Rivotril 2

Indications of Rivotril 2 Tablet

Epilepsy

Rivotril is indicated, primarily as an adjunct or in refractory cases, in most forms of epilepsy especially absence seizures including atypical absence seizures; Lennox-Gastaut syndrome; myoclonic and atonic seizures. For infantile spasms (including West-Syndrome) and tonic-clonic seizures it is only indicated as an adjunct or in refractory cases.

Panic disorder

Rivotril is indicated for the treatment of Panic Disorder, with or without agoraphobia.

 

Pharmacology of Rivotril 2 Tablet

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

 

Dosage & Administration of Rivotril 2 Tablet

Adults: The initial dose for adults with Panic Disorder is 0.25 mg twice daily (0.5 mg/day). An increase to 0.5 mg twice daily (1 mg/day) may be made after 3 days. Subsequent up-titration should be made at intervals of 3 days until Panic Disorder is controlled or until limited by side effects. The usual maintenance dose is 1 mg twice daily (2 mg/day). A maximum dose of 2 mg twice daily (4 mg/day) may be prescribed in exceptional cases. Once a stable dose is achieved, patients may switch to a once daily dose, usually taken at bedtime.

Duration of treatment: Maintenance treatment is recommended for at least 12-24 months, and in some cases, indefinitely. After at least 1 year of response gradual discontinuation should be attempted, with down-titration of 0.25 mg every 3 days, until the drug is completely withdrawn and close follow-up of the patient. Relapsing patients should begin taking medication again

 

Interaction of Rivotril 2 Tablet

Clonazepam appears to have no effect on the pharmacokinetics of phenytoin, carbamazepine, or phenobarbital. Clonazepam's impact on the metabolism of other medications has not been studied.

 

Contraindications

It should not be taken in individuals who have a history of benzodiazepine hypersensitivity, or in patients who have clinical or biochemical indications of severe liver damage. It is safe to use in individuals with open angle glaucoma who are getting adequate treatment, but it is not safe in people with acute narrow angle glaucoma.

 

Side Effects of Rivotril 2 Tablet

Clonazepam's most common adverse effects are those associated with CNS depression. Drowsiness has been observed in around 50% of individuals treated for seizures, with ataxia occurring in approximately 30%. In some situations, symptoms may fade with time; behavioral issues have been reported in roughly 25% of patients. Aphonia, coma, tremor, vertigo, disorientation, depression, forgetfulness, hallucinations, hysteria, increased libido, sleeplessness, psychosis, and palpitations are all possible side effects.

 

Pregnancy & Lactation

From preclinical studies it cannot be excluded that clonazepam possesses the possibility of producing congenital malformations. From epidemiological evaluations there is evidence that anticonvulsant drugs act as teratogens. However, it is difficult to determine from published epidemiological reports which drug or combination of drugs is responsible for defects in the newborn. The possibility also exists that other factors e.g. genetic factors or the epileptic condition itself may be more important than drug therapy in leading to birth defects. Under these circumstances, the drug should only be administered to pregnant women if the potential benefits outweigh the risk to the foetus. During pregnancy, Rivotril may be administered only if there is a compelling indication. Administration of high doses in the last trimester of pregnancy or during labour can cause irregularities in the heartbeat of the unborn child and hypothermia, hypotonia, mild respiratory depression and poor feeding in the neonate. It should be borne in mind that both pregnancy itself and abrupt discontinuation of the medication can cause exacerbation of epilepsy.

 

Precautions & Warnings

Clonazepam may increase the incidence or hasten the start of generalized tonic-clonic seizures when taken in individuals with multiple seizure disorders. This may necessitate the inclusion of anticonvulsants or an increase in their doses. Concurrent usage of valproic acid and Clonazepam may result in absent status.

 

Therapeutic Class

Central nervous system (CNS)

 

Storage Conditions

This medicine should not be used after the expiry date (EXP) shown on the pack.
Store in a cool & dry place at below 30°C, protect from light & moisture. 

 

Pharmaceutical Name of Rivotril 2 Tablet

Radiant Pharmaceutical Ltd

 

Generic of Rivotril 2 Tablet

Clonazepam