Please check your internet connection and try again.
# Clobazam (Oral Formulation)
## Overview
Clobazam is a benzodiazepine derivative with anticonvulsant properties. It is primarily used as adjunctive therapy for seizures associated with Lennox-Gastaut syndrome (LGS).
## Primary Indications
* Adjunctive therapy for seizures in patients 2 years of age and older with Lennox-Gastaut syndrome (LGS).
## Adult Dosing
* **Initiation:** Start with 5 mg twice daily.
* **Titration:** Increase dose every week as tolerated, up to a maximum of 10 mg twice daily.
* **Maintenance:** Usual maintenance dose is 10 mg twice daily. The maximum recommended dose is 20 mg twice daily.
## Pediatric Dosing (2 to <10 years or <30 kg)
* **Initiation:** Start with 2.5 mg twice daily.
* **Titration:** Increase dose every week as tolerated, up to a maximum of 5 mg twice daily.
* **Maintenance:** Usual maintenance dose is 5 mg twice daily. The maximum recommended dose is 10 mg twice daily.
*Note: Dosing in pediatric patients may depend on weight and local protocol.*
## Dose Adjustments
* **Hepatic Impairment:** Use with caution. Consider a lower starting dose and slower titration. Data is limited.
* **Renal Impairment:** Use with caution. Consider a lower starting dose and slower titration. Data is limited.
## Contraindications
* Hypersensitivity to clobazam or other benzodiazepines.
## Adverse Effects
Common adverse effects include somnolence, decreased appetite, constipation, aggression, irritability, vomiting, and difficulty with coordination. Serious adverse effects include severe skin reactions (e.g., Stevens-Johnson syndrome), respiratory depression, and potential for dependence and withdrawal.
## Key Drug Interactions
* **CNS Depressants (e.g., opioids, alcohol, other sedatives):** Increased risk of sedation, respiratory depression, and death.
* **CYP2C19 Inhibitors (e.g., fluconazole, omeprazole):** May increase clobazam plasma concentrations.
* **CYP2C19 Inducers (e.g., rifampin, carbamazepine):** May decrease clobazam plasma concentrations.
* **Antiepileptic Drugs (AEDs):** Potential for additive CNS depression; monitor for excessive sedation.
## Monitoring
* Monitor for excessive sedation, respiratory depression, and behavioral changes.
* Monitor for signs of severe skin reactions.
* Assess for effectiveness and tolerability, especially during dose titration.
* Consider monitoring for withdrawal symptoms upon discontinuation.
## Clinical Pearls
* Clobazam should be tapered gradually when discontinuing to avoid withdrawal symptoms.
* Patients and caregivers should be educated about the risks of severe skin reactions and to seek immediate medical attention if they occur.
* Due to its long half-life, clobazam may be given once or twice daily.
***
*This information is intended for healthcare professionals. Always consult the most current prescribing information and institutional protocols before making clinical decisions.*
