Rivotril 2mg (Clonazepam) is a benzodiazepine. Rivotril affects chemicals in the brain that may be unbalanced. Rivotril is also a seizure medicine, also called an anti-epileptic drug.
Rivotril 2mg (Clonazepam) is an antiepileptic drugs from the group of benzodiazepine derivatives. This medication has a pronounced anticonvulsant and central muscle relaxant, anxiolytic, sedative and hypnotic effects.
Why is Rivotril 2mg (Clonazepam) prescribed?
As the medication of I row – epilepsy : typical absence seizures (petit mal), atypical absence seizures (Lennox-Gastaut syndrome), nodding spasm, atonic seizures (a syndrome of “falling” or “drop-attacks”).
As the medication of II row – infantile spasms (West syndrome).
As the medication of III row – tonic-clonic seizures (grand mal), simple and complex partial seizures and secondary generalized tonic-clonic seizures.
Status epilepticus (IV injections).
Somnambulism, muscular hypertonicity, insomnia (especially in patients with organic brain damage), psychomotor agitation, alcohol withdrawal syndrome (acute agitation, tremor, threatening or acute delirium tremens and hallucinations), panic disorder.
Dosage and administration
Dosing regimen of Rivotril is individual. For oral administration for adults the recommended initial dose is not more than 1 mg / day. The maintenance dose is 4-8 mg / day.
For infants and children aged 1-5 years, the initial dose should not exceed 250 micrograms / day, for children aged 5-12 years – 500 mcg / day. Supporting daily doses for children under 1 year are 0.5-1 mg, 1-5 years – 1-3 mg, 5-12 years – 3-6 mg.
For elderly patients the recommended starting dose is not exceeding 500 micrograms.
The daily dose should be divided into 3-4 equal doses. Maintenance doses prescribed in 2-3 weeks of treatment.
IV (slowly) for adults – 1 mg, for children under the age of 12 years – 500 mcg.
Rivotril 2mg (Clonazepam) drug interactions
Simultaneous administration of Rivotril 2mg (Clonazepam) with:
drugs providing a depressing effect on the CNS, ethanol, ethanol containing drugs may increase the CNS depressant effects.
Rivotril enhances the action of muscle relaxants, with valproate sodium reducing sodium valproate and the provocation of seizures.
described the case to reduce the concentration of desipramine in plasma in 2 times and its increase after withdrawal of Rivotril.
carbamazepine which causes the induction of microsomal liver enzymes may increase metabolism and the resulting decrease in concentration of Rivotril in plasma.
caffeine may reduce sedative and anxiolytic effects of Rivotril, with lamotrigine – may decrease the concentration of Rivotril 2mg (Clonazepam) in plasma, with lithium carbonate – the development of neurotoxicity.
primidone increases its concentration in blood plasma, with tiapride – possibly the development of NMS.
toremifene it is possible significant reduction in AUC and T1/2 of toremifene in connection with the induction of liver enzymes under the influence of Rivotril which leads to faster metabolism of toremifene.
may increase the concentration of phenytoin in blood plasma and the development of toxic reactions, its reduction or absence of these changes.
cimetidine increases the side effects of the CNS, however, the frequency of seizures in some patients decreased. There was described a case of headache with localization in the occipital region, while the application with phenelzine.
Rivotril side effects, adverse reactions
CNS: early treatment – severe lethargy, fatigue, drowsiness, weakness, dizziness, stupor, headache; rarely – confusion, ataxia. When used in high doses, especially in long-term treatment – violation of articulation, diplopia, nystagmus, paradoxical reactions ; anterograde amnesia. Rarely – hyperergic reactions, muscle weakness – depression. With long-term treatment of some forms of epilepsy may increase the frequency of seizures.
Digestive system: rarely – dry mouth, nausea, diarrhea, heartburn, nausea, vomiting, decreased appetite, constipation or diarrhea, liver damage, elevated liver transaminases and alkaline phosphatase, jaundice. In infants and young children may increase salivation.
Cardiovascular system: decreased blood pressure, tachycardia.
Endocrine: changes in libido, dysmenorrhea, reversible premature sexual development in children (part-time early puberty).
Respiratory system: with / in the introduction possible respiratory depression, particularly after treatment with other medicines that cause respiratory depression; in infants and young children it is possible bronchial hypersecretion.
Hematopoietic system: leukopenia, neutropenia, agranulocytosis, anemia, and thrombocytopenia.
Urinary system: urinary incontinence, urinary retention, impaired renal function.
Allergic reactions: hives, skin rash, itching, extremely rare – anaphylactic shock.
Dermatological reactions: transient alopecia, discoloration.
Other: addiction, drug dependence, with a sharp decrease in dose or cessation of reception
Before using Rivotril Tablet, inform your doctor about your current list of medications, over the counter products (e.g. vitamins, herbal supplements, etc.), allergies, pre-existing diseases, and current health conditions (e.g. pregnancy, upcoming surgery, etc.). Some health conditions may make you more susceptible to the side-effects of the drug. Take as directed by your doctor or follow the direction printed on the product insert. Dosage is based on your condition. Tell your doctor if your condition persists or worsens. Important counseling points are listed below.
Avoid abrupt discontinuation of this drug
Compromised respiratory function
Impaired renal function
Interference with cognitive and motor performance
Report to doctor changes in mood and suicidal thoughts
Suicidal behavior and ideation.