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  • Rivotril
  • Unusually potent at antag. effects of pentylenetetrazol but almost without action in ECT-induced seizures thus has anticonvulsant activity in wide range of seizure type with notable exception of generalised tonic-clonic seizures & thus useful in absences & myoclonic seizures in children but tolerance to these actions often develop after 1-6mths when no dose of clonazepam will be of use!!;
  • Plasma Rx range not helpful; Optimal dose hard to predict;
  • To avoid sedation/irritability, keep initial dose low (eg. 0.25mg bd) & increased wkly.
  • Chronic use → behav. effects, drowsiness, lethargy, hypotonia;
  • High-dose as in IV 0.25-1mg use (as with IV diazepam) → reduce sustained high-frequency firing of neurons similar to that seen with phenytoin, carbamazepine & sodium valproate (Epilim);
  • After IV dose → redistributed (→ muscle → fat) terminating action;

Clinical usage and dosages


  • useful in acute Mx of absences & myoclonic seizures in children
  • Draw up all of 1ml ampoule (ie. 1mg) of clonazepam into 2ml syringe and dilute with 1ml diluent thus making final concentration of 0.5mg/ml.
  • ventilated neonate: 0.25mg IV
  • child:
    • Give 0.25mg slow IV over 1min, and repeat in 0.125mg doses every 2-3min as needed up to 1mg over 5-10min.
  • adult 1.0mg IV
clonazepam.txt · Last modified: 2011/08/25 11:22 by

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