Chemically, clonazepam is a derivative of benzodiazepam, mainly used as anticonvulsant drug. Clonazepam brings about direct inhibition of cortical and sub-cortical epileptogenic focus and prevents the formation of convulsive activity. It displays several pharmacological properties which are shown in the benzodiazepine class of drugs. At the special cord level clonazepam depresses more reflux pathways and potentiates presynaptic inhibition of Gamma Amino Butyric Acid in the CNS. Over compensatory excitation processes are thereby reduced via negative feedback without substantiation of other physiologic neuronal activity.

1. Epilepsy a. Status epilepticus, b. Lennox-Gastaunt Syndrome, c. lnfentile spasm, d. Absence seizure, e. Myclonic seizure, f. Tonic-clonic seizures, g. Akinetic and atonic seizures, h. Partial seizure, 2. Panic Disorders, 3. Drug indued dyskinesia, 4. Bipolar effective disorder, 5. Fulgurant pain, 6. Choreiform movements, 7. Resistant depression, 8. Trigeminal neuralgia

According to the patient’s clinical response and tolerance of the drug the standard dose of clonazepam must be individually adjusted. As a general rule, clonazepam is given as low dose. Adults: 1 mg (elderly 0.5 mg), initially at for 4 (four) nights, not to exceed 1.5 mg/day. Increased over 2-4 weeks to a usual maintenance dose of 4-8 mg daily in divided doses. Child: Up to 1 year 0.25 mg daily in divided dose, increase gradually to 0.5 - 1 mg. 1-5 years start with 0.25 mg, increased to 1- 3 mg. 5-12 years initial dose 0.5 mg in divided dose, increased to 3-6 mg.

Clonazepam must not be used in patients with known hypersensitivity to clonazepam or any other excipients, in patients dependent on medications, drugs of abuse or alcohol or in patients suffering from myasthenia gravis. Clonazepam may be used only with particular caution in patients with spinal or cerebellar ataxia, in the event of acute intoxication with alcohol, other antiepileptic drugs, hypnotics, analgesics, neuroleptic agents, antidepressants or lithium in patients with severe liver damage (cirrhosis of the liver).

The dosage of clonazepam must be carefully adjusted to individual requirements in elderly patients, patients with pre-existing diseases of the respiratory system (e.g. chronic obstructive pulmonary disease), liver or kidney and in patients undergoing treatment with other centrally acting medications of anticonvulsants (anti epileptic) agents.

Adverse effects like tiredness, sleepiness, muscular hypotonia, dizziness, co-ordination disturbances, hyper salivation in infants, paradoxical aggression, irritability, light-headache and ataxia. These effects are usually transients and generally disappear spontaneously in the course of treatment or on the reduction of dosage.

The use of clonazepam during pregnancy or lactation should be avoided. Clonazepam is excreted into the breast milk and should therefore be avoided in breast-feeding mothers.

Narcotics, barbiturates, non-barbiturates, hypnotics, anti-anxiety agents, MAO inhibitors, tricyclic antidepressant and other anticonvulsant drugs may potentiate the CNS-depressant action of the benzodiazepine class of drugs.

Symptoms of clonazepam over dosage, like those produced by other CNS depressants, include somnolence, confusion, and coma and diminished reflexes.

Keep in a dry place away from light and heat. Keep out of the reach of children.

Myotril 0.5 mg Tablet: Each box contains 50 (10x5's) tablets in blister pack. Myotril 2 mg Tablet: Each box contains 30 (10x3's) tablets in blister pick.