About this Medication
- How does this medication work? What will it do for me?
- How should I use this medication?
- What form(s) does this medication come in?
- Who should NOT take this medication?
- What side effects are possible with this medication?
- Are there any other precautions or warnings for this medication?
- What other drugs could interact with this medication?
How does this medication work? What will it do for me?
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 antiseizure 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.
This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.
Your doctor may have suggested this medication for conditions other than those 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.
Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.
How should I use this medication?
The recommended adult dose of clobazam ranges from 5 mg to 80 mg daily, as directed by your doctor, taken in 1 or 2 doses with or without food. Doses up to 30 mg daily may be taken as a single daily dose. Higher doses must be split into 2 daily doses. If the dose is divided, the higher portion of the dose should be taken at night. The dose is usually started at 5 mg to 15 mg daily and increased gradually as needed. For children 2 to 16 years, the starting dose should be 5 mg daily, increased gradually to a maximum of 40 mg per day. For children younger than 2 years, the starting dose is based on body weight. If you have reduced liver or kidney function, your doctor may recommend a lower 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 important to take this medication exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.
Store this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children.
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.
What form(s) does this medication come in?
Each white, uncoated, round tablet, scored on one side with "B" marked above the score line and "GL" below the score line, and the other side marked with a logo, contains clobazam 10 mg. Nonmedicinal ingredients: lactose, cornstarch, talc, colloidal silicon dioxide, and magnesium stearate.
Who should NOT take this medication?
Do not take this medication if you:
- are allergic to clobazam or any ingredients of the medication
- are allergic to other benzodiazepines (e.g., diazepam, lorazepam)
- are breast-feeding
- are in the first 3 months of pregnancy
- have a history of drug or alcohol dependence
- have acute narrow-angle (closed-angle) glaucoma
- have myasthenia gravis
- have severe breathing problems or sleep apnea
- have severe liver impairment
What side effects are possible with this medication?
Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.
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.
The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.
Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.
- blurred vision
- decreased interest in sexual activity
- dry mouth
- loss of appetite
- loss of muscle coordination
- weight gain
Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.
Check with your doctor as soon as possible if any of the following side effects occur:
- abnormal thinking (disorientation or loss of sense of reality)
- behavioural changes, including: aggressiveness, bizarre behaviour, decreased inhibition, angry outbursts
- decreased emotional responses
- difficulty breathing
- fast, pounding, or irregular heartbeat
- hallucinations (seeing or hearing things that are not there)
- increased restlessness, irritation, or mood swings
- memory difficulties
- muscle weakness
- signs of anemia (low red blood cells; e.g., dizziness, pale skin, unusual tiredness or weakness, shortness of breath)
- signs of bleeding (e.g., unusual nosebleeds, bruising, blood in urine, coughing blood, bleeding gums, cuts that don't stop bleeding)
- signs of a urinary tract infection (pain or burning sensation when urinating, frequent urination, blood in the urine)
- signs of pneumonia (e.g., fever, chills, shortness of breath, cough)
- trouble sleeping
Stop taking the medication and seek immediate medical attention if any of the following occur:
- frequent muscle spasms
- slow, shallow, or weak breathing
- symptoms of a serious allergic reaction (e.g., difficulty breathing, hives, swelling of the face, lips, or throat)
- symptoms of a serious skin reaction (e.g., skin blistering or peeling off; blistering of skin around the lips, eyes, mouth, nose, or genitals; skin rash with fever and muscle or joint pain)
- symptoms of lupus (red blotchy rash, mainly on the face, with fever, fatigue, nausea, or loss of appetite)
- thoughts of suicide
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.
Are there any other precautions or warnings for this medication?
Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.
HEALTH CANADA ADVISORY
October 30, 2020
Health Canada has issued new restrictions concerning the use of benzodiazepines and benzodiazepine-like prescription drugs. To read the full Health Canada Advisory, visit Health Canada's web site at www.hc-sc.gc.ca.
Asthma and breathing disorders: Clobazam can suppress breathing. If you have asthma, or another lung disease that increases your risk for breathing difficulties, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Drowsiness and reduced alertness: Clobazam causes drowsiness and slows down reaction time. Determine how clobazam affects you before performing potentially hazardous activities requiring mental alertness and physical coordination (such as driving or operating dangerous machinery).
Kidney function: Kidney disease or reduced kidney function may cause this medication to build up in the body, causing side effects. If you have reduced kidney function or kidney disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. People with severely reduced kidney function should not use this medication.
Liver function: Liver disease or reduced liver function may cause this medication to build up in the body, causing side effects. If you have liver problems, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. People with severely reduced liver function should not take this medication.
Mental and emotional disorders: Medications to treat seizures have been known to contribute to mood swings, symptoms of depression, aggravation of psychosis and other behavioural changes. If you have depression or a history of depression, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. If you experience symptoms of depression such as poor concentration, changes in weight, changes in sleep, decreased interest in activities, or notice them in a family member who is taking this medication, contact your doctor as soon as possible.
Myasthenia gravis: Myasthenia gravis is a condition that causes specific muscle weakness. Clobazam can make symptoms of this illness worse. People with myasthenia gravis should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Suicidal thoughts and behaviour: Some people taking anti-seizure medications may have suicidal thoughts or behaviour. If this happens to you or you notice this in a family member who is taking this medication, contact your doctor immediately. You should be closely monitored by your doctor for emotional and behaviour changes while taking this medication.
Tolerance: Clobazam may lead to tolerance when used for a long period of time. Tolerance means that your body gets used to the medication so that more medication may be needed to produce the same effect. Your doctor will recommend the dose of clobazam that is most appropriate for you. Do not change your dose or the way you are using the medication on your own. If you find that a dose of clobazam is not providing the same amount of seizure control as before, contact your doctor.
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:
- abdominal cramps
- extreme anxiety
- hypersensitivity to light
- memory impairment
- mood changes
- muscle pain
- sleep problems
- tension, restlessness
Reducing the dose gradually can help prevent or decrease these withdrawal symptoms. Do not try to stop the medication or reduce the dose on your own – consult your doctor for help.
Pregnancy: Clobazam is not recommended during the first 3 months of pregnancy as it may harm the development of the unborn baby. In later stages of pregnancy, it should not be used unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.
Breast-feeding: This medication passes into breast milk. If you are a breast-feeding mother and are taking clobazam, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding, however it is generally recommended that women do not breast-feed while they are taking this medication.
Seniors: The drowsiness caused by clobazam may affect seniors even more than others. Ask your doctor what you can do to reduce your risk of falls.
What other drugs could interact with this medication?
There may be an interaction between clobazam and any of the following:
- anesthetics (e.g., halothane, nitrous oxide)
- antihistamines (e.g,. cetirizine, doxylamine, diphenhydramine, hydroxyzine, loratadine)
- antipsychotics (e.g., chlorpromazine, clozapine, haloperidol, olanzapine, quetiapine, risperidone)
- "azole" antifungals (e.g., itraconazole, ketoconazole, voriconazole)
- barbiturates (e.g., butalbital, pentobarbital phenobarbital)
- benzodiazepines (e.g., alprazolam, diazepam, lorazepam)
- birth control pills
- chloral hydrate
- grapefruit juice
- HIV non-nucleoside reverse transcriptase inhibitors (NNRTIs; delaviridine, efavirenz, etravirine only)
- kava kava
- muscle relaxants (e.g., cyclobenzaprine, methocarbamol, orphenadrine)
- narcotic analgesics (e.g., codeine, morphine, hydrocodone, fentanyl)
- other seizure medications (e.g., carbamazepine, clobazam, ethosuximide, felbamate, levetiracetam, phenobarbital, phenytoin, primidone, topiramate, valproic acid, zonisamide)
- selective serotonin reuptake inhibitors (SSRIs; e.g., citalopram, duloxetine, fluoxetine, paroxetine, sertraline)
- theophyllines (e.g., aminophylline, oxtriphylline, theophylline)
- tricyclic antidepressants (e.g., amitriptyline, desipramine, imipramine, nortriptyline)
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. Speak to your doctor about how any drug interactions are being managed or should be managed.
Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications 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.
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