Clobazam (Oral)

Prescribed to patients with Lennox-Gastaut Syndrome, Clobazam is used to control seizures associated with the condition.

Overview

Lennox-Gastaut Syndrome is a form of childhood epilepsy and is characterized by seizures, mental regression and abnormal electroencephalography (EEG) results. By controlling seizures, Clobazam helps to manage the condition and reduces the frequency of convulsions.

Although Lennox-Gastaut Syndrome is often caused by a lack of oxygen at birth, it can also be brought on by brain infections, such as meningitis, rubella and/or encephalitis. If the brain is injured because of a lack of oxygen or an infection, it can lead to long-term complications, such as Lennox-Gastaut Syndrome.

Whilst patients can suffer the causative effects of Lennox-Gastaut Syndrome at birth, they may not exhibit seizures until the ages of three to five. As the condition is generally classed as a severe form of childhood epilepsy, patients can suffer from various different types of convulsions.

When treating epilepsy it's vital to control seizures and minimize their frequency as much as possible. This helps patients to lead as normal a life as possible and also helps to reduce instances of seizure-related injuries. Although Clobazam does not cure childhood epilepsy of Lennox-Gastaut Syndrome, it can be used to manage the condition on a long-term basis.

Although Clobazam is a benzodiazepine, it is also recognized as an anxiolytic and an anticonvulsant medication. Clobazam has a tranquilizing effect and has an impact on a neurotransmitter known as gamma-aminobutyric acid (GABA). When the effects of GABA are increased, nerve signals are transmitted from the brain at a lower rate than normal.

As well as reducing anxiety and panic, increasing levels of GABA and slowly nerve signals helps to prevent seizures from occurring.

Whilst Clobazam is often effective in managing the convulsions associated with childhood epilepsy, it is generally used in conjunction with other medications. Patients may exhibit other signs of epilepsy, for example, and alternative medications may be used to manage these symptoms, whilst Clobazam is used to target the seizures associated with the condition.

As Lennox-Gastaut Syndrome is not a particularly common form of epilepsy, it can require specialist treatment. Known to be difficult to treat, patients may trial various combinations of treatment before finding relief from seizures with Clobazam.

Clobazam is mainly used to treat patients with epilepsy but, in rare cases, it may also be used to treat patients with chronic anxiety. Although the long-term use of benzodiazepines for anxiety is not normally recommended, physicians may prescribe the medication to anxious patients for a short time. In addition to this, Clobazam can be given to patients with schizophrenia and other mental health conditions, alongside other medications.

Although Clobazam is associated with some side-effects, it can be extremely effective when used appropriately. Whilst it is not normally a first-line treatment, patients who have not benefitted from other medications often find that Clobazam helps to reduce seizures caused by childhood epilepsy.

Conditions Treated

  • Lennox-Gastaut Syndrome
  • Anxiety and/or panic disorders

Type of Medicine

  • Benzodiazepine
  • Anxiolytic
  • Anticonvulsant

Side Effects

Although Clobazam can be extremely effective in treating epileptic seizures, it has been associated with some side-effects. Common adverse effects associated with the medication may include:

  • style="font-weight: 400;">Behavior which is aggressive
  • Redness of the skin
  • Body pain or aching
  • Lack of appetite
  • Difficulty passing a bowel movement
  • Drooling
  • Welts, hives or rashes
  • Congestion of the ears
  • Irritability
  • Voice loss
  • Nasal congestion
  • Pressure in stomach
  • Runny nose
  • Drowsiness or sleepiness
  • Sneezing
  • Urine cloudy in appearance
  • Vomiting
  • Bladder pain
  • Cough with mucus
  • Increased frequency of urination
  • Increase in appetite
  • Pain in side and/or lower back
  • Double vision
  • Bloated or feeling
  • Headache
  • Spasms of the muscles
  • Swelling of the stomach and surrounding area

Often, these side-effects present as fairly mild and they are unlikely to affect every patient. In some cases, patients may notice side-effects diminish as they become accustomed to the effects of the medication. If they are relatively mild and not distressing for the patient, the side-effects listed above may not require urgent medical attention. If patients are concerned about the presence of adverse effects or if they are struggling to cope with the side-effects of Clobazam, they should certainly seek medical help.

There are some side-effects associated with Clobazam which may require medical attention. If patients notice the following symptoms when taking Clobazam, they should contact their physician or a medical professional:

  • Tarry, black stools
  • Agitation
  • Irritated or bleeding gums
  • blistering, loosening or peeling of skin
  • Blood in stools and/or urine
  • Pain in chest area
  • Chills
  • Swelling of glands
  • Confusion as to place, time, or people
  • White spots, ulcers and/or sores in mouth or on lips
  • Cough
  • Sore throat
  • Diarrhea
  • Troubled or difficult breathing
  • Hearing, feeling or seeing things which are not present
  • Holding false beliefs that are unchanged by fact
  • Irritated and/or red eyes
  • Shallow, fast, slow or irregular breathing
  • Itching
  • Muscle and/or joint pain
  • Lack of emotions or feelings
  • Difficulty urinating
  • Blue or pale skin, lips, or fingernails
  • Pinpoint spots on skin which are in color
  • Skin lesions which are red and may have a purple center
  • Difficulty breathing with exertion
  • Changes in pattern of speech
  • Unusual bruising or bleeding
  • Restlessness
  • Unusual nervousness and/or excitement
  • Speech may be slurred
  • Weakness or tiredness
  • Difficulty sitting still
  • Difficulty speaking
  • Trouble swallowing
  • Unsteady walk
  • Fever
  • Shakiness
  • Trembling or issues with muscle coordination or control

Although patients should seek medical help if they develop the side-effects listed above, their treatment will not necessarily be continued. Providing Clobazam isn't causing them harm, a change in dose may be trialed in order to see if the side-effects are reduced. Alternatively, physicians may prescribe additional medications in order to limit the side-effects associated with Clobazam.

As patients are typically prescribed Clobazam on an ongoing basis, they should not attempt to deal with unpleasant or unwanted side-effects without medical assistance. Often, the side-effects associated with prescription medications can be relieved with medical intervention.

In order to seek help with the side-effects of treatment, patients should contact their physician or visit their nearest emergency room if their condition requires it. Patients are also able to report the presence of side-effects to the Food and Drug Administration on 1-800-FDA-1088.

Dosage

When patients are prescribed Clobazam, they should follow their doctor's instructions regarding the appropriate dose. Similarly, patients may be told when to take the medication in order for it to be most effective.

If patients are given Clobazam to treat seizures and they weigh over 30kg, a starting dose of 10mg per day is usually prescribed. In most instances, patients are advised to split the dose and take the medication twice daily. Following this, doctors may increase their dose of Clobazam as needed, although the maximum dose prescribed does not usually exceed 40mg per day.

If patients weigh less than 30kg, a starting dose of 5mg per day is normally given. Once doctors have had a chance to assess the patient's response to the medication, they may increase the dose. For patients weighing less than 30kg, the maximum dose of Clobazam is normally 20mg daily.

Regardless of their weight, older patients may be given a starting dose of 5mg per day when they are first prescribed Clobazam. As geriatric patients can find it more difficult to metabolize medications, physicians may prefer to err on the side of caution before increasing their dose. Providing the patient weighs over 30kg, their dose can be increased up to a maximum of 40mg per day, if this is required.

Currently, Clobazam is not recommended for use in patients under the age of two years. If physicians believe the benefits of the medicine outweigh any potential risks, they may prescribe Clobazam to infants under this age. If so, the appropriate dose will depend on the patient's weight and the severity of their symptoms.

When patients are given Clobazam, they will usually be given written instructions to follow when taking the medication. In most cases, Clobazam can be taken with or without food and, if prescribed in tablet form, the tablet can be broken if it makes the medication easier for the patient to swallow. Alternatively, patients may be able to crush the tablet if this is an easier way for them to take the medication.

Clobazam can be prescribed as a liquid and this may be an easier way for patients to take the medication, particularly if Clobazam is prescribed to young children. If patients are having trouble swallowing Clobazam tablets, they should ask their physician if they can use Clobazam oral liquid instead.

When taking Clobazam liquid, it's important that the dose is measured correctly. A dosage syringe should normally be used as this helps to ensure that the patient does not receive too little or too much of the medicine. If a syringe is used, it should be washed after each use but should not be placed in a dishwasher.

When patients are prescribed Clobazam, it's important that they follow their doctor's directions. Whilst the above information is applicable to most situations, patients are always given unique dosage instructions. If patients are unsure how to take the medication or when to take Clobazam, they should seek medical help.

If patients miss a dose of Clobazam, it should be taken as soon as possible. If the next dose of medication is due soon, the missed dose should be skipped entirely. Patients should not attempt to take a double dose of Clobazam, even if they have missed a previous dose of medicine.

Potential Drug Interactions

When treating childhood epilepsy or Lennox-Gastaut Syndrome, physicians will often prescribe a combination of medications to relieve the patients symptoms. There are some medications, however, which should not be prescribed alongside Clobazam. Due to the possibility of interactions occurring, patients are not normally given Clobazam if they are already taking:

  • Thioridazine
  • Flumazenil

When using the following medications, taking Clobazam as well is not normally recommended. If physicians deem it appropriate to prescribe alongside these medications, the standard dose may be altered to reduce the chance of drug interactions taking place. These medications include:

  • Alfentanil
  • Eslicarbazepine Acetate
  • Amobarbital
  • Eliglustat
  • Anileridine
  • Doxylamine
  • Bromazepam
  • Calcifediol
  • Buprenorphine
  • Butorphanol
  • Butabarbital
  • Chlorzoxazone
  • Butalbital
  • Codeine
  • Carbinoxamine
  • Doxorubicin
  • Carisoprodol
  • Doxorubicin Hydrochloride Liposome
  • Chloral Hydrate
  • Dihydrocodeine
  • Clozapine
  • Donepezil
  • Dantrolene
  • Ethchlorvynol
  • Propoxyphene
  • Fentanyl
  • Orlistat
  • Flibanserin
  • Hydrocodone
  • Oxymorphone
  • Hydromorphone
  • Methadone
  • Levorphanol
  • Periciazine
  • Meperidine
  • Piperaquine
  • Mephenesin
  • Pentobarbital
  • Mephobarbital
  • Oxycodone
  • Meprobamate
  • Phenobarbital
  • Metaxalone
  • Primidone
  • Methocarbamol
  • Morphine Sulfate Liposome
  • Methohexital
  • Secobarbital
  • Mirtazapine
  • Pentazocine
  • Morphine
  • Remifentanil
  • Nifedipine
  • Sodium Oxybate
  • Zolpidem
  • Sufentanil
  • Tapentadol
  • Tamoxifen
  • Tramadol
  • Thiopental

Furthermore, taking Clobazam at the same time as the following medicines could increase the risk of side-effects occurring:

  • Theophylline
  • Dextromethorphan
  • Phenytoin
  • Etravirine
  • Ketoconazole
  • Felbamate
  • Ethanol
  • Ginkgo
  • Fosphenytoin

If Clobazam is given to patients alongside these drugs, physicians may change their dose or provide specific treatment instructions in order to reduce the risk of side-effects. Alternatively, doctors may prescribe additional medicines to counteract any side-effects which occur.

Warnings

If patients have other medical conditions, as well as epilepsy, it may affect the suitability of Clobazam as a treatment. Patients with a history of depression or behavioral and mood disorders may not be prescribed Clobazam, for example. As the medication can make mood problems worse, an alternative treatment may be offered.

Similarly, patients with a history of liver disease or porphyria may find it difficult to process Clobazam and it could worsen their existing condition. Due to this, patients with liver disease may not be given Clobazam and, if they are, they should be monitored closely to ensure their health doesn't worsen.

Patients should not stop taking Clobazam suddenly, unless they are advised to do so by their physician. Stopping Clobazam suddenly may cause the patient to experience withdrawal symptoms. In most cases, doctors will advise the patient to reduce their dose gradually if the patient is to stop using Clobazam.

Benzodiazepines can be habit-forming if they are taken for long periods of time. Although it may be appropriate for patients to take Clobazam on a long-term basis if they are being treated for epilepsy, it may not be a long-term treatment option for patients with anxiety and/or panic disorders.

If patients have any of the following conditions, they should inform their doctor before taking Clobazam:

Clobazam is not usually given to pregnant patients as it may present a risk to an unborn fetus. Doctors will only give Clobazam to pregnant patients if they believe it is absolutely necessary and that the benefits of doing so will outweigh the risks. Patients should discuss the possible consequences of taking Clobazam when pregnant before they begin treatment.

If patients become pregnant while taking Clobazam, they should contact their physician for advice.

When breastfeeding, some medications can be passed on to the infant and they may have adverse effects. Due to this, patients are normally advised not to breastfeed when taking Clobazam. If patients are breastfeeding and are prescribed Clobazam, they should discuss the potential risks with their physician.

As Clobazam is a tranquilizer, it tends to have a sedating effect. Due to this, patients should not drive or operate heavy machinery when using Clobazam.

Patients are usually advised not to consume alcohol whilst taking Clobazam. The medication exacerbates the effect of alcohol and consuming alcohol is also likely to greatly increase the medicine's side-effects.

If patients take too much Clobazam, they will require urgent medical attention. When an overdose of Clobazam is taken, patients may exhibit symptoms including drowsiness, confusion, slurred speech, loss of consciousness, slow reflexes, tremors and/or slow breathing.

Before taking Clobazam, patients should inform their physician of any allergies they are aware of. If patients exhibit an allergic reaction to the medication, the will require immediate medical attention. An allergic reaction to any medication or substance can be life-threatening so it's vital that patients receive medical help quickly.

Storage

When patients are storing Clobazam at home, they will need to find a secure location so that the medication can't be accessed by anyone else. They should be particularly vigilant if children and/or pets are present in the home. Often, patients are advised to use a locked cupboard or secure medical box when storing prescription medications, such as Clobazam.

Although Clobazam is normally stored at room temperature and away from direct light, moisture and heat, patients should read the relevant instructions before choosing where to keep their medication.

In most cases, patients will need to dispose of Clobazam oral liquid if it has been open for ninety days, regardless of whether it has been used or not. When disposing of medication, patients should not throw it out with household waste. Instead, they should contact their pharmacist or medical clinic and ensure that the medication can be disposed of safely.

Summary

Although Lennox-Gastaut Syndrome can be particularly difficult to treat, Clobazam can provide relief from the seizures and convulsions associated with the condition. Whilst Clobazam may be prescribed for patients with anxiety and panic disorders, it is not usually a first-line of treatment for these conditions.

Predominantly prescribed to patients with childhood epilepsy, Clobazam does not represent a cure for the condition. Instead, Clobazam can be used to manage the patient's symptoms and reduce the frequency of convulsions. When used in conjunction with other medications, Clobazam can help to relieve the patient's symptoms and improve their quality of life.