Clobazam
Mechanism :
Clobazam is a benzodiazepine derivative. It is an anxiolytic and an anticonvulsant.
Indication :
- Absence seizure
- Tonic and clonic seizure
- Atonic seizure
- Myoclonic seizure
- Partial seizure
- Catamenial (menstruation) seizures
- Cluster seizure
Contraindications :
Acute severe respiratory insufficiency, alcohol or drug dependence, myasthenia gravis, sleep apnea, hepatic dysfunction. Dose adjustment is required in hepatic and renal impairment.
Dosing :
<12 years:
Initially oral 125 microgram/kg/dose BDS, followed by 250 microgram/dose, Max: 500 microgram/dose in 2 doses.
12-18 years:
10 mg/dose 2 times daily followed by maintenance doses 10-15 mg/dose, Max: 30 mg/dose in 2 doses.
Adverse Effect :
Somnolence, pyrexia, tachyphylaxis, behaviour disturbance and cognitive dysfunction.
Interaction :
Antiepileptics: May alter plasma levels of other antiepileptics.
Cimetidine: May enhance the effects.
Rifampicin: May reduce the effects of clobazam.
Renal Dose :
Dose in Renal Impairment GFR (mL/min)
| 20-50 | Dose as in normal renal function |
| 10-20 | Dose as in normal renal function |
| <10 | Dose as in normal renal function. Start with low doses |
Dose in Patients undergoing Renal Replacement Therapies
| CAPD | Unlikely to be dialysed. Dose as in GFR<10 mL/min |
| HD | Not dialysed. Dose as in GFR<10 mL/min |
| HDF/High flux | Unlikely to be dialysed. Dose as in GFR<10 mL/min |
| CAV/VVHD | Unknown dialysability. Dose as in normal renal function |
Hepatic Dose :
Mild to moderate hepatic impairment
> 30 kg: Start with 5 mg PO OD and increase to 5 mg PO BD after one week, 10 mg PO BD after 2 weeks and then 20 mg PO BD at the end of 3 weeks if clinically indicated.
< 30kg: Start with 5 mg PO OD and increase to 5 mg PO BD after two weeks, 10 mg PO BD after 3 weeks if clinically indicated.
Severe hepatic impairment
Dosing data not available.