Clorazepate Dosage

Medically reviewed by Drugs.com. Last updated on Aug 2, 2023.

Usual Adult Dose for Anxiety

Initial dose: 15 mg orally at bedtime or in divided doses
Maintenance dose: 15 to 60 mg orally in divided doses

Comments:

• Drowsiness may develop at the start of treatment and with dosage increases.
• The usual daily dose is 30 mg/day.
• Efficacy of long-term management in patients with anxiety (e.g., greater than 4 months) has not been established.

Uses:

• Management of anxiety disorders
• Short-term relief of the symptoms of anxiety

Usual Adult Dose for Alcohol Withdrawal

Day 1: 30 mg orally, followed by 30 to 60 mg in divided doses
Day 2: 45 to 90 mg orally in divided doses
Day 3: 22.5 to 45 mg orally in divided doses
Day 4: 15 to 30 mg orally in divided doses
After Day 4: The daily dose should be reduced to 7.5 to 15 mg
Maximum dose: 90 mg/day

Comments:

• Use should be discontinued as soon as patient's condition is stable.
• Excessive reductions in the total amount of drug administered on successive days should be avoided.

Use: Symptomatic relief of acute alcohol withdrawal

Usual Adult Dose for Seizure Prophylaxis

Initial dose: 7.5 mg orally 3 times a day
Maintenance dose: May increase by no more than 7.5 mg orally every week
Maximum dose: 90 mg/day

Comments:

• To minimize drowsiness, the recommended initial dosages and dosage increments should not be exceeded.
• Continued therapeutic activity was established in patients with epilepsy during long-term studies.

Use: Adjunctive therapy in the management of partial seizures

Usual Pediatric Dose for Seizure Prophylaxis

9 to 12 years:

• Initial dose: 7.5 mg orally 2 times a day
• Maintenance dose: May increase by no more than 7.5 mg orally every week
• Maximum dose: 60 mg/day

12 years or older:

• Initial dose: 7.5 mg orally 3 times a day
• Maintenance dose: May increase by no more than 7.5 mg orally every week
• Maximum dose: 90 mg/day

Comments:

• To minimize drowsiness, the recommended initial dosages and dosage increments should not be exceeded.
• Continued therapeutic activity was established in patients with epilepsy during long-term studies.

Use: Adjunctive therapy in the management of partial seizures

Renal Dose Adjustments

Renal dysfunction: Frequent monitoring recommended.

Liver Dose Adjustments

Liver dysfunction: Frequent monitoring recommended.

Dose Adjustments

Elderly and/or debilitated patients:

• Initial doses should be decreased, and titration should be determined by the patient's response to treatment.
• Anxiety: Treatment should be initiated at a daily dose of 7.5 to 15 mg.

Precautions

US BOXED WARNINGS:
RISKS FROM CONCOMITANT USE WITH OPIOIDS:

• Concomitant use of benzodiazepines and opioids may result in profound sedation, respiratory depression, coma, and death.
• Reserve concomitant prescribing of these drugs for use in patients for whom alternative treatment options are inadequate.
• Limit dosages and durations to the minimum required.
• Follow patients for signs and symptoms of respiratory depression and sedation.

Safety and efficacy have not been established in patients younger than 9 years; this drug is not recommended for use in these patients.

Consult WARNINGS section for additional precautions.

US Controlled Substance: Schedule IV

Dialysis

Data not available

Other Comments

Storage requirements:

• Protect from light and moisture.

General:

• Anxiety/tension associated with the stress of everyday life usually does not require treatment with an anxiolytic.
• Patients should be periodically reassessed for the continued need of treatment.

Monitoring:

• Hematologic: Periodic blood counts
• Hepatic: Periodic liver function tests

Psychiatric:

• Patients with a history of alcohol or drug abuse should be monitored frequently.
• Patients should be monitored for worsening and emergence of suicidal thoughts.

Patient advice:

• Patients should be cautioned accordingly since this drug may impair the mental and/or physical abilities required for the performance of operating an automobile or machinery.
• Patients and caregivers of those who are taking concomitant opioid therapy should be told to immediately report profound central nervous system or respiratory depression.
• Patients should be told to avoid drinking alcohol or taking other drugs that may cause sleepiness or dizziness while taking this drug until you talk to your healthcare provider.
• If this drug is prescribed to a woman of childbearing potential, she should be warned to contact her physician regarding discontinuation if she intends to become pregnant or is pregnant.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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