Pharm
Clobazam
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Clobazam
, Sympazan, Onfi
See Also
Seizure Disorder
Indications
Seizure Disorder
(Lennox-Gastaut Syndrome)
Adjunctive anticonvulsant
Mechanism
Benzodiazepine
and partial
Gamma-Aminobutyric Acid
(
GABA
) receptor
Agonist
Anticonvulsant,
Sedative
and
Anxiolytic
properties
Binds CNS at the
Benzodiazepine
-
GABA
-A-chloride ionophore receptor complex
GABA
affinity becomes increased at receptor site resulting in increased
Neuron
chloride channel opening
Hyperpolarizes the
Neuron
, inhibiting the
Action Potential
and a decreasing
Neuron
excitability
Precautions
Exercise
caution in elderly
Avoid in combination with
Opioid
s and other
Sedative
s (e.g. other
Benzodiazepine
s)
May result in respiratory depression or coma
Dosing
Seizure Disorder
(Lennox-Gastaut Syndrome)
Available as tablets, oral suspension (2.5 mg/ml) and oral films (Sympazan)
Film (Sympazan) should be applied to
Tongue
and allowed to dissolve (do not take with liquids)
Weight >30 kg (and age >=2 years)
Start 5 mg orally twice daily
Increase to 10 mg orally twice daily after 1 week
Increase to 20 mg orally twice daily after 2 weeks
Weight <30 kg (and age >=2 years)
Start 5 mg orally daily
Increase to 5 mg orally twice daily after 1 week
Increase to 10 mg orally twice daily after 2 weeks
Metabolism
CYP2C19
metabolism
Lower dose and titrate slowly in slow
CYP2C19
metabolizers
Safety
Avoid in Pregnancy
Use in second and third trimester associated with fetal adverse effects
Effects include decreased fetal movement,
Floppy Infant
syndrome and medication dependence and withdrawal
Unknown Safety in
Lactation
Resources
Clobazam (DailyMed)
https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=a77ffbdd-4e3e-4ec4-b0fa-b51ee610df0f
References
(2022) Presc Lett, Resource #361206, Antiseizure Medications
Olson (2020) Clinical
Pharmacology
, Medmaster Miami, p. 56-7
Hamilton (2020) Tarascon Pocket Pharmacopoeia
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