Description
Rivotril (Clonazepam)
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Rivotril (Clonazepam)is the brand name for clonazepam, a benzodiazepine medication that enhances the calming neurotransmitter GABA in the brain.
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It’s used primarily for:
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Epilepsy/seizure disorders (e.g., absence, myoclonic, Lennox–Gastaut syndrome)
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Panic disorder with or without agoraphobia
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In some cases, it may also be used off-label for other movement-related issues.
Available Forms & Strengths
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Oral tablets in 0.5 mg, 1 mg, and 2 mg strengths. Disintegrating tablets (ODTs) are also available.
Dosing Guidelines
Seizure Disorders (Adults)
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Initial: Up to 1.5 mg/day, divided into three doses.
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Increase by 0.5–1 mg every 3 days as needed.
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Maintenance: Typically 2–8 mg/day.
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Maximum: 20 mg/day.
Panic Disorder (Adults)
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Initial: 0.25 mg twice a day (0.5 mg/day).
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Titrate to 1 mg/day after 3 days.
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Maximum: 4 mg/day.
Pediatric Dosing (Seizures)
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Children ≤10 years or ≤30 kg: Start at 0.01–0.03 mg/kg/day, increase gradually to maintenance of ~0.1–0.2 mg/kg/day.
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Children >10 years or >30 kg: Similar to adult dosing starting around 1.5 mg/day.
Prescribing Notes:
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Dose adjustments should be individualized.
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Gradual tapering recommended when discontinuing to avoid withdrawal.
Safety & Risks
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Classified as a Schedule IV controlled substance—risks include tolerance, dependence, and potential for misuse.
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Common side effects: drowsiness, dizziness, memory issues, impaired coordination.
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Serious risks: respiratory depression (especially combined with other CNS depressants), withdrawal seizures upon abrupt cessation.
Quick Table Summary
| Condition | Initial Dose | Maintenance Dose | Max Dose |
|---|---|---|---|
| Seizures (Adult) | Up to 1.5 mg/day (divided) | 2–8 mg/day | 20 mg/day |
| Panic Disorder | 0.25 mg twice/day | Approx. 1 mg/day | 4 mg/day |
| Children (Seizures) | 0.01–0.03 mg/kg/day | ~0.1–0.2 mg/kg/day | Varies by age |
Final Thoughts
Rivotril (clonazepam) is effective for seizure control and panic disorders but comes with significant dependence risks. Proper dosing, close medical supervision for adjustments, and carefully managed discontinuation are essential to minimize complications.
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