clorazepate

Pronunciation

Generic Name: clorazepate (klor AZ e pate)
Brand Name: Tranxene SD, Tranxene T-Tab

What is clorazepate?

Clorazepate is in a group of drugs called benzodiazepines (ben-zoe-dye-AZE-eh-peens). Clorazepate affects chemicals in the brain that may become unbalanced and cause anxiety or seizures.

Clorazepate is used to treat anxiety disorders, partial seizures, or alcohol withdrawal symptoms.

Clorazepate may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about clorazepate?

Do not use this medication if you are allergic to clorazepate or to other benzodiazepines, such as alprazolam (Xanax), chlordiazepoxide (Librium), diazepam (Valium), lorazepam (Ativan), or oxazepam (Serax).

This medication can cause birth defects in an unborn baby. Do not use clorazepate if you are pregnant.

Slideshow: Flashback: FDA Drug Approvals 2013

Before taking clorazepate, tell your doctor if you have any breathing problems, glaucoma, kidney or liver disease, or a history of depression, suicidal thoughts, or addiction to drugs or alcohol.

Do not drink alcohol while taking clorazepate. This medication can increase the effects of alcohol.

Avoid using other medicines that make you sleepy. They can add to sleepiness caused by clorazepate.

Clorazepate may be habit-forming and should be used only by the person it was prescribed for. Clorazepate should never be shared with another person, especially someone who has a history of drug abuse or addiction. Keep the medication in a secure place where others cannot get to it.

What should I discuss with my healthcare provider before taking clorazepate?

Do not use this medication if you have narrow-angle glaucoma, or if you are allergic to clorazepate or to other benzodiazepines, such as alprazolam (Xanax), chlordiazepoxide (Librium), diazepam (Valium), lorazepam (Ativan), or oxazepam (Serax).

Before taking clorazepate, tell your doctor if you are allergic to any drugs, or if you have:

  • glaucoma;

  • asthma, emphysema, bronchitis, chronic obstructive pulmonary disorder (COPD), or other breathing problems;

  • kidney or liver disease;

  • epilepsy or other seizure disorder;

  • a history of depression or suicidal thoughts or behavior; or

  • a history of drug or alcohol addiction.

If you have any of these conditions, you may need a dose adjustment or special tests during treatment.

Clorazepate can cause birth defects in an unborn baby. Do not use clorazepate without your doctor's consent if you are pregnant. Tell your doctor if you become pregnant during treatment. Use an effective form of birth control while you are using this medication.

Clorazepate can pass into breast milk and could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

The sedative effects of clorazepate may last longer in older adults. Accidental falls are common in elderly patients who take benzodiazepines. Use caution to avoid falling or accidental injury while you are taking clorazepate.

Do not give this medication to a child younger than 9 years old.

How should I take clorazepate?

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.

Your doctor may occasionally change your dose to make sure you get the best results from this medication.

Clorazepate should be used for only a short time. Do not take this medication for longer than 4 months without your doctor's advice.

Clorazepate may be habit-forming and should be used only by the person it was prescribed for. Clorazepate should never be shared with another person, especially someone who has a history of drug abuse or addiction. Keep the medication in a secure place where others cannot get to it.

Contact your doctor if this medicine seems to stop working as well in treating your anxiety symptoms.

Do not stop using clorazepate suddenly without first talking to your doctor. You may need to use less and less before you stop the medication completely.

Your symptoms may return when you stop using clorazepate after using it over a long period of time. You may also have withdrawal symptoms when you stop using clorazepate. Withdrawal symptoms may include tremor, sweating, trouble sleeping, muscle cramps, stomach pain, vomiting, diarrhea, irritability, memory problems, confusion, unusual thoughts or behavior, and seizure (convulsions).

To be sure this medication is not causing harmful effects, your blood and liver function may need to be tested on a regular basis. Do not miss any scheduled visits to your doctor.

Store clorazepate at room temperature away from moisture, heat, and light.

Keep track of how many pills have been used from each new bottle of this medicine. Benzodiazepines are drugs of abuse and you should be aware if any person in the household is using this medicine improperly or without a prescription.

What happens if I miss a dose?

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at your next regularly scheduled time. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine. An overdose of clorazepate can be fatal.

Overdose symptoms may include extreme drowsiness, feeling light-headed, fainting, or coma.

What should I avoid while taking clorazepate?

Do not drink alcohol while taking clorazepate. This medication can increase the effects of alcohol.

Clorazepate can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

Tell your doctor if you regularly use other medicines that make you sleepy (such as cold or allergy medicine, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures, depression, or anxiety). They can add to sleepiness caused by clorazepate.

Clorazepate side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have any of these serious side effects:

  • confusion, unusual thoughts or behavior;

  • depressed mood, thoughts of suicide or hurting yourself;

  • muscle twitching, tremor; or

  • problems with urination.

Less serious side effects may include:

  • drowsiness, tiredness;

  • amnesia or forgetfulness;

  • dizziness;

  • blurred vision;

  • feeling nervous or irritable;

  • sleep problems (insomnia);

  • muscle weakness, lack of balance or coordination;

  • skin rash;

  • nausea, vomiting, stomach pain, constipation; or

  • dry mouth; or

  • headache.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Clorazepate dosing information

Usual Adult Dose for Anxiety:

Initial dose: 15 mg orally once a day at bedtime or 7.5 mg orally twice a day.
Maintenance dose: 15 to 60 mg in divided doses.
Usual dose: 15 mg orally twice a day.

Usual Adult Dose for Alcohol Withdrawal:

Day 1 dose: 30 mg initially, followed by 30 to 60 mg in divided doses.
Day 2 dose: 45 to 90 mg in divided doses.
Day 3 dose: 22.5 to 45 mg in divided doses.
Day 4 dose: 15 to 30 mg in divided doses.
Then, gradually reduce the daily dose to 7.5 to 15 mg. Discontinue drug therapy as soon as patient's condition is stable.
The maximum recommended total daily dose is 90 mg.
Avoid excessive reductions in the total amount of drug administered on successive days.

Usual Adult Dose for Seizure Prophylaxis:

Initial Dose: 7.5 mg orally three times a day.
Maintenance dose: May increase by 7.5 mg every week and should not exceed 90 mg/day.

Usual Geriatric Dose for Anxiety:

Initial dose: 7.5 mg orally once a day at bedtime or 3.75 mg orally twice a day.
Maintenance dose: May increase as needed and tolerated.

Usual Geriatric Dose for Seizure Prophylaxis:

Initial Dose: 3.75 mg orally three times a day.
Maintenance dose: May increase as needed and tolerated.

Usual Pediatric Dose for Seizure Prophylaxis:

9 to less than 13 years: Initial dose: 7.5 mg orally twice a day.
Maintenance dose: May increase by no more than 7.5 mg every week and should not exceed 60 mg/day.

Less than or equal to 13 years: Initial dose: 7.5 mg orally 3 times a day.
Maintenance dose: May increase by no more than 7.5 mg every week and should not exceed 90 mg/day.

What other drugs will affect clorazepate?

Before taking clorazepate, tell your doctor if you are taking any other anti-anxiety medications, or if you are using any of the following drugs:

  • a barbiturate such as amobarbital (Amytal), butabarbital (Butisol), mephobarbital (Mebaral), secobarbital (Seconal), or phenobarbital (Luminal, Solfoton);

  • an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate);

  • medicines to treat psychiatric disorders, such as chlorpromazine (Thorazine), haloperidol (Haldol), mesoridazine (Serentil), pimozide (Orap), or thioridazine (Mellaril);

  • narcotic medications such as butorphanol (Stadol), codeine, hydrocodone (Lortab, Vicodin), levorphanol (Levo-Dromoran), meperidine (Demerol), methadone (Dolophine, Methadose), morphine (Kadian, MS Contin, Oramorph), naloxone (Narcan), oxycodone (OxyContin), propoxyphene (Darvon, Darvocet); or

  • antidepressants such as amitriptyline (Elavil, Etrafon), amoxapine (Asendin), citalopram (Celexa), clomipramine (Anafranil), desipramine (Norpramin), doxepin (Sinequan), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), imipramine (Janimine, Tofranil), nortriptyline (Pamelor), paroxetine (Paxil), protriptyline (Vivactil), sertraline (Zoloft), or trimipramine (Surmontil).

This list is not complete and there may be other drugs that can interact with clorazepate. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

  • Your pharmacist can provide more information about clorazepate.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 5.04. Revision Date: 2010-12-15, 5:01:39 PM.

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