Clobazam belongs to the class of medications known as benzodiazepines. It is used to treat certain seizure disorders. It is used as an add-on to other anti-seizure medications when extra treatment for control of seizures is needed. Seizures are caused by uncontrolled firing of neurons in the brain (also referred to as increased electrical activity in the brain). This medication works by reducing the rate of firing of these neurons.

Your doctor may have suggested this medication for conditions other than the ones listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

The recommended adult dose of clobazam ranges from 5 mg to 80 mg daily, as directed by the doctor, taken in one or two doses with or without food. The dose is usually started at 5 mg to 15 mg daily and increased gradually as needed. For children two to 16 years, the initial dose should be 5 mg daily, increased gradually to a maximum of 40 mg per day. For children younger than two years, the initial dose is based on body weight. People with reduced liver or kidney function should take a reduced dose.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is very important that this medication be taken on a regular schedule as prescribed by the doctor. If you miss a dose of this medication, take it as soon as you remember it. If it is almost time for your next dose, skip the missed dose and carry on with your regular schedule. Do not double-up on doses.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Each white to off-white, round, flat-faced, bevel-edged, compressed tablet, engraved N on one side and 1|0 on the other side, contains clobazam 10 mg. Nonmedicinal ingredients: colloidal silicon dioxide, cornstarch, lactose monohydrate, magnesium stearate, sodium starch glycolate and talc.

Some medications may have other generic brands available. Always ask your doctor or pharmacist about the safety of switching between brands of the same medication.

Clobazam should not be taken by anyone who:

• has an allergy to clobazam or any of the other ingredients of the medication or an allergy to other benzodiazepines
• has myasthenia gravis
• has acute narrow-angle (closed-angle) glaucoma
• has a history of drug or alcohol dependence with severe breathing problems or sleep apnea
• has severe liver impairment
• is in the first three months of pregnancy
• is breast-feeding

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor. Your health professional may be able to help you to deal with some of the effects.

The following side effects may go away as your body becomes used to the medicine; check with your doctor if they continue or become bothersome.

More common:

• clumsiness or unsteadiness
• dizziness or lightheadedness
• drowsiness
• slurred speech

  Less common or rare:

• abdominal or stomach cramps or pain
• blurred vision or other changes in vision
• changes in sexual desire or ability
• constipation
• diarrhea
• dryness of mouth or increased thirst
• false sense of well-being
• headache
• increased lung secretions or watering of mouth
• muscle spasm
• nausea or vomiting
• problems with urination
• trembling or shaking
• unusual tiredness or weakness
• weight gain

Check with your doctor as soon as possible if any of the following side effects occur:

Less common:

• anxiety
• confusion
• fast, pounding, or irregular heartbeat
• lack of memory
• depression

  Rare:

• abnormal thinking (disorientation or loss of sense of reality)
• agitation
• behavioural changes, including:
  • aggressiveness
  • bizarre behaviour
  • decreased inhibition
  • angry outbursts
• convulsions (seizures)
• hallucinations
• low blood pressure
• muscle weakness
• skin rash or itching
• sore throat, fever, and chills
• trouble sleeping
• ulcers or sores in mouth or throat
• uncontrolled movements of body, including the eyes
• unusual bleeding or bruising
• unusual excitement, nervousness, or irritability
• unusual tiredness or weakness (severe)
• yellow eyes or skin

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Liver and kidney disease: Clobazam should not be used by people with severely impaired liver function. People with less severe liver or kidney impairment may require lower doses of clobazam.

Medical conditions: Clobazam is not recommended for use by people with depression or psychosis. It should be used with caution by seniors, those who are debilitated, those with organic brain disorders such as dementia, and those with breathing problems such as asthma.

Occupational hazards: Since clobazam causes drowsiness, undertaking potentially hazardous activities requiring mental alertness and physical coordination (such as driving or operating dangerous machinery) is not recommended until you determine how clobazem affects you.

Withdrawal: Clobazam can become habit-forming. Withdrawal symptoms similar to those occurring with other medications of this class have been observed when clobazam was stopped suddenly after it was taken regularly over a period of time. Withdrawal symptoms include:

seizures irritability mood changes nervousness sleep problems agitation tremors diarrhea abdominal cramps

vomiting memory impairment headache muscle pain extreme anxiety tension, restlessness confusion sweating hypersensitivity to light

Reducing the dose gradually can help prevent or decrease these withdrawal symptoms.

Pregnancy: Clobazam is not recommended during the first three months of pregnancy. In later stages of pregnancy, it must only be used if there are compelling reasons. The risks posed by the medication must be weighed against the risks posed by seizures. If you are or may be pregnant and are taking clobazam, it is important to contact your doctor about stopping the medication.

Breast-feeding: Nursing mothers who require clobazam should not breast-feed, since some of the medication passes into breast milk.

Seniors: The drowsiness caused by clobazam may affect seniors even more than others. Extra caution is needed, for example, to prevent accidental falls when getting up during the night.

The following medications may affect how clobazam works or increase the risk of side effects:

• alcohol
• anesthetics (e.g., halothane, nitrous oxide)
• antipsychotics (e.g., haloperidol, droperidol)
• carbamazepine
• lithium
• narcotic analgesics (e.g., codeine, morphine, hydrocodone, fentanyl)
• phenobarbital
• phenytoin
• sedative-hypnotics (e.g., chloral hydrate)
• sedating antihistamines (e.g., chlorpheniramine)
• valproate

The following medications may be affected by clobazam:

• carbamazepine
• lithium
• muscle relaxants (e.g., methocarbamol)
• phenobarbital
• phenytoin
• valproate

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. In many cases, interactions are intended or are managed by close monitoring. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than the ones listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications that you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.