Indications
Klarix is prescribed for:
- Treatment of panic disorder, with or without agoraphobia, characterized by unexpected panic attacks and anxiety about future attacks.
- Management of Lennox-Gastaut Syndrome (petit mal variant), as well as akinetic and myoclonic seizures.
- Cases of absence seizures (petit mal) that have not responded to succinimides.
Long-term effectiveness (beyond 9 weeks) has not been thoroughly studied in clinical trials. Physicians should regularly assess the necessity of continuing treatment with Klarix.
Always consult a registered healthcare professional before use.
Pharmacology
Klarix contains clonazepam, which belongs to the benzodiazepine class, offering anticonvulsive, sedative, muscle relaxant, and anxiolytic properties. Its mechanism involves enhancing GABAergic neurotransmission at inhibitory synapses, increasing the efficacy of GABA on chloride ion flux across postsynaptic membranes. Clonazepam has demonstrated efficacy in suppressing various types of paroxysmal activity in EEG studies, proving beneficial for both generalized and focal epilepsies.
Dosage & Administration
Oral Dosage:
- Adults: Start with a maximum of 1.5 mg/day, divided into three doses. Adjust in increments of 0.5 to 1 mg every three days as needed. Maximum dose is 20 mg.
- Panic Disorder: Begin with 0.25 mg in two doses; increase to 1 mg/day after three days.
- Children: Initial dose is 0.01 to 0.03 mg/kg/day (max 0.05 mg/kg/day) divided into two or three doses.
Injection:
- Infants and Children: 0.5 mg via slow IV injection or infusion.
- Adults: 1 mg via slow IV injection or infusion, repeating as necessary (total max of 10 mg). Injection rate should not exceed 0.25-0.5 mg/min.
Always consult a registered healthcare professional before use.
Interactions
Klarix does not significantly affect the pharmacokinetics of phenytoin, carbamazepine, or phenobarbital. The impact on other medications has not been thoroughly evaluated.
Contraindications
Klarix is contraindicated in patients with hypersensitivity to benzodiazepines and those with significant liver disease. Caution is advised for patients with open-angle glaucoma receiving appropriate therapy; avoid in acute narrow-angle glaucoma.
Side Effects
Common side effects include:
- Drowsiness (occurring in ~50% of patients)
- Ataxia (~30% of patients)
- Behavior issues (~25% of patients)
- Other possible effects: abnormal eye movements, confusion, depression, and hallucinations.
Pregnancy & Lactation
Use during pregnancy should only occur if benefits outweigh risks, as clonazepam may cause congenital malformations. Breastfeeding is not recommended during treatment.
Precautions & Warnings
Discontinue Klarix if severe hypersensitivity reactions occur. Monitor for generalized tonic-clonic seizures in patients with multiple seizure types. Use with caution in patients on other CNS depressants.
Use in Special Populations
- Pediatric: Increased saliva and bronchial secretions may occur in young patients, requiring airway management.
- Geriatric: Effects may be more pronounced in the elderly due to age-related changes.
- Renal and Hepatic Impairment: No dosage adjustment is needed for renal impairment; hepatic impairment may alter clearance.
Overdose Effects
Overdose may cause drowsiness, ataxia, or more severe respiratory depression and hypotension. Supportive measures are crucial, and flumazenil may be considered in severe cases.
Therapeutic Class
Benzodiazepine hypnotics, adjunct anti-epileptic drugs.
Reconstitution & Storage Conditions
For IV use, dilute with sterile water and monitor during administration. Store in a dry place, away from light and heat, and keep out of reach of children.
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