Monday, November 14, 2016

Use and side effects of Clonotril

Clonotril ® is a brand of clonazepam available in Indian sub-continent. It is a benzodiazepine class medication prescribed for epilepsy, anxiety disorders and for sleep disorders. Most common side effects reported by patients are drowsiness, dizziness, light headedness and walking difficulties (ataxia).

Long term side effects of Clonotril 

In addition to the common short term side effects mentioned above this medication has habit forming properties (Where the person need increasingly higher dosage to get the same effect esp. Sleep and reduction in anxiety) in long term use.

Clonotril 2mg tablets

What are the Uses of Clonotril ®

Epilepsy is the primary use of this medication. It decreases seizure frequency in epileptic patients. But it is commonly used in combination with other anti-epileptic medications. In psychiatry, it can be used to calm down severely disturbed patients and it is also used to treat sleep problems.

However, when it is used for sleep problems, it is very important to identify the underlying cause for the sleep problem. It is important to practice sleep hygiene techniques before getting treatment from sleep medications.

There are many causes for sleep problems that can be treated without sleep inducing medications. Depression and anxiety disorders are common causes for sleep disturbances. These problems settle once underlying cause is treated. In addition, there can be numerous medical problems associated with sleep difficulties.

Clonotril is prescribed in sleep problems, but sleep hygiene techniques should be tried first

Following sleep hygiene methods should be tried before taking medications

1. It is important to use the bed only for sleep

2. Do not take daytime naps or minimize them

3. It is very important not to take alcohol, coffee, coke or chocolate (Caffeine) just before sleep. Alcohol causes serious sleep disturbances. 

4. When you are having difficult time falling asleep then you need to get up from the bed and do something else without staying on the bed.

5. It is also important to make the sleeping environment comfortable, quiet and calm. Make your bed sheets clean and tidy.  

6. Exercise in day time, but not in night before sleep. 

Dose of Clonotril and how to use it

Dosage range is between 0.5mg to 4mg. However, most doctors prescribe between is 1mg and 2mgs. It is usually taken in the night to make sure drowsiness would not interfere with day to day activities. In addition, this medication has long action (30 – 40 hrs), so it is usually prescribed once a day.

Crushing this medication would increase side effects. E.g. Taking half a tablet would increase blood levels rapidly and cause more side effects so take the dose similar to ½ tablet as whole. In addition, take this medication with meal and with a full glass of water. 

It is very important not to exceed the dose prescribed by the doctor. If you feel you need more medication, then discuss with your prescribing doctor. This medication is having habit forming properties, therefore do not take it for long term without explicit advice from your doctor. If you discontinue it suddenly after prolonged use then there is possibility that it will cause severe withdrawal symptoms. 

What are the side effects of Clonotril

Following are a list of common side effects

1. Drowsiness
2. Dizziness
3. Unsteady gait (walking)
4. Muscle weakness

Drowsiness is a very significant side effect. It can affect driving and machinery operation. Sometimes it can persist into the morning even after night dose. Therefore, it is very important that you to see how you feel before driving or operating machinery. 

Operating machinery and driving can be dangerous when you are on this medication

What are the less common side effects of this medication? 

1. Headache and pain

2. Vertigo or unbalanceness 

3. Slurred speech

4. Low blood pressure 

5. Tremors of hands and body

6. Urine problems: - Common in elderly people

7. Respiratory depression: - It is important to tell whether you have respiratory problems such as Asthma, before getting the prescription. 

8. Blood disorders

9. Skin reactions

10. Paradoxical excitation: - Can cause disinhibition and increased activity in certain group of people.

What you should to tell your doctor, before getting the prescription?

If you are known to have following problems or medical condition, it is important that you tell that to your family doctor.

1. Liver problems
2. Kidney problems
3. Heart problems

4. Snoring in the night: - It is an indication of a condition called obstructive sleep apnea. In such people, it can cause dangerous lowering of breathing which causes the blood oxygen levels to drop during sleep. It may result in brain damage. Due to poor sleep at night, people with snoring complaints daytime drowsiness. 

5. Any medications or drugs you are taking, including street drugs

6. If you are a woman, then it is important to mention whether you are pregnant. 

You need to tell whether you are pregnant before getting prescription


Clonotril ® is a benzodiazepine class medication prescribed for epilepsy, calm down disturbed patients and for sleep problems. Common problems associated with this medication are drowsiness, lightheadedness and it can be habit forming in long term use.

Pictures  Courtesy : Wikimedia

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