As indicated in the instructions, "Clonazepam" refers to drugs with anticonvulsant, muscle relaxant, sedative and antiepileptic effects. The medicine is available in tablet form, the complete set is a package with three blisters of 10 capsules. The composition of one tablet is the active substance under the same name (0.5 or 2.0 mg). The Latin name of the drug is Clonazepam, manufacturers are TPWP (Poland) and Remedica (Cyprus). Consider the indications for treatment with this tool, its substitutes, as well as examine consumer reviews.
Pharmacodynamic properties
The drug is classified as a derivative of benzodiazepine elements, enhancing the inhibitory effect of gamma-aminobutyric acid on nerve endings. According to the instructions, "Clonazepam" stimulates the corresponding receptors, which are localized in the postsynaptic allosteric center. They are located in the insertion neurons of the lateral branches of the spinal cord, as well as in the ascending reticular stem cell formation.
The drug reduces the spinal reflexes of the postsynaptic type, leveling the activity of the subcortical sections of the brain, including the thalamus, limbs and hypothalamus. The main effect of the drug is due to the effect on the amygdala of the limbic structure. The effect is expressed in easing feelings of anxiety, fear, emotional stress.
Sedation is associated with the effect of the drug on non-specific areas of the thalamus and the reticular configuration of the brain stem. This is expressed in reducing the symptoms of a neurotic appearance, including anxiety and anxiety.
As indicated in the instructions to "Clonazepam", the drug has an anticonvulsant effect due to the activation of presynaptic retardation. In this case, the spread of epileptic excitement that occurs in the foci of the limbic compartments, the thalamus and the cortex is prevented. In this case, the active state is not completely eliminated.
Features
It is officially proved that in the human body after taking the indicated drug, the paroxysmal activity of various configurations is quickly minimized, including on the adhesions of the temporal localization. Also, the generalized and slow process of the “spike wave” and identical manifestations, accompanied by absences (decrease in consciousness without visible convulsions) are reduced. Adhesive waves of an irregular nature are reduced.
The instructions to "Clonazepam" and analogues indicate that changes in the generalized type of indications on the electroencephalogram due to the suppression of the manifestations of the drug are better than a similar effect on the symptoms of the focal type. Nevertheless, a positive effect after taking the medicine is observed in both cases.
The cause of muscle relaxant directed exposure is the inhibition of polysynaptic in spinal afferent compartments. It is believed that there is a direct inhibition of the functionality of muscles and the functioning of motor receptors.
Pharmacokinetics
The instructions to "Clonazepam" noted that after oral administration, the drug is absorbed from the gastrointestinal system by almost 90 percent. The maximum level of active substance in blood plasma is observed 2-3 hours after ingestion. The drug binds to proteins by about 5%, penetrates the barriers of the placental and blood-brain type, being determined in breast milk.
The drug in question is metabolized in the liver to elements that have almost no pharmacological activity, the average half-life is about 60 hours. The procedure is carried out by the kidneys (50-70%) and the gastrointestinal tract (20-30%). About one percent of the dose taken comes out with urine.
Indications and contraindications
The instructions for use of "Clonazepam" says that it is indicated for the following diagnoses and symptoms:
- Myoclonic and akinetic epilepsy.
- Seizures of focal, generalized, temporal, submaximal type in children and adults.
- Paroxysmal fear, phobias (in patients over 18 years old).
- Cyclothymia in the manic phase.
- Psychomotor excessive activity in reactive psychosis.
The drug in question has a lot of contraindications, namely:
- Violations of breathing and consciousness.
- Glaucoma.
- Myasthenia gravis
- Significant liver disorders in the acute phase.
- Respiratory failure.
- Hypersensitivity to the components of the drug.
- Age up to 18 years (in some cases).
The instructions to "Clonazepam" mentioned that pregnant women should take the drug solely for absolute indications. During lactation, breastfeeding must be stopped. With caution, the medicine should be used in patients over 65 years of age, as well as in patients with chronic diseases of the respiratory apparatus and impaired kidney and liver function.
Instructions for use of tablets "Clonazepam"
The drug in question is taken orally. With epilepsy, the following dosage is usually prescribed:
- Adult patients. The initial dose is 0.5 mg three times a day with a gradual increase in the intake rate (0.5-1 mg every three days). The stimulating daily dose is up to eight milligrams in 3-4 doses. The maximum norm in 24 hours is no more than 20 mg.
- Children are shown such a starting dose - 0.5 mg twice a day. The increase is gradual - by 0.5 mg every three days. The limit norm for 24 hours is 0.2 mg / kg, the maintenance dose is 1-6 mg per day.
Treatment of paroxysmal fear syndrome is carried out in adults. Dosage - from one to four milligrams of the drug per day.
Side effects
According to the provisions of the instructions for use of "Clonazepam" and patient reviews, a number of undesirable effects may occur during the period of the drug. Among them:
- Fatigue and drowsiness.
- Head spin.
- General weakness, ataxia.
- Decorating.
- Impaired memory, speech, vision.
- Constipation, abdominal pain.
- Inflammation of the upper respiratory tract.
- Depression and disorientation.
- Frequent urination.
- Menstrual irregularities.
- Decreased libido.
- Muscle pains.
- Allergic reactions.
- Insomnia or excessive agitation.
Such manifestations require urgent consultation with a doctor and discontinuation of therapy.
Overdose
The instructions to "Clonazepam" noted that an overdose can occur as follows:
- Insomnia.
- Lowering blood pressure.
- Confusion of consciousness.
- Bradycardia.
- Difficulty breathing and weakening reflexes.
- Inhibition of the respiratory system.
- Coma.
For the treatment of these symptoms, gastric lavage and the use of sorbents (for example, activated carbon) are prescribed. Symptomatic therapy is indicated to stabilize pressure and respiration. Hemodialysis in this case is ineffective.
Recommendations
The instruction for tablets "Clonazepam" states that prolonged use of the drug leads to a decrease in its effect.
During therapy and for 72 hours after its completion, it is not recommended to drink alcohol.
Cancellation of treatment involves a gradual decrease in the dose of the drug. This is due to the fact that a sharp cessation of medication can trigger the occurrence of psychophysical dependence and the development of withdrawal symptoms.
With long-term treatment of children with "Clonazepam", the risk of side effects on development in physical and mental terms should be taken into account. It can occur even several years after undergoing therapy.
During active treatment, mechanisms and motor vehicles cannot be driven.
Store the medicine in a dark, dry and out of reach of children at a temperature of no higher than 25 ° C. Shelf life - 36 months, dispensed by prescription.
Substitutes
Instructions for use of analogues and Clonazepam have similar provisions and recommendations. Among the main substitutes for the drug are:
- Nitrazepam. This medicine also has a calming effect, relaxes muscles, has an anticonvulsant and anxiolytic effect. The only difference is that Nitrazepam has a less powerful effect in overcoming active convulsive manifestations.
- "Clonotril" - a drug that is a complete analogue of "Clonazepam", reduces the excitability of the subcortex of the brain, has a pronounced antiepileptic effect.
- Rivotril. Another identical substitute. Indications for this medicine and Clonazepam are similar. The drug is prescribed to reduce convulsive manifestations, has a sedative, hypnotic, muscle relaxant effect.
Interaction with other medical devices
The instruction to "Clonazepam" and reviews of experts indicate that the effect of the drug is enhanced by antidepressants, barbiturates, antipsychotics, alcohol, narcotic analgesics. Substances aimed at reducing the skeletal muscle tone also increase the effectiveness of the drug. The simultaneous use of nicotine and "clonazepam" reduces the effect of the latter.
Taking alcohol during therapy provokes the development of paradoxical reactions in the form of aggressive behavior, psychomotor agitation. Sometimes there is a state of pathological intoxication.
Reviews
Instructions for use of "Clonazepam" and analogues should be studied before treatment in any case. It also does not interfere with listening to patient feedback and the recommendations of specialists. Users note that in most cases, treatment with this drug is normal, without undesirable consequences. Efficiency is manifested in the elimination of manifestations of epilepsy, convulsive seizures, West syndrome, muscle hypertonicity.
Consumers indicate that with great caution, the medicine should be used during an exacerbation of diseases, children, pregnant and lactating women, the elderly. In the latter category of patients, the activity of elimination of the drug may slow down, increased aggressiveness can be observed, especially in the case of diagnosing pulmonary heart failure.
Summarize
The recommendations and provisions on the drug "Clonazepam" will help people with serious illnesses to decide on the choice of an effective treatment. You can buy pills and analogues in any pharmacy by prescription. Cost - from 150 rubles per standard package. It should be noted that in any case, self-medication is dangerous, a preliminary consultation of a specialist is required.