Clonazepam — NZ Medication Guide

What is Clonazepam?

Clonazepam is a long-acting benzodiazepine used for epilepsy, panic disorder, and restless legs syndrome. This medication is funded by Pharmac for epilepsy under Special Authority; Class C controlled drug.

What is Clonazepam Used For?

Clonazepam is used as adjunct or monotherapy for certain seizure types (myoclonic, akinetic, absence seizures, Lennox-Gastaut syndrome), panic disorder, and restless legs syndrome. It is a Class C controlled drug.

How Does Clonazepam Work?

Clonazepam enhances GABA-A receptor function, increasing inhibitory neurotransmission in the central nervous system. Its long half-life (18–50 hours) makes it suitable for conditions requiring sustained CNS inhibition, such as epilepsy and panic disorder.

How to Take Clonazepam

For epilepsy: start at 0.5 mg/day increasing to 4–8 mg/day in 2–4 divided doses. For panic disorder: 0.25 mg twice daily increasing to 1 mg/day. For restless legs: 0.5–2 mg at bedtime. Tablets are available in 0.5 mg and 2 mg. Do not stop abruptly.

Common Side Effects of Clonazepam

  • Sedation and drowsiness
  • Dizziness and ataxia
  • Memory impairment
  • Irritability or depression
  • Weight gain

Serious Side Effects — Seek Medical Attention

Contact your doctor or call 111 immediately if you experience any of the following:

  • Dependence and withdrawal seizures (do not stop abruptly after prolonged use)
  • Respiratory depression (with other CNS depressants)
  • Paradoxical excitation (in children and the elderly)
  • Anterograde amnesia
  • Suicidal ideation (all antiepileptics)

Drug Interactions

Clonazepam may interact with other medicines. Always inform your doctor and pharmacist of all medications you are taking. Key interactions include:

  • Other CNS depressants (alcohol, opioids — additive respiratory depression)
  • Other anticonvulsants (complex interactions)
  • Valproate (may increase absence seizures paradoxically in some patients)

New Zealand Prescribing Information

Clonazepam (0.5 mg and 2 mg tablets — Rivotril®) is funded by Pharmac under Special Authority for epilepsy. As a Class C controlled substance, prescriptions must comply with NZ Controlled Drugs regulations. Long-term use in non-epileptic indications (anxiety, insomnia) is not recommended due to dependence risks. Any discontinuation of clonazepam must be gradual (dose reduced by no more than 25% per 1–2 weeks) to prevent withdrawal seizures.

Frequently Asked Questions

Can I stop clonazepam suddenly if I have been taking it for epilepsy?

No — abrupt cessation of clonazepam can cause withdrawal seizures, even in patients without a prior seizure history. Always reduce the dose gradually under your neurologist’s supervision. This is particularly critical in epilepsy management.

Is clonazepam the same as Rivotril?

Yes — Rivotril® is the brand name for clonazepam in New Zealand and many countries. Generic clonazepam is also available. They contain the same active ingredient at the same dose.

Reviewed by a Registered Pharmacist NZ

References & Further Information

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The following New Zealand and international resources were used to inform this page:

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