Disopan 2

Indications of Disopan 2 Tablet

It is suitable for the treatment of panic disorder with or without agoraphobia. Panic disorder is characterized by unexpected panic attacks and related concerns about recurrence, concerns about the effects or consequences of the attack.

It can also be used alone or as an adjuvant treatment for Lennox-Gastaut syndrome (minor variant), dyskinesias and myoclonic seizures. It may be suitable for patients with absence seizures (minor illnesses) who do not respond to succinimide.

The efficacy of long-term use of clonazepam, that is, more than 9 weeks, has not been systematically studied in controlled clinical trials. Clinicians who choose to use clonazepam for a prolonged period should periodically re-evaluate the long-term effectiveness of the drug for individual patients.

 

Pharmacology of Disopan 2 Tablet

Clonazepam has benzodiazepine-like pharmacological characteristics, such as anticonvulsive, sedative, muscle relaxing, and anxiolytic actions. Benzodiazepines' central effects are mediated by an increase in GABAergic neurotransmission at inhibitory synapses. Positive allosteric modulation of the GABA receptor for the neurotransmitter is increased in the presence of benzodiazepines, resulting in greater effect of released GABA on the postsynaptic transmembrane chloride ion flow.

There is additional evidence of clonazepam's impact on serotonin in animals. Clonazepam suppresses many types of paroxysmal activity, including spike and wave discharge in absence of seizures (petit mal), slow spike wave, generalized spike wave, spikes with temporal or other locations, as well as irregular spikes and waves, according to animal data and electroencephalographic investigations in humans. EEG abnormalities in general are repressed more frequently than abnormalities in specific areas. Clonazepam appears to be helpful in both widespread and localized epilepsies, according to these studies.

 

Dosage & Administration of Disopan 2 Tablet

Oral:

• Adults: The initial dose for adults with seizure disorders should not exceed 1.5 mg/day divided into three doses. Dosage may be increased in increments of 0.5 to 1 mg every 3 days until seizures are adequately controlled or until side effects preclude any further increase. Maintenance dosage must be individualized for each patient depending upon response. Maximum recommended daily dose is 20 mg.

• The initial dose for adults with panic disorder is 0.25 mg given in two divided dose. An increase to the target dose for most patients of 1 mg/day may be made after 3 days.
• Pediatric Patients: In order to minimize drowsiness, the initial dose for infants and children (up to 10 years of age or 30 kg of body weight) should be between 0.01 and 0.03 mg/kg/day but not to exceed 0.05 mg/kg/day given in two or three divided doses.

Injection:

• Infants and children: half of a vial (0.5 mg) by slow IV injection or by IV infusion.

• Adults: 1 vial (1 mg) by slow IV injection or by IV infusion. This dose can be repeated as required (1-4 mg are usually sufficient to reverse the status). In adults, the rate of injection must not exceed 0.25 - 0.5 mg per minute (0.5-1.0 ml of the prepared solution) and a total dose of 10 mg should not be exceeded.

 

Interaction of Disopan 2 Tablet

Phenytoin, carbamazepine, and phenobarbital pharmacokinetics do not appear to be affected by clonazepam. Clonazepam's impact on the metabolism of other medications has not been studied.

 

Contraindications

It should not be used in individuals who have a history of benzodiazepine hypersensitivity, as well as those who have clinical or biochemical indications of severe liver damage. It can be utilized in individuals with open angle glaucoma who are on the right medication, but it's not recommended for acute narrow angle glaucoma.

 

Side Effects of Disopan 2 Tablet

Clonazepam's most common adverse effects include depression of the central nervous system (CNS). Drowsiness has been reported in around 50 percent of patients treated for seizures, with ataxia occurring in approximately 30 percent. These may improve with time in some situations; behavior issues have been reported in about 25% of individuals. Aphonia, coma, tremor, vertigo, disorientation, sadness, forgetfulness, hallucinations, hysteria, increased libido, sleeplessness, psychosis, and palpitations are some of the symptoms that might arise.

 

Pregnancy & Lactation

Pregnancy: It cannot be ruled out from preclinical studies that clonazepam has the possibility of birth defects. From epidemiological evaluation, there is evidence that anticonvulsants can be used as teratogens. However, it is difficult to determine from published epidemiological reports which drug or drug combination is the cause of neonatal defects. There is also the possibility that other factors exist. For example, genetic factors or epilepsy itself may be more important than medications in causing birth defects. In these cases, the drug should be used for pregnant women only when the potential benefits outweigh the risks to the fetus. During pregnancy, clonazepam should only be used if there are compelling indications. The use of high doses in the last trimester of pregnancy or during delivery can cause irregular heartbeats in the fetus and neonatal hypothermia, hypotonia, mild respiratory depression and poor diet. It should be remembered that both pregnancy itself and sudden withdrawal from the drug can cause seizures. Benzodiazepines occasionally cause withdrawal symptoms in newborns.

Nursing Mothers: Although only a small amount of the active ingredient in clonazepam has been found to pass into breast milk, mothers receiving this drug should not breastfeed. If there are convincing indications for clonazepam, breastfeeding should be stopped.

 

Precautions & Warnings

Clonazepam may increase the incidence or hasten the start of generalized tonic-clonic seizures in individuals who have multiple distinct forms of seizure disorders. This may necessitate the addition of or an increase in the dosage of anticonvulsants. The use of valproic acid and Clonazepam at the same time might cause absent status.

 

Therapeutic Class

Adjunct anti-epileptic drugs, Benzodiazepine hypnotics

 

Storage Conditions

Keep away from light and heat in a dry area. Keep out of children's reach.

 

Pharmaceutical Name of Disopan 2 Tablet

Incepta Pharmaceuticals Ltd

 

Generic of Disopan 2 Tablet

Clonazepam