Drug reference

Clobazam

BNF 80 (2020–2021)

Source: BNF 80 (2020–2021)
PDF pages: 375, 376

Review source pages for extracted sections and age labels. BNF dose snippets show only their first line.

Overview

Indications And Dose

Adjunct in epilepsy ▶BY MOUTH ▶Child 6–17 years: Initially 5 mg daily, dose to be increased if necessary at intervals of 5 days, maintenance 0.3–1 mg/kg daily, daily doses of up to 30 mg may be given as a single dose at bedtime, higher doses should be divided; maximum 60 mg per day ▶Adult: 20–30 mg daily, then increased if necessary up to 60 mg daily Anxiety (short-term use) ▶BY MOUTH ▶Adult: 20–30 mg daily in divided doses, alternatively 20–30 mg once daily, dose to be taken at bedtime; increased if necessary up to 60 mg daily in divided doses, dose only increased in severe anxiety (in hospital patients), for debilitated patients, use elderly dose ▶Elderly: 10–20 mg daily l UNLICENSED USE ▶In children Not licensed as monotherapy.

PDF page 375

Contra Indications

Respiratory depression

PDF page 375

Cautions

Muscle weakness. organic brain changes CAUTIONS, FURTHER INFORMATION The effectiveness of clobazam may decrease signiﬁcantly after weeks or months of continuous therapy.

PDF page 375

Prescribing And Dispensing Information

Switching between formulations Care should be taken when switching between oral formulations in the treatment of epilepsy. The need for continued supply of a particular manufacturer’s product should be based on clinical judgement and consultation with the patient or their carer, taking into account factors such as seizure frequency and treatment history. Patients being treated for epilepsy may need to be maintained on a speciﬁc manufacturer’s branded or generic clobazam product.

PDF page 375

National Funding Access Decisions

NHS restrictions Clobazam is not prescribable in NHS primary care except for the treatment of epilepsy; endorse prescription ’SLS’.

PDF page 375

Safety

Important Safety Information

SAFE PRACTICE Clobazam has been confused with clonazepam; care must be taken to ensure the correct drug is prescribed and dispensed.

PDF page 375

Interactions

→Appendix 1: clobazam

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Side Effects

Appetite decreased. consciousness impaired. constipation. drug abuse. dry mouth. fall. gait unsteady. libido loss. movement disorders. muscle spasms. nystagmus. respiratory disorder. severe cutaneous adverse reactions (SCARs). skin reactions. speech impairment. weight increased

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Breast Feeding

Benzodiazepines are present in milk, and should be avoided if possible during breast-feeding. Monitoring All infants should be monitored for sedation, feeding difﬁculties, adequate weight gain, and developmental milestones.

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Renal Impairment

Dose adjustments Start with small doses in severe impairment.

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Monitoring Requirements

▶In children Routine measurement of plasma concentrations of antiepileptic drugs is not usually justiﬁed, because the target concentration ranges are arbitrary and often vary between individuals. However, plasma drug concentrations may be measured in children with worsening seizures, status epilepticus, suspected Nervous system noncompliance, or suspected toxicity. Similarly, haematological and biochemical monitoring should not be undertaken unless clinically indicated.

PDF page 375

Dose and formulations

Medicinal Forms

There can be variation in the licensing of different medicines containing the same drug. Forms available from special-order manufacturers include: capsule, oral suspension Oral suspension CAUTIONARY AND ADVISORY LABELS 2, 8, 19 ▶Clobazam (Non-proprietary) Clobazam 1 mg per 1 ml Clobazam 5mg/5ml oral suspension sugar free sugar-free | 150 ml P £90.00 DT = £90.00 d sugar-free | 250 ml P £150.00 d Clobazam 2 mg per 1 ml Clobazam 10mg/5ml oral suspension sugar free sugar-free | 150 ml P £95.00 DT = £95.00 d sugar-free | 250 ml P £158.33 d ▶Perizam (Rosemont Pharmaceuticals Ltd) Clobazam 1 mg per 1 ml Perizam 1mg/ml oral suspension sugar-free | 150 ml P £90.00 DT = £90.00 d Clobazam 2 mg per 1 ml Perizam 2mg/ml oral suspension sugar-free | 150 ml P £95.00 DT = £95.00 d ▶Tapclob (Martindale Pharmaceuticals Ltd) Clobazam 1 mg per 1 ml Tapclob 5mg/5ml oral suspension sugar- free | 150 ml P £90.00 DT = £90.00 d sugar-free | 250 ml P £150.00 d Clobazam 2 mg per 1 ml Tapclob 10mg/5ml oral suspension sugar- free | 150 ml P £95.00 DT = £95.00 d sugar-free | 250 ml P £158.34 d ▶Zacco (Thame Laboratories Ltd) Clobazam 1 mg per 1 ml Zacco 5mg/5ml oral suspension sugar-free | 150 ml P £82.00 DT = £90.00 d Clobazam 2 mg per 1 ml Zacco 10mg/5ml oral suspension sugar-free | 150 ml P £87.00 DT = £95.00 d Tablet CAUTIONARY AND ADVISORY LABELS 2, 8, 19 ▶Clobazam (Non-proprietary) Clobazam 10 mg Clobazam 10mg tablets | 30 tablet P £3.78 DT = £3.76 d ▶Frisium (Sanofi) Clobazam 10 mg Frisium 10mg tablets | 30 tablet P £2.51 DT = £3.76 d eiiii F 359

PDF pages 375, 376

Clinical care

Patient And Carer Advice

Medicines for Children leaflet: Clobazam for preventing seizures www.medicinesforchildren.org.uk/clobazam-preventing- seizures-0

PDF page 375

Dose text by age group

Child 6–17 years

Initially 5 mg daily, dose to be

First-line fragment. Read the complete Indications and Dose section above.

PDF page 375

Age labels are extracted for navigation. Check the complete source section and current local guidance before clinical use.

Drug reference

Clobazam

BNF 80 (2020–2021)

Source: BNF 80 (2020–2021)
PDF pages: 375, 376

Review source pages for extracted sections and age labels. BNF dose snippets show only their first line.

Overview

Indications And Dose

PDF page 375

Contra Indications

Respiratory depression

PDF page 375

Cautions

Muscle weakness. organic brain changes CAUTIONS, FURTHER INFORMATION The effectiveness of clobazam may decrease signiﬁcantly after weeks or months of continuous therapy.

PDF page 375

Prescribing And Dispensing Information

PDF page 375

National Funding Access Decisions

NHS restrictions Clobazam is not prescribable in NHS primary care except for the treatment of epilepsy; endorse prescription ’SLS’.

PDF page 375

Safety

Important Safety Information

SAFE PRACTICE Clobazam has been confused with clonazepam; care must be taken to ensure the correct drug is prescribed and dispensed.

PDF page 375

Interactions

→Appendix 1: clobazam

PDF page 375

Side Effects

PDF page 375

Breast Feeding

PDF page 375

Renal Impairment

Dose adjustments Start with small doses in severe impairment.

PDF page 375

Monitoring Requirements

PDF page 375

Dose and formulations

Medicinal Forms

PDF pages 375, 376

Clinical care

Patient And Carer Advice

Medicines for Children leaflet: Clobazam for preventing seizures www.medicinesforchildren.org.uk/clobazam-preventing- seizures-0

PDF page 375

Dose text by age group

Child 6–17 years

Initially 5 mg daily, dose to be

First-line fragment. Read the complete Indications and Dose section above.

PDF page 375

Age labels are extracted for navigation. Check the complete source section and current local guidance before clinical use.