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Pronunciation
(kloe NA ze pam)
Generic Available (U.S.)
Yes
Controlled Substance
C-IV
Medication Guide
An FDA-approved patient medication guide, which is available with the product information and at http://www.fda.gov/downloads/Drugs/DrugSafety/UCM225680.pdf, must be dispensed with this medication.
REMS Components
KlonoPIN®: Released from REMS requirement 11/29/2011
Brand Names: U.S.
Brand Names: Canada
Pharmacologic Category
Use: Labeled Indications
Alone or as an adjunct in the treatment of petit mal variant (Lennox-Gastaut), akinetic, and myoclonic seizures; petit mal (absence) seizures unresponsive to succimides; panic disorder with or without agoraphobia
Use: Dental
Burning mouth syndrome
Use: Unlabeled
Restless legs syndrome; neuralgia; multifocal tic disorder; parkinsonian dysarthria; bipolar disorder; adjunct therapy for schizophrenia; burning mouth syndrome
Pregnancy Risk Factor
D
Pregnancy Considerations
Clonazepam was shown to be teratogenic in some animal studies. Clonazepam crosses the placenta. Teratogenic effects have been observed with some benzodiazepines; however, additional studies are needed. Epilepsy itself, the number of medications, genetic factors, or a combination of these probably influence the teratogenicity of anticonvulsant therapy. The incidence of premature birth and low birth weights may be increased following maternal use of benzodiazepines; hypoglycemia and respiratory problems in the neonate may occur following exposure late in pregnancy. Neonatal withdrawal symptoms may occur within days to weeks after birth and “floppy infant syndrome” (which also includes withdrawal symptoms) has been reported with some benzodiazepines, including clonazepam.Patients exposed to clonazepam during pregnancy are encouraged to enroll themselves into the AED Pregnancy Registry by calling 1-888-233-2334. Additional information is available at www.aedpregnancyregistry.org.
Lactation
Enters breast milk/not recommended
Breast-Feeding Considerations
Clonazepam enters breast milk. Drowsiness, lethargy, or weight loss in nursing infants have been observed in case reports following maternal use of some benzodiazepines.
Contraindications
Hypersensitivity to clonazepam or any component of the formulation (cross-sensitivity with other benzodiazepines may exist); significant liver disease; narrow-angle glaucoma; pregnancy
Warnings/Precautions
Concerns related to adverse effects:
• Anterograde amnesia: Benzodiazepines have been associated with anterograde amnesia.
• CNS depression: May cause CNS depression, which may impair physical or mental abilities; patients must be cautioned about performing tasks which require mental alertness (eg, operating machinery or driving).
• Paradoxical reactions: Paradoxical reactions, including hyperactive or aggressive behavior, have been reported with benzodiazepines, particularly in adolescent/pediatric or psychiatric patients.
• Suicidal ideation: Pooled analysis of trials involving various antiepileptics (regardless of indication) showed an increased risk of suicidal thoughts/behavior (incidence rate: 0.43% treated patients compared to 0.24% of patients receiving placebo); risk observed as early as 1 week after initiation and continued through duration of trials (most trials ≤24 weeks). Monitor all patients for notable changes in behavior that might indicate suicidal thoughts or depression; notify healthcare provider immediately if symptoms occur.
Disease-related concerns:
• Depression: Use caution in patients with depression, particularly if suicidal risk may be present.
• Drug abuse: Use with caution in patients with a history of drug abuse or acute alcoholism; potential for drug dependency exists. Tolerance, psychological and physical dependence may occur with prolonged use.
• Hepatic impairment: Use with caution in patients with hepatic impairment.
• Impaired gag reflex: Use with caution in patients with an impaired gag reflex.
• Renal impairment: Use with caution in patients with renal impairment.
• Respiratory disease: Use with caution in patients with respiratory disease.
Concurrent drug therapy issues:
• CNS depressants/psychoactive medications: Use with caution in patients receiving other CNS depressants or psychoactive medication; effects with other sedative drugs or ethanol may be potentiated.
• Valproic acid: Concurrent use with valproic acid may result in absence status.
Special populations:
• Debilitated patients: Use with caution in debilitated patients.
• Elderly: In older adults, benzodiazepines increase the risk of impaired cognition, delirium, falls, fractures, and motor vehicle accidents. Due to increased sensitivity in this age group and slower metabolism of long-acting agents (such as clonazepam), avoid use for treatment of insomnia, agitation, or delirium (Beers Criteria).
• Fall risk: Use with extreme caution in patients who are at risk of falls; benzodiazepines have been associated with falls and traumatic injury.
Other warnings/precautions:
• Appropriate use: Does not have analgesic, antidepressant, or antipsychotic properties. Worsening of seizures may occur when added to patients with multiple seizure types. Monitoring of CBC and liver function tests has been recommended during prolonged therapy.
• Withdrawal: Rebound or withdrawal symptoms may occur following abrupt discontinuation or large decreases in dose. Use caution when reducing dose or withdrawing therapy; decrease slowly and monitor for withdrawal symptoms. Flumazenil may cause withdrawal in patients receiving long-term benzodiazepine therapy.
Adverse Reactions
Reactions reported in patients with seizure and/or panic disorder. Frequency not always defined.
Cardiovascular: Edema (ankle or facial), palpitation
Central nervous system: Amnesia, ataxia (seizure disorder ~30%; panic disorder 5%), behavior problems (seizure disorder ~25%), coma, confusion, depression, dizziness, drowsiness (seizure disorder ~50%), emotional lability, fatigue, fever, hallucinations, headache, hypotonia, hysteria, insomnia, intellectual ability reduced, memory disturbance, nervousness; paradoxical reactions (including aggressive behavior, agitation, anxiety, excitability, hostility, irritability, nervousness, nightmares, sleep disturbance, vivid dreams); psychosis, slurred speech, somnolence (panic disorder 37%), suicidal attempt, suicide ideation, vertigo
Dermatologic: Hair loss, hirsutism, skin rash
Endocrine & metabolic: Dysmenorrhea, libido increased/decreased
Gastrointestinal: Abdominal pain, anorexia, appetite increased/decreased, coated tongue, constipation, dehydration, diarrhea, gastritis, gum soreness, nausea, weight changes (loss/gain), xerostomia
Genitourinary: Colpitis, dysuria, ejaculation delayed, enuresis, impotence, micturition frequency, nocturia, urinary retention, urinary tract infection
Hematologic: Anemia, eosinophilia, leukopenia, thrombocytopenia
Hepatic: Alkaline phosphatase increased (transient), hepatomegaly, transaminases increased (transient)
Neuromuscular & skeletal: Choreiform movements, coordination abnormal, dysarthria, muscle pain, muscle weakness, myalgia, tremor
Ocular: Blurred vision, eye movements abnormal, diplopia, nystagmus
Respiratory: Chest congestion, cough, bronchitis, hypersecretions, pharyngitis, respiratory depression, respiratory tract infection, rhinitis, rhinorrhea, shortness of breath, sinusitis
Miscellaneous: Allergic reaction, aphonia, dysdiadochokinesis, encopresis, “glassy-eyed” appearance, hemiparesis, lymphadenopathy
Metabolism/Transport Effects
Substrate of CYP3A4 (major); Note: Assignment of Major/Minor substrate status based on clinically relevant drug interaction potential
Drug Interactions
Alcohol (Ethyl): CNS Depressants may enhance the CNS depressant effect of Alcohol (Ethyl). Risk C: Monitor therapy
Antifungal Agents (Azole Derivatives, Systemic): May decrease the metabolism of Benzodiazepines (metabolized by oxidation). Management: The following combinations are specifically contraindicated: itraconazole with alprazolam, estazolam, oral midazolam, or triazolam; ketoconazole with alprazolam, estazolam, or triazolam. Consider initial dose reductions of other benzodiazepines. Risk D: Consider therapy modification
Aprepitant: May increase the serum concentration of Benzodiazepines (metabolized by oxidation). Risk C: Monitor therapy
Calcium Channel Blockers (Nondihydropyridine): May decrease the metabolism of Benzodiazepines (metabolized by oxidation). Exceptions: Bepridil [Off Market]. Risk D: Consider therapy modification
CarBAMazepine: May increase the metabolism of Benzodiazepines (metabolized by oxidation). Risk C: Monitor therapy
Cimetidine: May decrease the metabolism of Benzodiazepines (metabolized by oxidation). Risk C: Monitor therapy
CloZAPine: Benzodiazepines may enhance the adverse/toxic effect of CloZAPine. Management: Consider decreasing the dose of (or possibly discontinuing) benzodiazepines prior to initiating clozapine. Risk D: Consider therapy modification
CNS Depressants: May enhance the adverse/toxic effect of other CNS Depressants. Exceptions: Levocabastine (Nasal). Risk C: Monitor therapy
Conivaptan: May increase the serum concentration of CYP3A4 Substrates. Risk X: Avoid combination
Contraceptives (Estrogens): May decrease the metabolism of Benzodiazepines (metabolized by oxidation). Risk C: Monitor therapy
Contraceptives (Progestins): May increase the serum concentration of Benzodiazepines (metabolized by oxidation). Risk C: Monitor therapy
CYP3A4 Inducers (Strong): May increase the metabolism of CYP3A4 Substrates. Risk C: Monitor therapy
CYP3A4 Inhibitors (Moderate): May decrease the metabolism of CYP3A4 Substrates. Risk C: Monitor therapy
CYP3A4 Inhibitors (Strong): May decrease the metabolism of CYP3A4 Substrates. Risk D: Consider therapy modification
Dasatinib: May increase the serum concentration of CYP3A4 Substrates. Risk C: Monitor therapy
Deferasirox: May decrease the serum concentration of CYP3A4 Substrates. Risk C: Monitor therapy
Droperidol: May enhance the CNS depressant effect of CNS Depressants. Management: Consider dose reductions of droperidol or of other CNS agents (e.g., opioids, barbiturates) with concomitant use. Risk D: Consider therapy modification
Fosaprepitant: May increase the serum concentration of Benzodiazepines (metabolized by oxidation). Specifically, the active metabolite aprepitant is likely responsible for this effect. Risk C: Monitor therapy
Fosphenytoin: Benzodiazepines may increase the serum concentration of Fosphenytoin. Short-term exposure to benzodiazepines may not present as much risk as chronic therapy. Risk C: Monitor therapy
Grapefruit Juice: May decrease the metabolism of Benzodiazepines (metabolized by oxidation). Risk D: Consider therapy modification
HydrOXYzine: May enhance the CNS depressant effect of CNS Depressants. Risk C: Monitor therapy
Isoniazid: May decrease the metabolism of Benzodiazepines (metabolized by oxidation). Risk C: Monitor therapy
Ivacaftor: May increase the serum concentration of CYP3A4 Substrates. Risk C: Monitor therapy
Macrolide Antibiotics: May decrease the metabolism of Benzodiazepines (metabolized by oxidation). Exceptions: Azithromycin; Azithromycin (Systemic); Fidaxomicin; Spiramycin. Risk D: Consider therapy modification
Methotrimeprazine: CNS Depressants may enhance the CNS depressant effect of Methotrimeprazine. Methotrimeprazine may enhance the CNS depressant effect of CNS Depressants. Management: Reduce adult dose of CNS depressant agents by 50% with initiation of concomitant methotrimeprazine therapy. Further CNS depressant dosage adjustments should be initiated only after clinically effective methotrimeprazine dose is established. Risk D: Consider therapy modification
Metyrosine: CNS Depressants may enhance the sedative effect of Metyrosine. Risk C: Monitor therapy
Mifepristone: May increase the serum concentration of CYP3A4 Substrates. Management: Minimize doses of CYP3A4 substrates, and monitor for increased concentrations/toxicity, during and 2 weeks following treatment with mifepristone. Avoid cyclosporine, dihydroergotamine, ergotamine, fentanyl, pimozide, quinidine, sirolimus, and tacrolimus. Risk D: Consider therapy modification
OLANZapine: May enhance the adverse/toxic effect of Benzodiazepines. Management: Avoid concomitant use of parenteral benzodiazepines and IM olanzapine due to risks of additive adverse events (e.g., cardiorespiratory depression). Olanzapine prescribing information provides no specific recommendations regarding oral administration. Risk X: Avoid combination
Phenytoin: Benzodiazepines may increase the serum concentration of Phenytoin. Short-term exposure to benzodiazepines may not present as much risk as chronic therapy. Risk C: Monitor therapy
Proton Pump Inhibitors: May increase the serum concentration of Benzodiazepines (metabolized by oxidation). Exceptions: Lansoprazole; Pantoprazole; RABEprazole. Risk C: Monitor therapy
Rifamycin Derivatives: May increase the metabolism of Benzodiazepines (metabolized by oxidation). Risk D: Consider therapy modification
Selective Serotonin Reuptake Inhibitors: May decrease the metabolism of Benzodiazepines (metabolized by oxidation). Exceptions: Citalopram; Escitalopram; PARoxetine; Sertraline. Risk C: Monitor therapy
Selective Serotonin Reuptake Inhibitors: CNS Depressants may enhance the adverse/toxic effect of Selective Serotonin Reuptake Inhibitors. Specifically, the risk of psychomotor impairment may be enhanced. Risk C: Monitor therapy
St Johns Wort: May increase the metabolism of Benzodiazepines (metabolized by oxidation). Risk C: Monitor therapy
Theophylline Derivatives: May diminish the therapeutic effect of Benzodiazepines. Risk D: Consider therapy modification
Tocilizumab: May decrease the serum concentration of CYP3A4 Substrates. Risk C: Monitor therapy
Yohimbine: May diminish the therapeutic effect of Antianxiety Agents. Risk C: Monitor therapy
Ethanol/Nutrition/Herb Interactions
Ethanol: May increase CNS depression; monitor for increased effects with coadministration. Caution patients about effects.
Food: Clonazepam serum concentration is unlikely to be increased by grapefruit juice because of clonazepam's high oral bioavailability.
Herb/Nutraceutical: St John's wort may decrease clonazepam levels. Avoid valerian, St John's wort, kava kava, gotu kola (may increase CNS depression).
Mechanism of Action
The exact mechanism is unknown, but believed to be related to its ability to enhance the activity of GABA; suppresses the spike-and-wave discharge in absence seizures by depressing nerve transmission in the motor cortex
Pharmacodynamics/Kinetics
Onset of action: 20-60 minutes
Duration: Infants and young children: 6-8 hours; Adults: ≤12 hours
Absorption: Well absorbed
Distribution: Adults: Vd: 1.5-4.4 L/kg
Protein binding: 85%
Metabolism: Extensively hepatic via glucuronide and sulfate conjugation
Half-life elimination: Children: 22-33 hours; Adults: 19-50 hours
Time to peak, serum: 1-3 hours; Steady-state: 5-7 days
Excretion: Urine (<2% as unchanged drug); metabolites excreted as glucuronide or sulfate conjugates
Dosage
Oral:
Children <10 years or 30 kg: Seizure disorders:
Initial daily dose: 0.01-0.03 mg/kg/day (maximum: 0.05 mg/kg/day) given in 2-3 divided doses; increase by no more than 0.5 mg every third day until seizures are controlled or adverse effects seen
Usual maintenance dose: 0.1-0.2 mg/kg/day divided 3 times/day, not to exceed 0.2 mg/kg/day
Adults:
Burning mouth syndrome (unlabeled use): 0.25-3 mg/day in 2 divided doses, in morning and evening
Seizure disorders:
Initial daily dose not to exceed 1.5 mg given in 3 divided doses; may increase by 0.5-1 mg every third day until seizures are controlled or adverse effects seen (maximum: 20 mg/day)
Usual maintenance dose: 0.05-0.2 mg/kg; do not exceed 20 mg/day
Panic disorder: 0.25 mg twice daily; increase in increments of 0.125-0.25 mg twice daily every 3 days; target dose: 1 mg/day (maximum: 4 mg/day)
Discontinuation of treatment: To discontinue, treatment should be withdrawn gradually. Decrease dose by 0.125 mg twice daily every 3 days until medication is completely withdrawn.
Elderly: Initiate with low doses and observe closely
Hemodialysis: Supplemental dose is not necessary
Dental Usual Dosing
Burning mouth syndrome (unlabeled use): Adults: Oral: 0.25-3 mg/day in 2 divided doses, in morning and evening
Administration: Oral
Orally-disintegrating tablet: Open pouch and peel back foil on the blister; do not push tablet through foil. Use dry hands to remove tablet and place in mouth. May be swallowed with or without water. Use immediately after removing from package.
Monitoring Parameters
CBC, liver function tests; observe patient for excess sedation, respiratory depression; suicidality (eg, suicidal thoughts, depression, behavioral changes)
Reference Range
Relationship between serum concentration and seizure control is not well established
Timing of serum samples: Peak serum levels occur 1-3 hours after oral ingestion; the half-life is 20-40 hours; therefore, steady-state occurs in 5-7 days
Therapeutic levels: 20-80 ng/mL; Toxic concentration: >80 ng/mL
Patient Education
Drug may cause physical and/or psychological dependence. While using this medication, do not use alcohol. You may experience drowsiness, dizziness, blurred vision, nausea, vomiting, loss of appetite, dry mouth, or constipation. If medication is used to control seizures, wear identification that you are taking an antiepileptic medication. Report excessive drowsiness, dizziness, fatigue, or impaired coordination; CNS changes (confusion, depression, increased sedation, excitation, headache, agitation, insomnia, or nightmares) or changes in cognition; respiratory difficulty or shortness of breath; changes in urinary pattern; changes in sexual activity; muscle cramping, weakness, tremors, or rigidity; ringing in ears or visual disturbances; excessive perspiration; excessive GI symptoms (cramping, constipation, vomiting, anorexia); or worsening of seizure activity or loss of seizure control.
Geriatric Considerations
Hepatic clearance may be decreased allowing accumulation of active drug. Also, metabolites of clonazepam are renally excreted and may accumulate in the elderly as renal function declines with age. Observe for signs of CNS and pulmonary toxicity.
This medication is considered to be potentially inappropriate in this patient population (Beers Criteria: Quality of evidence - high; Strength of recommendation - strong).
Additional Information
Ethosuximide or valproic acid may be preferred for treatment of absence (petit mal) seizures. Clonazepam-induced behavioral disturbances may be more frequent in mentally handicapped patients. Abrupt discontinuation after sustained use (generally >10 days) may cause withdrawal symptoms. Flumazenil, a competitive benzodiazepine antagonist at the CNS receptor site, reverses benzodiazepine-induced CNS depression.
Anesthesia and Critical Care Concerns/Other Considerations
Flumazenil, a competitive benzodiazepine antagonist at the CNS receptor site, reverses benzodiazepine-induced CNS depression. Abrupt discontinuation after sustained use (generally >10 days) may cause withdrawal symptoms.
Dental Health: Effects on Dental Treatment
Key adverse event(s) related to dental treatment: Xerostomia and changes in salivation (normal salivary flow resumes upon discontinuation), gum soreness, and coated tongue.
Dental Health: Vasoconstrictor/Local Anesthetic Precautions
No information available to require special precautions
Mental Health: Comment
In 2007, the FDA requested that all manufacturers of sedative-hypnotic drug products revise labeling to include a greater emphasis on the risks of adverse effects. These risks include severe allergic reactions (anaphylaxis, angioedema) and complex sleep-related behaviors, which may include sleep-driving (driving while not fully awake and with no memory of the event), making phone calls, and preparing and eating food while asleep.
There are two subtypes of GABA receptors (GABA-A and GABA-B) and three different benzodiazepine receptors (Bz1, Bz2, and Bz3). Benzodiazepine receptors and effects appear to be linked to the GABA-A receptors. Benzodiazepines do not bind to GABA-B receptors. The role of GABA-B receptors is unclear. Benzodiazepines have no specificity for benzodiazepine receptor subtypes.
Clonazepam is a long half-life benzodiazepine. Duration of action after a single dose is determined by redistribution rather than metabolism. Tolerance develops to the sedative, hypnotic, and anticonvulsant effects. It does not develop to the anxiolytic or skeletal muscle relaxing effects. Psychological and physical dependence may occur with prolonged use of benzodiazepines. The onset of withdrawal symptoms is usually seen on the first day without drug and lasts 5-7 days in patients receiving short half-life benzodiazepines, whereas, the onset occurs after 5 days with a duration of 10-14 days after abrupt discontinuance of long half-life benzodiazepines. Risk factors for abuse include personal or family history of substance abuse and personality disorder.
Nursing: Physical Assessment/Monitoring
Assess for signs of CNS depression. Assess history of addiction; long-term use can result in dependence, abuse, or tolerance; periodically evaluate need for continued use. For inpatient use, institute safety measures to prevent falls. Taper dosage slowly when discontinuing. Teach patient seizure precautions (if administered for seizures).
Dosage Forms
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Tablet, oral: 0.5 mg, 1 mg, 2 mg
KlonoPIN®: 0.5 mg [scored]
KlonoPIN®: 1 mg, 2 mg
Tablet, orally disintegrating, oral: 0.125 mg, 0.25 mg, 0.5 mg, 1 mg, 2 mg
Pricing: U.S. (www.drugstore.com)
Tablet, orally-disintegrating (ClonazePAM ODT)
0.125 mg (60): $69.99
0.25 mg (60): $76.99
0.5 mg (60): $74.99
1 mg (60): $80.99
2 mg (60): $105.99
Tablets (ClonazePAM)
0.5 mg (30): $13.99
1 mg (30): $11.99
2 mg (30): $12.99
Tablets (KlonoPIN)
0.5 mg (30): $60.99
1 mg (30): $67.99
2 mg (30): $89.99
Extemporaneously Prepared
A 0.1 mg/mL oral suspension may be made with tablets and one of three different vehicles (cherry syrup; a 1:1 mixture of Ora-Sweet® and Ora-Plus®; or a 1:1 mixture of Ora-Sweet® SF and Ora-Plus®). Crush six 2 mg tablets in a mortar and reduce to a fine powder. Add 10 mL of the chosen vehicle and mix to a uniform paste; mix while adding the vehicle in incremental proportions to almost 120 mL; transfer to a calibrated bottle, rinse mortar with vehicle, and add quantity of vehicle sufficient to make 120 mL. Label “shake well” and “protect from light”. Stable for 60 days when stored in amber prescription bottles in the dark at room temperature or refrigerated.
Allen LV Jr and Erickson MA 3rd, "Stability of Acetazolamide, Allopurinol, Azathioprine, Clonazepam, and Flucytosine in Extemporaneously Compounded Oral Liquids," Am J Health Syst Pharm, 1996, 53(16):1944-9.
References
American Academy of Pediatrics Committee on Drugs, "Transfer of Drugs and Other Chemicals Into Human Milk,” Pediatrics, 2001, 108(3):776-89.
"American Geriatrics Society Updated Beers Criteria for Potentially Inappropriate Medication Use in Older Adults," J Am Geriatr Soc, 2012 [epub ahead of print].
Barnett AM, “Treatment of Epilepsy With Clonazepam,” S Afr Med J, 1973, 47(37):1683-6.
Bergman U, Rosa FW, Baum C, et al, "Effects of Exposure to Benzodiazepine During Fetal Life," Lancet, 1992, 340(8821):694-6.
Birnbaum CS, Cohen LS, Bailey JW, et al, "Serum Concentrations of Antidepressants and Benzodiazepines in Nursing Infants: A Case Series," Pediatrics, 1999, 104(1):e11.
Bladin PF, “The Use of Clonazepam as an Anticonvulsant - Clinical Evaluation,” Med J Aust, 1973, 1(14):683-8.
Brogden RN and Goa KL, “Flumazenil. A Preliminary Review of Its Benzodiazepine Antagonist Properties, Intrinsic Activity, and Therapeutic Use,” Drugs, 1988, 35(4):448-67.
Buchanan J and Zakrzewska J, “Burning Mouth Syndrome,” Clin Evid (online), March 14, 2008. Available at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2907957/pdf/2008-1301.pdf
Iqbal MM, Sobhan T, Ryals T, et al, "Effects of Commonly Used Benzodiazepines on the Fetus, the Neonate, and the Nursing Infant," Psychiatr Serv, 2002, 53(1):39-49.
Mínguez Serra MP, Salort Llorca C, Silvestre Donat FJ, “Pharmacological Treatment of Burning Mouth Syndrome: A Review and Update,” Med Oral Patol Oral Cir Bucal, 2007, 12(4):E299-304.
Mokhlesi B, Leikin JB, Murray P, et al, “Adult Toxicology in Critical Care: Part II: Specific Poisonings,” Chest, 2003, 123(3):897-922.
Sugai K, “Seizures With Clonazepam: Discontinuation and Suggestions for Safe Discontinuation Rates in Children,” Epilepsia, 1993, 34(6):1089-97.
Wikner BN, Stiller CO, Bergman U, et al, "Use of Benzodiazepines and Benzodiazepine Receptor Agonists During Pregnancy: Neonatal Outcome and Congenital Malformations," Pharmacoepidemiol Drug Saf, 2007, 16(11):1203-10.
International Brand Names
Lexi-Comp.com
Last full review/revision April 2012
Content last modified April 2012
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