Impaired hepatic function : in severely impaired liver function, use is contraindicated. In case of mild to moderate hepatic impairment, use the lowest possible dose and be careful.
Impaired Renal Function : No dosage adjustment is necessary as renal dysfunction does not affect pharmacokinetics.
In the elderly : use the lowest possible dose. Due to age-related changes in receptor interactions, post-receptor mechanisms and organ function, the effect may be greater in the elderly than in the young at similar plasma concentrations.
Administration
- Administer the drops mixed with water, tea or fruit juice on a spoon;
- Do not use PVC infusion bags or systems as clonazepam is absorbed by PVC (this can lead to a 50% reduction in concentration after a 24 hour contact period). Use caution when changing from PVC-containing to PVC-free infusion systems and bags.
Interactions
Central depressants potentiate the central effect of benzodiazepines. When combined, careful consideration should be given to the dosage of the various antiepileptic drugs to avoid potentiating side effects or inducing a seizure.
Carbamazepine, lamotrigine, phenytoin phenobarbital and possibly also valproic acid may decrease plasma levels.
Clonazepam, when used concomitantly, may not affect, decrease or increase phenytoin levels, depending on dosage and patient-related factors.
Concomitant use of primidone can lower the level of clonazepam, but also cause more side effects.
Do not consume alcohol as this may reduce the effectiveness of the treatment and cause severe sedation and respiratory and cardiovascular depression.
