Clonazepam (Rivotril): Uses, Side Effects,Mechanism & Dosage

Clonazepam (Brand name Rivotril) belongs to a group of drugs known as Benzodiazepine.Other members of This group are diazepam, alprazolam, Lorazepam, and Flurazepam.Generally, these drugs are used as a sedative, or to decrease anxiety and Seizures.

Clonazepam is available as

• Rivotril Injection 1 mg/mL

Rivotril Tablets include;

• Rivotril 0.5 mg
• Rivotril 2 mg  (Rivotril 2 mg tablet is used is a very effective medicine for the treatment of seizures of different types. It is also used to treat panic attacks and sleep disorders.)
• Klonopin Tablets.

Rivotril Uses

Rivotril (Clonazepam) is used primarily as an anticonvulsant in the treatment of;

• Absence seizures,
• Petit mal variant seizures (Lennox-Gastaut syndrome),
• Akinetic and myoclonic seizures, and
• Nocturnal myoclonus.
• It can also be used for the treatment of panic disorders.

Pharmacokinetics

Clonazepam is rapidly and completely absorbed after oral administration. The absolute bioavailability of clonazepam is approximately 90%. C max, oral administration = 1-4 hours. The biotransformation occurs mainly by reduction of the 7-nitro group to the 4-amino derivative. This derivative can be acetylated, hydroxylated and glucuronide. 85% bound to plasma proteins. and the half-life of clonazepam is 30 to 40 hours. It is highly metabolized, with less than 2% unchanged Clonazepam excreted in the urine. Clonazepam metabolites are excreted by the kidneys. Clonazepam is also acetylated via NAT2.

Rivotril Mechanism Of Action

Benzodiazepines act on specific receptors in the CNS. These are located on a complex glycoprotein molecule that surrounds a chloride channel.This Glycoprotein act as a GABA Receptor.This GABA receptor is made up of five subunits, a pentameric structure.These Five Subunits are selected from eight types if polypeptides, alpha, beta, gamma, delta, epsilon, Pi, Rho, and Theta.There are six different types of alpha, four types of beta and three types of gamma subunits.Alpha, Beta and Gamma subunits are the major polypeptide of the GABA receptors and their presence is essential for normal function of the receptor.They are distributed in various combinations in different parts of the CNS.Clonazepam enhances the activity of gamma-aminobutyric acid (GABA), which is a major inhibitory neurotransmitter in the central nervous system.Binding of GABA on these receptors causes the opening of chloride channels.This causes passage of chloride ions into neuron increasing negative ions inside the neurons.This result in hyperpolarization of neurons and these are difficult to be depolarised.

Rivotril Side Effects

The more common side effects of clonazepam oral tablet can include:

• Dizziness
• A headache
• Weakness
• Drowsiness
• Amnesia
• Confusion
• Depression
• Problems with walking and coordination
• Problems with memory
• Fatigue

While Serious side effects include the following:

• Depressed mood or thoughts of suicide (harming yourself)
• Seizures
• Respiratory Depression
• Low Blood Pressure
• Increased Heart Rate.

Don’t Use Rivotril If 

• You Have acute narrow or closed angle glaucoma
• You Are allergic to clonazepam or any ingredients of the medication
• You Have had an allergic reaction to any other medicine of benzodiazepine group.s
• You have myasthenia gravis
• You have sleep apnea
• You have severe breathing problems
• You have a severe liver disease.

Rivotril In Pregnancy

If you take Clonazepam during pregnancy, your baby is at risk of serious birth defects. These defects can occur in the first month of pregnancy, even before you know that you are pregnant. Congenital malformations may even occur in children born to women who are not on medication and have no other risk factors. This medicine should be used during pregnancy only in severe cases where it is necessary to treat a dangerous condition in the mother.

Clonazepam Dosage 

• Rivotril injection, Clonazepam 1 mg /ml in Solvent for dilution with 1 ml water for injections immediately before injection.

The dose of Klonopin Tablets and Rivotril Tablet (Containing Clonazepam) is tailored to the patient’s needs.

• For adult convulsions, the starting dose is 1.5 mg daily in 3 divided doses.The dosage may be increased from 0.5 to 1 mg per day every 3 days until seizures are controlled or side effects prevent further dose increase.
  The maximum dose is 20 mg per day. The starting dose for panic disorder is 0.25 mg twice daily.
  The dose may be increased to the target dose of 1 mg daily after 3 days.

Related Article: Pharmacology Of Benzodiazepines