In general, benzodiazepines may have a longer half-life in babies (who have not developed the mechanisms for metabolism). Monitor Closely (1)clonazepam and papaverine both increase sedation. If coadministration is unavoidable, monitor patients for loss of therapeutic effect of these drugs. Use Caution/Monitor. Profound sedation, respiratory depression, coma, and death may result if coadministered. Monitor Closely (1)clonazepam and topiramate both increase sedation. These side effects can increase the risk of falling.During pregnancy, this medication should be used only when clearly needed. Cobicistat is a CYP3A4 inhibitor; consider benzodiazepine dose reduction. Use Caution/Monitor. ethinylestradiol will increase the level or effect of clonazepam by Mechanism: decreasing metabolism. Monitor Closely (1)hyaluronidase, clonazepam. Avoid or Use Alternate Drug. 20021170722-overviewDiseases & Conditions, encoded search term (clonazepam (Klonopin)) and clonazepam (Klonopin). Consider lowering benzodiazepine dose. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Use Caution/Monitor. carbinoxamine and clonazepam both increase sedation. Comment: Avoid use of metoclopramide intranasal or interacting drug, depending on importance of drug to patient. Use Caution/Monitor. Serious - Use Alternative (2)benzhydrocodone/acetaminophen, clonazepam. Use Caution/Monitor. Effect of interaction is not clear, use caution. Use Caution/Monitor. Enhanced metabolism incr levels of hepatotoxic metabolites. Minor/Significance Unknown. Uses Warnings Before taking Side effects Interactions Dosage FAQ What is clonazepam? Use Caution/Monitor.Minor (1)brimonidine increases effects of clonazepam by pharmacodynamic synergism. Use Caution/Monitor. Monitor Closely (1)esketamine intranasal, clonazepam. Applies only to oral form of both agents. Use Caution/Monitor. Effect of interaction is not clear, use caution. Use Caution/Monitor. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment. Use Caution/Monitor. Use Caution/Monitor. Minor/Significance Unknown. Hoffmann-La Roche, Inc; 340 Kingsland Street; Nutley, NJ 07110, Jazz Pharmaceuticals, Inc; 3180 Porter Drive; Palo Alto, CA 94304, 0.01-0.03 mg/kg/day PO divided q8hr; increase by 0.25-0.5 mg/day q3Days to maximum 0.1-0.2 mg/kg/day PO divided q8hr, Maintenance dose: 0.1-0.2 mg/kg/day PO divided q8hr; not to exceed 0.2 mg/kg/day, <10 years: Treatment should be withdrawn gradually, as necessary, 10 years: Withdraw treatment gradually; decrease the dose q3Days by 0.125 mg PO q12hr until completely withdrawn, calcium/magnesium/potassium/sodium oxybates, elvitegravir/cobicistat/emtricitabine/tenofovir DF, levonorgestrel oral/ethinylestradiol/ferrous bisglycinate, On September 2020, FDA addressed serious risks of benzodiazepine addiction, abuse, and misuse, which can lead to overdose and death, Physical dependence can occur when taken steadily for several days to weeks, even as prescribed, Stopping abruptly or reducing dosage too quickly can result in withdrawal reactions, including seizures, which can be life-threatening, Abuse and misuse of benzodiazepines commonly involve concomitant use of other medications, alcohol, and/or illicit substances, which is associated with an increased frequency of serious adverse outcomes; before prescribing and throughout treatment, assess each patients risk for abuse, misuse, and addiction, Assess each patients risk prior to prescribing and monitor regularly for the development of these conditions, Risks of dependence and withdrawal increase with longer treatment duration and higher daily dose; although injection is indicated only for intermittent use, if used more frequently than recommended, abrupt discontinuation or rapid dosage reduction may precipitate acute withdrawal reactions, including seizures, which can be life-threatening; use gradual taper when discontinuing therapy to reduce withdrawal reactions risk. clonazepam and nabilone both increase sedation. Modify Therapy/Monitor Closely. Monitor Closely (1)etomidate and clonazepam both increase sedation. clonazepam decreases effects of cisatracurium by pharmacodynamic antagonism. If you log out, you will be required to enter your username and password the next time you visit. Effect of interaction is not clear, use caution. Answer Clonazepam, generic for the brand name Klonopin, is classified as a benzodiazepine type drug and is typically indicated for panic disorders and anxiety. Dosage adjustment may be necessary if lemborexant is coadministered with other CNS depressants because of potentially additive effects. Monitor Closely (1)mitotane decreases levels of clonazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Benzodiazepines may be more effective than, However, benzodiazepines may worsen symptoms in patients with comorbid depression or. Use Caution/Monitor. Effect of interaction is not clear, use caution. Use Caution/Monitor. Use Caution/Monitor. Modify Therapy/Monitor Closely. Monitor Closely (2)phenobarbital and clonazepam both increase sedation. orlistat decreases levels of clonazepam by inhibition of GI absorption. This effect was not observed with istradefylline 20 mg/day. Suppresses muscle contractions by facilitating inhibitory GABA neurotransmission and other inhibitory transmitters, Suppresses the spike-and-wave discharge in absence seizures by depressing nerve transmission in motor cortex, Peak plasma time: 1-4 hr; 5-7 days (steady state), Metabolized by CYP3A4 (minor), glucuronic acid conjugation, Half-life: 17-60 hr (adults); 22-33 hr (children). elagolix will decrease the level or effect of clonazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. clonazepam increases and salmeterol decreases sedation. Use Caution/Monitor. Potential for increased toxicity. Minor/Significance Unknown. Avoid or Use Alternate Drug. Effect of interaction is not clear, use caution. Use Caution/Monitor. Use Caution/Monitor. Clinical monitoring is recommended upon coadministration with anticonvulsants. Minor/Significance Unknown. For children, the dose is also based on weight. To view formulary information first create a list of plans. Use Caution/Monitor. Effect of interaction is not clear, use caution. Use Caution/Monitor. If used, choose an agent with a shorter half-life. AU - Weinstein,Sujin,Pharm.D., BCPP Consider dose reduction of the sensitive CYP3A4 substrate(s) if unable to avoid. Biotin supplementation may be necessary. Avoid or Use Alternate Drug. Four weeks later, the patient displayed further alleviation of his depressive symptoms, so he has been continued on 0.75 mg/day of clonazepam. I am pretty much hooked now. Minor (1)clonazepam, valproic acid. To prevent withdrawal, your doctor may lower your dose slowly. Use Caution/Monitor. Use Caution/Monitor. omeprazole increases levels of clonazepam by decreasing metabolism. Profound sedation, respiratory depression, coma, and death may result if coadministered. clonazepam and ziconotide both increase sedation. Use Caution/Monitor. Use Caution/Monitor. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Use Caution/Monitor. gemifloxacin increases levels of clonazepam by decreasing metabolism. unspecified interaction mechanism. Prescription Pad a 'Lethal Weapon' for MD Indicted on Murder Charges, Doctors, Patients Struggle With Benzodiazepine Use. Either increases toxicity of the other by pharmacodynamic synergism. Note: Your username may be different from the email address used to register your account. Use Caution/Monitor. Modify Therapy/Monitor Closely. Monitor Closely (1)clonazepam increases and xylometazoline decreases sedation. USES: Clonazepam is used to prevent and control seizures. Minor (1)clonazepam decreases levels of cyanocobalamin by inhibition of GI absorption. clonazepam increases and levalbuterol decreases sedation. clonazepam and lormetazepam both increase sedation. Use Caution/Monitor. Modify Therapy/Monitor Closely. Monitor Closely (1)brexanolone, clonazepam. clonazepam decreases levels of cyanocobalamin by inhibition of GI absorption. Monitor closely for signs of respiratory depression and sedation. Use Caution/Monitor. Use Caution/Monitor. Effect of interaction is not clear, use caution. Monitor Closely (1)levoketoconazole will increase the level or effect of clonazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. larotrectinib will increase the level or effect of clonazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Monitor Closely (1)clonazepam increases and isoproterenol decreases sedation. Withdrawal symptoms may sometimes last weeks to months. Modify Therapy/Monitor Closely. clonazepam increases and methamphetamine decreases sedation. The dosage of clonazepam was increased to 0.75 mg/day and remission was facilitated. clonazepam and dipipanone both increase sedation. clonazepam increases and fenfluramine decreases sedation. Use Caution/Monitor. Coadministration of encorafenib with sensitive CYP3A4 substrates may result in increased toxicity or decreased efficacy of these agents. Use Caution/Monitor. Use Caution/Monitor. Monitor for drug toxiticities when initiating or discontinuing methylphenidate. Coadministration may result in profound sedation, respiratory depression, coma, and/or death. Minor/Significance Unknown. Effect of interaction is not clear, use caution. . Use Caution/Monitor. Alprazolam: Safety has not been established in children, Chlordiazepoxide: Not recommended for children younger than 6 years of age. Use Caution/Monitor. Monitor Closely (1)pregabalin, clonazepam. Either increases toxicity of the other by Other (see comment). Adjust dosage of CYP3A4 substrates, if clinically indicated. Effect of interaction is not clear, use caution. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely. Use alternatives if available. To lower your risk, your doctor should have you take the smallest dose of clonazepam that works, and take it for the shortest possible time. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Monitor Closely (1)clonazepam increases and phenylephrine decreases sedation. Use Caution/Monitor. Either increases toxicity of the other by pharmacodynamic synergism. Profound sedation, respiratory depression, coma, and death may result if coadministered. acetazolamide will increase the level or effect of clonazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use alternatives if available. Either increases toxicity of the other by pharmacodynamic synergism. Monitor Closely (1)clonazepam and haloperidol both increase sedation. Minor/Significance Unknown. Modify Therapy/Monitor Closely. Patients treated with selinexor may experience neurological toxicities. Use Caution/Monitor. Monitor Closely (1)clonazepam and loxapine inhaled both increase sedation. clonazepam and dextromoramide both increase sedation. Effect of interaction is not clear, use caution. Satisfaction. Consider dose reduction of the sensitive CYP3A4 substrate(s) if unable to avoid. How do they differ? Monitor Closely (1)phenytoin will decrease the level or effect of clonazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. clarithromycin will increase the level or effect of clonazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. cinnarizine and clonazepam both increase sedation. Theoretical interaction; some species of sage may cause convulsions. Avoid or Use Alternate Drug. commonly, these are "non-preferred" brand drugs or specialty commonly, these are generic drugs. Use Caution/Monitor. clonazepam and amoxapine both increase sedation. clonazepam and quazepam both increase sedation. Modify Therapy/Monitor Closely. clonazepam and quetiapine both increase sedation. voxelotor will increase the level or effect of clonazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Monitor Closely (1)clonazepam and meperidine both increase sedation. It may harm an unborn baby. Use Caution/Monitor. cyclophosphamide will increase the level or effect of clonazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Use Caution/Monitor. Use Caution/Monitor. Consider lowering benzodiazepine dose. Minor/Significance Unknown. DB - Johns Hopkins Guides Use Caution/Monitor. Comment: Ezogabine may induce glucuronidation that results in small decreases of trough levels. Use Caution/Monitor. Use Caution/Monitor. Consult your doctor before breast-feeding. Use Caution/Monitor. clonazepam increases and metaproterenol decreases sedation. Avoid or Use Alternate Drug. Effect of interaction is not clear, use caution. Monitor Closely (1)clonazepam and chloral hydrate both increase sedation. Enhanced metabolism incr levels of hepatotoxic metabolites. Monitor Closely (1)duvelisib will increase the level or effect of clonazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Boudinot FD, Homon CA, Jusko WJ, et al. Clinical monitoring is recommended upon coadministration with anticonvulsants. Use Caution/Monitor. brivaracetam and clonazepam both increase sedation. Monitor Closely (1)clonazepam and oxymorphone both increase sedation. Monitor Closely (1)chlordiazepoxide and clonazepam both increase sedation. Either increases effects of the other by sedation. Monitor closely for signs of respiratory depression and sedation. clonazepam increases and diethylpropion decreases sedation. Use Caution/Monitor. MISSED DOSE: If you miss a dose, take it as soon as you remember. Use Caution/Monitor. Monitor Closely (1)lorlatinib will decrease the level or effect of clonazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. If your doctor prescribes Klonopin with an opioid, they'll monitor you closely for signs of serious side effects. Use Caution/Monitor. Use Caution/Monitor. Monitor Closely (1)clonazepam and hydromorphone both increase sedation. Monitor closely for signs of respiratory depression and sedation. Use Caution/Monitor. ezogabine decreases levels of clonazepam by Other (see comment). avapritinib and clonazepam both increase sedation. Monitor Closely (1)clonazepam increases and dextroamphetamine decreases sedation. Monitor Closely (1)clonazepam and clorazepate both increase sedation. remimazolam, clonazepam. Modify Therapy/Monitor Closely. Minor/Significance Unknown. Use Caution/Monitor. Modify Therapy/Monitor Closely. Use Caution/Monitor. Monitor Closely (1)diazepam intranasal, clonazepam. Use Caution/Monitor. Modify Therapy/Monitor Closely. Coadministration of encorafenib with sensitive CYP3A4 substrates may result in increased toxicity or decreased efficacy of these agents. Use alternatives if available. Use Caution/Monitor. Monitor closely for signs of respiratory depression and sedation. Profound sedation, respiratory depression, coma, and death may result if coadministered. Avoid or Use Alternate Drug. clonazepam and thiothixene both increase sedation. ceritinib will increase the level or effect of clonazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. tipranavir increases levels of clonazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Monitor Closely (1)primidone and clonazepam both increase sedation. Excreted primary by kidneys and some via feces, Chlordiazepoxide: Metabolized by the liver and excreted primary by kidneys, Clonazepam: Metabolized by the liver (CYP3A4: oxidation and reduction) and excreted primary by kidneys, Diazepam: Metabolized by the liver (CYP2C19 and CYP3A4: glucuronidation, methylation, oxidation, and hydroxylation) and excreted primary by kidneys, Lorazepam: Metabolized by the liver (glucuronidation). clonazepam and trazodone both increase sedation. Serious - Use Alternative (1)clonazepam, metoclopramide intranasal. Coadministration may result in profound sedation, respiratory depression, coma, and/or death. Risk for sedation increased if flibanserin is coadministration with other CNS depressants. Modify Therapy/Monitor Closely. Monitor Closely (1)letermovir increases levels of clonazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. clonazepam increases and benzphetamine decreases sedation. BT - Johns Hopkins Psychiatry Guide Use Caution/Monitor. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely. clonazepam and pholcodine both increase sedation. Use Caution/Monitor. Monitor Closely (1)clonazepam and opium tincture both increase sedation. Use Caution/Monitor. Coadministration of apalutamide, a strong CYP3A4 inducer, with drugs that are CYP3A4 substrates can result in lower exposure to these medications. clonazepam and haloperidol both increase sedation. Coadministration may potentiate the CNS-depressant effects of each drug. Limit use to patients for whom alternative treatment options are inadequate. Monitor Closely (1)clonazepam and sufentanil both increase sedation. Monitor Closely (1)clonazepam increases and methamphetamine decreases sedation. Monitor Closely (1)elagolix will decrease the level or effect of clonazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Enhanced metabolism incr levels of hepatotoxic metabolites. Minor/Significance Unknown. However, since untreated seizures are a serious condition that can harm both a pregnant woman and her unborn baby, do not stop taking this medication unless directed by your doctor. Monitor Closely (1)promethazine and clonazepam both increase sedation. Use Caution/Monitor. Monitor Closely (1)clonazepam and nortriptyline both increase sedation. If it is near the time of the next dose, skip the missed dose. Modify Therapy/Monitor Closely. Efficacy and tolerability of benzodiazepines versus antidepressants in anxiety disorders: a systematic review and meta-analysis. Use Caution/Monitor. Use Caution/Monitor. Monitor Closely (1)crofelemer increases levels of clonazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Monitor Closely (1)clonazepam increases and dexfenfluramine decreases sedation. Monitor Closely (1)clonazepam and nalbuphine both increase sedation. clonazepam and doxylamine both increase sedation. Monitor Closely (1)brexpiprazole and clonazepam both increase sedation. Both are short. Minor (1)clonazepam decreases effects of rimabotulinumtoxinB by pharmacodynamic antagonism. Ethinyl estradiol may inhibit the clearance of benzodiazepines that undergo oxidation, thereby increasing serum concentrations of concomitantly administered benzodiazepines. Use Caution/Monitor. Use Caution/Monitor. Monitor Closely (1)clonazepam and melatonin both increase sedation. Effect of interaction is not clear, use caution. Monitor Closely (1)clonazepam and belladonna and opium both increase sedation. clonazepam and risperidone both increase sedation. Use Caution/Monitor. Use Caution/Monitor. Use alternatives if available. Avoid or Use Alternate Drug. Avoid or substitute another drug for these medications when possible. Monitor Closely (1)clonazepam and meprobamate both increase sedation. Clinical pharmacokinetics of alprazolam. clonazepam increases toxicity of buprenorphine subdermal implant by pharmacodynamic synergism. Monitor Closely (2)secobarbital will decrease the level or effect of clonazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Protein binding of oxazepam and its glucuronide conjugates to human albumin. Minor (1)clonazepam decreases levels of acetaminophen IV by increasing metabolism. clonazepam and clozapine both increase sedation. Modify Therapy/Monitor Closely. Modify Therapy/Monitor Closely. phenytoin will decrease the level or effect of clonazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. cenobamate will decrease the level or effect of clonazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. cyclizine and clonazepam both increase sedation. clonazepam increases and epinephrine decreases sedation. Minor/Significance Unknown. Either increases effects of the other by pharmacodynamic synergism. Those using clonazepam for anxiety or a panic disorder will be started on .25 mg, which can be increased to 1 mg after three days. ketamine and clonazepam both increase sedation. Most tecovirimat will decrease the level or effect of clonazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. The recipient will receive more details and instructions to access this offer. Effect of interaction is not clear, use caution. clonazepam and olanzapine both increase sedation. Use Caution/Monitor. Limit dosages and durations to the minimum required. Use Caution/Monitor. Consider lowering benzodiazepine dose. Avoid or Use Alternate Drug. The maximum dose of clonazepam should not exceed 20 mg daily for those using the drug as a seizure medication. clonazepam and cyclobenzaprine both increase sedation. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Use Caution/Monitor. Monitor Closely (1)avapritinib and clonazepam both increase sedation. Limit dosages and durations to the minimum required. Seizure disorders: Oral: Initial daily dose not to exceed 1.5 mg given in 3 divided doses; may increase by 0.5 to 1 mg every third day until seizures are controlled or adverse effects seen (maximum: 20 mg/day). Clonazepam is used alone or together with other medicines to treat certain seizure disorders (eg, Lennox-Gastaut syndrome, akinetic, myoclonic, and absence seizures). Minor/Significance Unknown. See also Drug Interactions section. clonazepam and buprenorphine buccal both increase sedation. Enhanced CNS depressant effects. Use Caution/Monitor. Use Caution/Monitor. Either increases effects of the other by pharmacodynamic synergism. Monitor Closely (1)clonazepam and estazolam both increase sedation. Use Caution/Monitor. Use Caution/Monitor. Caffeine component of green tea may decrease sedative effects of benzodiazepines. Monitor Closely (1)clonazepam and lofepramine both increase sedation. abametapir will increase the level or effect of clonazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. esomeprazole will increase the level or effect of clonazepam by affecting hepatic enzyme CYP2C19 metabolism. Advice about NHS strikes Find out what to do during the NHS industrial action from NHS England Home Medicines A to Z Clonazepam Find out how clonazepam treats epileptic seizures or fits, muscle spasms, panic disorder and restless legs syndrome, and how to take it. Either increases effects of the other by pharmacodynamic synergism. Effect of interaction is not clear, use caution. Avoid or Use Alternate Drug. clonazepam increases and armodafinil decreases sedation. Consider lowering benzodiazepine dose. Consult your pharmacist or local waste disposal company. Monitor Closely (1)clonazepam and olanzapine both increase sedation. clonazepam, clobazam. Use Caution/Monitor. Use Caution/Monitor. Child 1-4 years Clonazepam is a benzodiazepine drug used for the acute management of the panic disorder, epilepsy, and non-convulsive status epilepticus. Increase dose of CYP3A4 substrate, as needed, when coadministered with cenobamate.cenobamate, clonazepam. Monitor Closely (1)clonazepam increases toxicity of buprenorphine, long-acting injection by pharmacodynamic synergism. clonazepam and benperidol both increase sedation. Use Caution/Monitor. Coadministration of lasmiditan and other CNS depressant drugs, including alcohol have not been evaluated in clinical studies. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. Effect of interaction is not clear, use caution. clonazepam and diamorphine both increase sedation. Potential for increased toxicity. Use Caution/Monitor. cobicistat will increase the level or effect of clonazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. You may report side effects to Health Canada at 1-866-234-2345. Minor (1)moxifloxacin increases levels of clonazepam by decreasing metabolism. Minor (1)clonazepam decreases effects of rocuronium by pharmacodynamic antagonism. clonazepam and midazolam both increase sedation. Avoid coadministration of sensitive CYP3A4 substrates with ivosidenib or replace with alternate therapies. Diazepam: Well-absorbed orally; bioavailability 90%; time to peak concentration 0.5-6 hours (rapid), Lorazepam: Well-absorbed orally; bioavailability 90%; time to peak concentration 1-2 hours (intermediate), Alprazolam: Metabolized by the liver (CYP3A4). Modify Therapy/Monitor Closely. Use Caution/Monitor. Use Caution/Monitor. Potential for increased toxicity. Use Caution/Monitor. Monitor Closely (1)clonazepam and flibanserin both increase sedation. Monitor Closely (1)lemborexant, clonazepam. Minor/Significance Unknown. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Consider dose reduction of sensitive CYP3A4 substrates. Monitor Closely (1)clonazepam increases and methylenedioxymethamphetamine decreases sedation. clonazepam decreases effects of atracurium by pharmacodynamic antagonism. Monitor Closely (1)lurasidone, clonazepam. clonazepam and hydromorphone both increase sedation. Limit dosages and durations to the minimum required. Effect of interaction is not clear, use caution. Minor/Significance Unknown. bosentan will decrease the level or effect of clonazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Risk of convulsions. clonazepam and loxapine inhaled both increase sedation. Use Caution/Monitor. Minor/Significance Unknown. Use Caution/Monitor. Monitor Closely (1)encorafenib, clonazepam. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Potential for increased toxicity. Minor/Significance Unknown. Minor (1)clonazepam decreases effects of atracurium by pharmacodynamic antagonism. Studies have shown that the combination of benzodiazepines and buprenorphine altered the usual ceiling effect on buprenorphine-induced respiratory depression, making the respiratory effects of buprenorphine appear similar to those of full opioid agonists. Monitor Closely (1)desflurane and clonazepam both increase sedation. Use Caution/Monitor. There have been postmarketing reports of coma and death with coadministration of buprenorphine and benzodiazepines. Mechanism: unknown. clonazepam increases and isoproterenol decreases sedation. MECHANISM MECHANISM MECHANISM Benzodiazepines act through the gamma-aminobutyric acid (GABA) A receptor, which regulates chloride entry into neurons, resulting in neuronal hyperpolarization [1]. Minor (1)omeprazole increases levels of clonazepam by decreasing metabolism. Chouinard G. Issues in the clinical use of benzodiazepines: potency, withdrawal, and rebound. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Use Caution/Monitor. Clonazepam (Klonopin): The initial dose is 0.25 mg daily to twice a day; the dose can be increased by 0.125-0.25 mg daily or two times a day every 2-3 days; the usual therapeutic dose is 1-4 mg total/day in divided doses. Do not increase your dose, take it more often, or take it for a longer time than directed.Take this medication regularly to get the most benefit from it. methylphenidate transdermal will increase the level or effect of clonazepam by decreasing metabolism. Use alternatives if available. Monitor Closely (1)disulfiram increases levels of clonazepam by decreasing metabolism. rifabutin decreases levels of clonazepam by increasing metabolism. saquinavir increases levels of clonazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. clonazepam decreases effects of onabotulinumtoxinA by pharmacodynamic antagonism. levonorgestrel oral/ethinylestradiol/ferrous bisglycinate will increase the level or effect of clonazepam by decreasing metabolism. Monitor Closely (1)clonazepam and moxonidine both increase sedation. Use Caution/Monitor. clonazepam, calcium/magnesium/potassium/sodium oxybates. Oxazepam (Serax): the initial dose is 10-15 mg daily; the dose can be increased by 10 mg daily in divided doses (three times a day); the usual therapeutic dose is 90 mg total/day, with three times a day dosing. Use Caution/Monitor. Minor/Significance Unknown. Use Caution/Monitor. Use Caution/Monitor. Minor/Significance Unknown. Use Caution/Monitor. clonazepam and pentazocine both increase sedation. ", Kim, P. M., & Weinstein, S. L. (2016). nafcillin will decrease the level or effect of clonazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Monitor CYP3A substrates if coadministered. Monitor Closely (1)clonazepam and zotepine both increase sedation. Either increases toxicity of the other by pharmacodynamic synergism. Consult your doctor right away if this happens. Avoid or Use Alternate Drug. Use Caution/Monitor. unspecified interaction mechanism. Monitor Closely (1)clonazepam and apomorphine both increase sedation. Use Caution/Monitor. Effect of interaction is not clear, use caution. Use Caution/Monitor. Monitor Closely (1)propofol and clonazepam both increase sedation. Use Caution/Monitor. Use Caution/Monitor. Use Caution/Monitor. Avoid or substitute another drug for these medications when possible. Monitor Closely (1)clonazepam increases and midodrine decreases sedation. midazolam intranasal, clonazepam. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Monitor Closely (1)clonazepam and levorphanol both increase sedation. Monitor Closely (1)brompheniramine and clonazepam both increase sedation. Effect of interaction is not clear, use caution. clonazepam and nalbuphine both increase sedation. Use Caution/Monitor. Use Caution/Monitor. Use Caution/Monitor. Use Caution/Monitor. clonazepam and meperidine both increase sedation. Use Caution/Monitor. clonazepam increases and phenylephrine PO decreases sedation. clonazepam and metaxalone both increase sedation. anastrozole will increase the level or effect of clonazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. clonazepam and flibanserin both increase sedation. darunavir will increase the level or effect of clonazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. An increase to the target dose for most patients of 1 mg/day may be made after 3 days. Effect of interaction is not clear, use caution. Minor/Significance Unknown. Avoid or Use Alternate Drug. clonazepam and flurazepam both increase sedation. Minor/Significance Unknown. Benzodiazepines. Use Caution/Monitor. butabarbital and clonazepam both increase sedation. Other (see comment). Monitor Closely (1)sevoflurane and clonazepam both increase sedation. clonazepam and carisoprodol both increase sedation. Use Caution/Monitor. Avoid or Use Alternate Drug. clonazepam decreases effects of vecuronium by pharmacodynamic antagonism. Use Caution/Monitor. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: a certain type of eye problem (narrow angle glaucoma), a certain blood disorder (porphyria), liver disease, kidney disease, lung/breathing problems, mental/mood problems (such as depression, thoughts of suicide), personal or family history of a substance use disorder (such as overuse of or addiction to drugs/alcohol).This drug may make you dizzy or drowsy. The maximum dosage (highest dose) of Klonopin for seizure disorders in adults is a total of 20 mg per day. Serious - Use Alternative (1)lonafarnib will increase the level or effect of clonazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. clonazepam and papaveretum both increase sedation. Avoid or Use Alternate Drug. Potential for increased toxicity. Y1 - 2016/12/19/ Use Caution/Monitor. Use Caution/Monitor. Use Caution/Monitor. clonazepam and meprobamate both increase sedation. Monitor Closely (1)clonazepam and chlorpromazine both increase sedation. Monitor Closely (1)ketamine and clonazepam both increase sedation. primidone and clonazepam both increase sedation. Concomitant use of benzodiazepines and opioids may result in profound respiratory depression, coma, and death; administer concomitantly when there are no alternative options; limit dosages and durations to minimum required; monitor for signs and symptoms of respiratory depression and sedation, Withdraw gradually when used for panic disorder, Use caution in COPD, sleep apnea, renal/hepatic disease, open-angle glaucoma (questionable), depression, suicidal ideation, Not recommended in patients with depressed neuroses, psychotic reactions, severe respiratory depression, myasthenia gravis (allowable in limited circumstances), acute alcohol intoxication, Anterograde amnesia reported benzodiazepine use, May cause CNS depression and impairs ability to perform hazardous tasks, Hyperactive or aggressive behavior reported with benzodiazepines in pediatric/adolescent patients and in psychiatric patients, Increased risk of suicidal thoughts/behavior reported with antiepileptic agents; monitor patient for suicidal behavior and notify health-care provider immediately, Use with caution in patients with a history of drug abuse or acute alcoholism; drug dependency possible; prolonged use may result in psychological and physical dependence, Use with caution in patients with compromised respiratory function, May have porphyrogenic effect; use with caution in patients with porphyria, Not for concomitant administration with alcohol or other CNS-depressant drugs, When used in patients in whom several different types of seizure disorders coexist, clonazepam may increase incidence or precipitate onset of generalized tonic-clonic seizures (grand mal); may require addition of appropriate anticonvulsants or increase in dosages; concomitant use of valproic acid and clonazepam may produce absence status, Abrupt withdrawal, particularly in patients on long-term, high-dose therapy, may precipitate status epilepticus; when discontinuing clonazepam, gradual withdrawal essential; while being gradually withdrawn, simultaneous substitution of another anticonvulsant may be indicated, Use of drug, particularly in patients at elevated risk, necessitates counseling about risks and proper use of drug along with monitoring for signs and symptoms of abuse, misuse, and addiction; do not exceed recommended dosing frequency, Avoid or minimize concomitant use of CNS depressants and other substances associated with abuse, misuse, and addiction (eg, opioid analgesics, stimulants); advise patients on proper disposal of unused drug; if a substance use disorder is suspected, evaluate patient and institute (or refer them for) early treatment, as appropriate, For patients using treated more frequently than recommended, to reduce risk of withdrawal reactions, use a gradual taper to discontinue therapy (a patient-specific plan should be used to taper the dose), Patients at an increased risk of withdrawal adverse reactions after benzodiazepine discontinuation or rapid dosage reduction include those who take higher dosages, and those who have had longer durations of use, In some cases, benzodiazepine users have developed a protracted withdrawal syndrome with withdrawal symptoms lasting weeks to more than 12 months, May produce increase in salivation; consider before giving drug to patients who have difficulty handling secretions, In some studies, up to 30% of patients who initially responded have shown a loss of anticonvulsant activity, often within 3 months of administration; in some cases, dosage adjustment may reestablish efficacy, Paradoxical reactions, such as agitation, irritability, aggression, anxiety, anger, nightmares, hallucinations, and psychoses may occur when using benzodiazepines; discontinue therapy, should this occur; paradoxical reactions are more likely to occur in children and in the elderly, There is a pregnancy exposure registry that monitors pregnancy outcomes in women exposed to AEDs, such as Klonopin, during pregnancy; healthcare providers are encouraged to recommend that pregnant women taking this medication enroll in the NAAED Pregnancy Registry by calling 1-888-233-2334 or online at http://www.aedpregnancyregistry.org/, There are no adequate and well-controlled studies of Klonopin in pregnant women; available human data on risk of teratogenicity are inconclusive; there is insufficient evidence in humans to assess effect of benzodiazepine exposure during pregnancy on neurodevelopment; administration of benzodiazepines immediately prior to or during childbirth can result in a syndrome of hypothermia, hypotonia, respiratory depression, and difficulty feeding; in addition, infants born to mothers who have taken benzodiazepines during later stages of pregnancy can develop dependence, and subsequently withdrawal, during the postnatal period, Monitor neonates exposed to this drug during pregnancy for signs of withdrawal; manage these neonates accordingly, Data for other benzodiazepines suggest possibility of adverse developmental effects (long-term effects on neurobehavioral and immunological function) in animals following prenatal exposure to benzodiazepines, This drug is excreted in human milk; there are reports of sedation, poor feeding and poor weight gain in infants exposed to benzodiazepines through breast milk, Infants exposed to this drug through breast milk should be monitored for sedation, poor feeding, and poor weight gain, Effects on breastfed infant and on milk production are unknown; developmental and health benefits of breastfeeding should be considered along with mother's clinical need for therapy and any potential adverse effects on breastfed infant from drug or from underlying maternal condition. Modify Therapy/Monitor Closely. Use Caution/Monitor. MEDICAL ALERT: Your condition can cause complications in a medical emergency. This information does not assure that this product is safe, effective, or appropriate for you. Monitor closely for signs of respiratory depression and sedation. Avoid or Use Alternate Drug. Monitor Closely (1)nelfinavir increases levels of clonazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. cenobamate will decrease the level or effect of clonazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Monitor Closely (1)clonazepam and thiothixene both increase sedation. Individual plans may vary Minor/Significance Unknown. Monitor Closely (1)clonazepam and orphenadrine both increase sedation. Use Caution/Monitor. Copyright(c) 2023 First Databank, Inc. Effect of interaction is not clear, use caution. Use Caution/Monitor. Monitor Closely (1)clonazepam increases and epinephrine racemic decreases sedation. Use Caution/Monitor. Modify Therapy/Monitor Closely. Use Caution/Monitor. clonazepam and lofepramine both increase sedation. Use Caution/Monitor. Use Caution/Monitor. Monitor Closely (1)indinavir increases levels of clonazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. The risk of dependence is increased with the agents that are rapidly absorbed and with shorter half-lives, i.e., alprazolam and diazepam. Use Caution/Monitor. The initial dose for adults with panic disorder is 0.25 mg twice daily. Minor/Significance Unknown. clonazepam and methocarbamol both increase sedation. Manage and view all your plans together even plans in different states. Minor/Significance Unknown. Use Caution/Monitor. Use Caution/Monitor. If coadministration is unavoidable, monitor patients for loss of therapeutic effect of these drugs. Monitor Closely (1)suvorexant and clonazepam both increase sedation. Use Caution/Monitor. Use Caution/Monitor. Monitor Closely (1)clonazepam and ethanol both increase sedation. Minor/Significance Unknown. Iloperidone is a time-dependent CYP3A inhibitor and may lead to increased plasma levels of drugs predominantly eliminated by CYP3A4. Use Caution/Monitor. Use Caution/Monitor. Use Caution/Monitor. US residents can call their local poison control center at 1-800-222-1222. kava and clonazepam both increase sedation. In many, but not all of these cases, buprenorphine was misused by self-injection. clonazepam and baclofen both increase sedation. dexchlorpheniramine and clonazepam both increase sedation. Minor/Significance Unknown. Modify Therapy/Monitor Closely. Use Caution/Monitor. Effect of interaction is not clear, use caution. Use Caution/Monitor. Minor (1)zolpidem, clonazepam. clonazepam and dantrolene both increase sedation. Minor/Significance Unknown. Monitor Closely (1)clonazepam increases and metaproterenol decreases sedation. The dosage of a benzodiazepine will vary depending on the patient and his or her history of sedative use. Use Caution/Monitor. Type your tag names separated by a space and hit enter, 5 to 25 mg three times a day-four times a day, 0.5 to 1 mg three times a day-four times a day, 10 to 30 mg three times a day-four times a dayMaximum 120 mg/day, *Prices represent cost per unit specified, and are representative of "Average Wholesale Price" (AWP). clonazepam and methadone both increase sedation. clonazepam and diazepam both increase sedation. Use Caution/Monitor. Panic disorder is a type of anxiety disorder in which people experience frequent and uncontrollable periods of intense, overwhelming fear. Concomitant use stiripentol with other CNS depressants, including alcohol, may increase the risk of sedation and somnolence. Use Caution/Monitor. Modify Therapy/Monitor Closely. For children older than 6 years of age, use 5 mg two to four times a day. Panic and anxiety: An initial adult dose of Klonopin is 0.25 mg two times a day. Cobicistat is a CYP3A4 inhibitor; consider benzodiazepine dose reduction. Physicians Behaving Badly: Is It Arrogance, Insecurity, or Stress? hyaluronidase, clonazepam. Use alternatives if available. Effect of interaction is not clear, use caution. Comment: Concomitant administration can increase the potential for CNS effects (e.g., increased sedation or respiratory depression). Monitor Closely (1)clonazepam and papaveretum both increase sedation. One may preferably choose lorazepam or oxazepam: both are metabolized through conjugation and do not produce active metabolites (fewer CYP 450 drug interactions). Monitor Closely (1)clonazepam and midazolam both increase sedation. Increase dose of CYP3A4 substrate, as needed, when coadministered with cenobamate. Monitor Closely (1)cinnarizine and clonazepam both increase sedation. Use Caution/Monitor. Minor/Significance Unknown. Either increases effects of the other by pharmacodynamic synergism. Monitor Closely (1)clonazepam and morphine both increase sedation. Adjust dose according to prescribing information if needed. Monitor Closely (1)clonazepam and quazepam both increase sedation. Monitor Closely (1)clonazepam increases and benzphetamine decreases sedation. Serious - Use Alternative (1)ivosidenib will decrease the level or effect of clonazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Effect of interaction is not clear, use caution. Most benzodiazepines can cause these side effects due to their inhibitory effects on brain neurotransmission: Withdrawal symptoms from benzodiazepines (seizures, hallucinations, agitation, tremors) are most common when using benzodiazepines with shorter half-lives, Alprazolam: Changes in appetite (decrease or increase), weight gain, reduced mucosal production leading to xerostomia and constipation, confusion, sedation, cognitive impairment, memory impairment, irritability, Chlordiazepoxide: Edema, constipation, nausea, confusion, sedation, cognitive impairment, memory impairment, irritability, Clonazepam: Depression, ataxia, dizziness, confusion, sedation, cognitive impairment, memory impairment, irritability, upper respiratory infection, respiratory depression, Diazepam: Hypotension, ataxia, dizziness, confusion, sedation, cognitive impairment, Lorazepam: Depression, ataxia, dizziness, confusion, sedation, cognitive impairment, Chlordiazepoxide: Irregular menses, decreased libido, Diazepam: Muscle weakness, respiratory depression; rash and diarrhea can occur with rectal gel use, Lorazepam: Delirium (especially in elderly patients), weakness, Alprazolam: Stevens-Johnson Syndrome, liver failure, Chlordiazepoxide: Agranulocytosis, liver failure. 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