mg (in divided doses), dose should not exceed 60 mg/day. Not recommended for under age 9.
Adults: initial 7.5 mg (in divided doses), dose should not exceed 90 mg/day
Does the body get used to the medication?
Yes
Medications to be careful with:
Other AEDs that can increase the blood level of clorazepate:
None anticipated
Other AEDs that can decrease the blood level of clorazepate:
None anticipated
Other drug interactions:
The actions of the benzodiazepines may be potentiated by barbiturates, narcotics, phenothiazines, monoamine oxidase inhibitors or other antidepressants.
Blood work required?
CBC and CPM?
Yes
How often?
Periodically
Are medication levels in blood useful?
No
Women’s health
Affects contraceptives?
No
Affect fertility?
No
Are safe in pregnancy?
Use of clorazepate during pregnancy is not recommended.
Category
Pregnancy Category D
Can breastfeed?
Use of clorazepate while breast feeding is not recommended.
Affect bones (osteoporosis)?
No
Men’s health
Affects sexual performance?
No
Affects fertility?
No
Use other than epilepsy:
Management of anxiety disorder or short-term relief of the symptoms of anxiety
Symptomatic relief of acute alcohol withdrawal