PRALUENT 150mg Price

Overview

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This medicine contains an important and useful components, as it consists of
Alirocumabis available in the market in concentration

Name

Clobazam

Precaution

Clobazam is a medication primarily used for the treatment of seizures, including those associated with epilepsy, and as an adjunctive therapy for generalized anxiety disorder. It belongs to the class of drugs known as benzodiazepines, which can cause sedative effects, so caution should be exercised in patients with a history of substance abuse, alcohol dependence, or addiction. Patients should be monitored for signs of misuse, abuse, and physical or psychological dependence, particularly with long-term use. Additionally, because clobazam can cause drowsiness, dizziness, and cognitive impairment, it should be used cautiously in patients who need to perform activities requiring full mental alertness, such as driving or operating heavy machinery. It should be avoided in patients with a history of respiratory depression or severe chronic obstructive pulmonary disease (COPD), as clobazam can exacerbate these conditions. In elderly patients, the risk of sedation and falls is higher, so a reduced dosage or more frequent monitoring may be required. Pregnant and breastfeeding women should consult with their healthcare provider before using clobazam, as the medication is categorized as a Category C drug in pregnancy (risk cannot be ruled out). Regular monitoring for adverse effects like sedation, respiratory depression, and changes in mood or behavior is recommended, especially during the initiation or dose adjustments of treatment.

Indication

Clobazam is indicated for the management of seizures in individuals with epilepsy, particularly for those who have not responded well to other anticonvulsant medications. It is often used as an adjunctive therapy in the treatment of partial seizures, including those with or without secondary generalization, as well as generalized seizures. Clobazam is also used for the treatment of anxiety disorders, particularly generalized anxiety disorder, in cases where other treatments are insufficient or not tolerated. This medication helps control the frequency and severity of seizures by inhibiting the transmission of nerve impulses in the brain, reducing hyperexcitability. It is approved for use in both adults and children (aged 2 years and older) for seizure disorders, but the treatment is typically based on a comprehensive approach, including lifestyle changes and other anticonvulsant therapies. While its primary use is for epilepsy and anxiety, clobazam is occasionally used off-label for conditions such as acute alcohol withdrawal or for the management of muscle spasms, though these uses are not FDA-approved.

Contra indication

Clobazam is contraindicated in patients who have a known hypersensitivity to clobazam, other benzodiazepines, or any of the ingredients in the formulation. It should not be used in individuals with acute narrow-angle glaucoma or a history of severe allergic reactions to benzodiazepines. Additionally, patients with severe liver impairment should not use clobazam, as the drug is metabolized by the liver, and liver dysfunction may lead to elevated drug levels, increasing the risk of side effects like sedation, respiratory depression, or even overdose. Clobazam is also contraindicated in patients with a history of substance abuse or those who are currently using alcohol or other CNS depressants, as this could increase the risk of severe sedation and respiratory depression. The drug should not be used during pregnancy unless absolutely necessary, due to the potential risks to the fetus, such as withdrawal symptoms or teratogenic effects, especially during the first trimester. Clobazam is also contraindicated in breastfeeding mothers because the drug can be excreted in breast milk, potentially affecting the infant.

Side Effect

The most common side effects of clobazam include drowsiness, dizziness, and sedation, which are typical of benzodiazepines and are often most pronounced during the initial stages of treatment or with dose increases. Other common side effects may include fatigue, ataxia (lack of coordination), and memory impairment. These side effects usually improve with continued use as the body adapts to the medication. Clobazam may also cause mood or behavior changes, including irritability, aggression, or depression, particularly in children and adolescents, which requires careful monitoring during treatment. Less commonly, patients may experience allergic reactions, including rash, itching, or swelling of the face, lips, or throat, which may indicate a serious condition requiring discontinuation of the medication. Serious side effects include respiratory depression, especially when combined with other CNS depressants, and a risk of overdose if used inappropriately. Long-term use of clobazam may lead to physical dependence or withdrawal symptoms if the medication is abruptly stopped, which may include anxiety, seizures, or tremors. Patients should never stop taking clobazam suddenly without a healthcare provider’s supervision, as a tapering schedule is recommended to reduce withdrawal symptoms.

Pregnancy Category ID

3

Mode of Action

Clobazam exerts its therapeutic effects through its action on the central nervous system (CNS) as a benzodiazepine. It works by enhancing the activity of gamma-aminobutyric acid (GABA), a neurotransmitter that inhibits nerve activity in the brain. GABA binds to receptors in the brain and increases chloride ion influx into neurons, leading to a hyperpolarized state that makes it more difficult for these neurons to fire. Clobazam binds to a specific site on the GABA-A receptor, potentiating the inhibitory effects of GABA, which in turn reduces neuronal excitability. This mechanism of action helps to control seizures by stabilizing electrical activity in the brain and preventing hyperexcitability that leads to seizure activity. In the case of anxiety disorders, clobazam’s enhancement of GABAergic activity reduces the overactive neural circuits that contribute to anxiety, leading to anxiolytic (anxiety-reducing) effects. The sedative properties of clobazam are a result of this GABAergic modulation, which can lead to drowsiness and muscle relaxation. The drug’s ability to manage both seizures and anxiety is attributed to this dual effect on the GABA system, making it a versatile medication for various CNS disorders.

Interaction

Clobazam can interact with a variety of medications, particularly those that affect the central nervous system (CNS). It should not be combined with other CNS depressants, such as alcohol, barbiturates, opioids, or other benzodiazepines, as this can increase the risk of severe sedation, respiratory depression, coma, or even death. The combination of clobazam with certain antidepressants, antipsychotics, or antihistamines may also increase the risk of drowsiness and cognitive impairment. Additionally, clobazam may enhance the sedative effects of other medications, including anticonvulsants, leading to increased side effects such as dizziness, drowsiness, and confusion. Clobazam is metabolized in the liver by the cytochrome P450 enzyme system, particularly CYP3A4 and CYP2C19. Drugs that inhibit these enzymes, such as ketoconazole, fluvoxamine, or grapefruit juice, may increase clobazam levels in the blood, raising the risk of adverse effects. Conversely, medications that induce these enzymes, such as carbamazepine or rifampin, can lower clobazam levels, potentially decreasing its efficacy in controlling seizures. Patients should inform their healthcare provider of all medications they are taking, including over-the-counter drugs and supplements, to avoid potential drug interactions.

Pregnancy Category Note

Information not available

Adult Dose

For adults, the initial recommended dose of clobazam for the treatment of seizures is typically 10 to 20 mg per day, administered orally, either as a single dose or divided into two doses. The dose can be gradually increased based on the patient’s response and tolerance, usually by increments of 10 mg every 3–4 days. The maximum recommended dose for adults is 40 mg per day. For anxiety, the starting dose may be lower, typically 10 mg daily, and can be increased to a maximum of 30 mg per day depending on the patient’s response. It is important to administer clobazam with caution in elderly patients, who may require lower starting doses (5 mg) to minimize the risk of sedation and cognitive impairment. Patients should take clobazam with or without food, and the dosage should be tailored based on the severity of symptoms, with adjustments made during follow-up visits. If clobazam is discontinued, it should be done gradually to prevent withdrawal symptoms.

Child Dose

For children aged 2 years and older, the recommended initial dose of clobazam for the treatment of seizures is typically 5 mg per day, which may be increased gradually based on the child's age, weight, and response to treatment. The usual dose range for children is between 5 mg and 20 mg per day, with a maximum dose of 20 mg per day for those aged 2 to 5 years and up to 40 mg per day for older children. For children with generalized anxiety disorder, the dose may be adjusted similarly, but caution is required due to the risk of side effects such as sedation, behavioral changes, and memory impairment. As with adults, the medication should be titrated to the lowest effective dose to minimize the risk of side effects, and children should be closely monitored for any signs of adverse reactions. Long-term use of clobazam in children requires careful monitoring of developmental milestones and mental health. The medication should be discontinued gradually in pediatric patients to avoid withdrawal symptoms.

Renal Dose

Clobazam is primarily metabolized in the liver, with minimal excretion through the kidneys, so renal impairment has a limited effect on its pharmacokinetics. However, for patients with severe renal impairment (e.g., creatinine clearance < 30 mL/min), clobazam should be used with caution, and dosage adjustments may be required based on clinical response. While renal function does not significantly impact the metabolism of clobazam, patients with impaired renal function should still be closely monitored for signs of excessive sedation or other adverse effects, especially if there is concomitant liver impairment. If any signs of systemic effects arise, such as increased sedation or respiratory depression, it may be necessary to reduce the dose of clobazam.

Administration

Information not available