2020-08-29 09:08 问：想请问clonazepam是不是一种安眠药，长期吃有什么副作用和会上瘾吗？ 答：氯硝西泮（clonazepam）是一种苯二氮平类（benzodiazepine）镇定剂，这类药物可抑制中枢神经系统，达到安眠镇静效果，并有抗痉挛、抗焦虑、抗癫痫以及肌肉松弛等功能。由于药物会在服药后1小时内发挥作用，效果一般可维持6至12小时。这类镇静安眠药作用在中枢神经系统的γ-胺基丁酸（Gamma-Aminobutyric
Acid，GABA）受体上，增加GABA内泌素的传递，使抑制性内泌素增加，而达到镇定安眠的效果。在一般治疗原则下，应避免连续服用苯二氮平类药物（BZDs）超过4周，否则有成瘾的可能性，超过6周则可能对药物产生耐受性（效果减弱）。 最常见的副作用为嗜睡、头晕、头痛、不安、疲劳、言语不清。其他可能发生的副作用包括唾液增加、食欲增加或减少、牙龈疼痛、口干、排尿困难、思维或记忆困难、性欲或能力变化、言语不清等。这些副作用通常在服用药物一阵子后渐渐消失。不过如果副作用达到困扰程度或经过一段时间还未完全消除，请告知医生以作调整。 长期使用苯二氮平类药有耐受性和依赖性。但是只要按照医生嘱咐的方式服药，不要擅自增减药量或停药，导致病情不稳定、难以控制，就不容易上瘾，或出现耐受性问题。 陈诗欣注册药剂师 文章来源： 问药 · 陈诗欣（注册药剂师）· 2020.09.01 本章节概述了控制晚期患者症状的常用药物（不包括阿片类药物）。其中包括药物的基本剂量，适应症和其可能出现的副作用。 请注意，以下介绍的是新加坡慈怀疗护中普遍使用的非阿片类药物，而这份名单的适应症和其副作用并不详尽。药物剂量仅适用于成年人。对肾脏或肝脏造成受损病患的药物剂量（如有），请征询药剂师以做出相应的调整。 使用持续性皮下输注时，请用水稀释药物，除非另有说明。 Route, Dosage and Frequency
Other InformationIndicationsNeuropathic pain, Seizures, Restless legs, Panic disorder. Side-EffectsSomnolence, Ataxia, Dizziness. RemarksBenzodiazepine. May stick to plastic syringe. Seizures may need higher doses (max 20mg/day). Reference
How does this medication work? What will it do for me?Clonazepam belongs to the class of medications called benzodiazepines. In general, benzodiazepines are used as a sedative or to decrease seizures or anxiety. Clonazepam is used to treat seizure disorders. It helps by slowing the activity of the nerves in the brain (i.e., the central nervous system). This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here. Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor. Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it. What form(s) does this medication come in?0.25 mg 0.5 mg 1 mg 2 mg pms-Clonazepam-R 500 µg How should I use this medication?The dose of clonazepam is determined based on how much is needed to control seizures and varies from person to person. It is important that the dose be individualized to your specific needs to avoid decreased coordination or excessive drowsiness. The recommended adult starting dose of clonazepam should not be greater than 1.5 mg per day in 3 divided doses. This helps to minimize drowsiness and other side effects. Your doctor will gradually increase the dose until your seizures are controlled. The recommended maintenance dose for adults is 8 mg to 10 mg per day in 3 divided doses. For children up to 10 years old or who weigh 30 kilograms or less, the dose is based on body weight. The starting dose should be calculated as 0.01 mg per kilogram of body weight per day to 0.03 mg per kilogram of body weight per day, divided into 2 or 3 doses. The maximum starting dose should be no more than 0.05 mg per kilogram of body weight per day. The doctor will gradually increase the dose until the child's seizures are controlled. Generally, the maintenance dose is between 0.1 mg per kilogram and 0.2 mg per kilogram of body weight. Clonazepam may be taken with food or on an empty stomach. Avoid drinking grapefruit juice while you are taking this medication as it can increase the levels of clonazepam in your blood. Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor. It is important to take this medication exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice. Store this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children. Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired. Who should NOT take this medication?Do not use clonazepam if you:
Clonazepam may be used by people with open angle glaucoma who are receiving appropriate treatment. What side effects are possible with this medication?Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor. The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time. Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.
Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention. Check with your doctor as soon as possible if any of the following side effects occur:
Stop taking the medication and seek immediate medical attention if any of the following occur:
Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication. Are there any other precautions or warnings for this medication?Before you begin taking a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should take this medication. Alcohol and other medications that cause drowsiness: Do not combine this medication with alcohol or other medications (e.g., antidepressants, sleeping pills, anxiety medications, narcotic pain relievers) that cause drowsiness. Doing so can cause additional drowsiness and reduced breathing as well as other side effects, which can be dangerous and possible fatal. People who have an addiction to alcohol or other drugs should not take clonazepam except in rare situations under medical supervision. Breathing: Clonazepam can suppress breathing. This effect on breathing may be more pronounced for people with breathing problems, brain damage, or who are taking other medications that suppress breathing (e.g., codeine, morphine). If you have severe breathing problems, discuss the risks and benefits of taking this medication with your doctor. Coordination problems: If you have a medical condition that affects coordination (e.g., spinal or cerebellar ataxia), discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. Dependence and withdrawal: Physical dependence (a need to take regular doses to prevent physical symptoms) has been associated with benzodiazepines such as clonazepam. Severe withdrawal symptoms may occur if the dose is significantly reduced or suddenly stopped. These symptoms include seizures, irritability, nervousness, sleep problems, agitation, tremors, diarrhea, abdominal cramps, vomiting, memory impairment, headache, muscle pain, extreme anxiety, tension, restlessness, and confusion. Reducing the dose gradually under medical supervision can help prevent or decrease these withdrawal symptoms. Do not suddenly stop taking this medication without talking to your doctor. Depression: Clonazepam, like other benzodiazepines, has been known to cause mood swings and symptoms of depression. If you have depression or a history of depression, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. If you experience symptoms of depression such as poor concentration, changes in weight, changes in sleep, decreased interest in activities, or notice them in a family member who is taking this medication, contact your doctor as soon as possible. Clonazepam is not recommended for use by people with depression or psychosis or who have attempted suicide. Drowsiness/reduced alertness: Because clonazepam causes drowsiness and sedation, avoid activities requiring mental alertness, judgment, and physical coordination (such as driving or operating machinery) while taking it. This is particularly true when first taking the medication and until you have established how clonazepam affects you. Alcohol can increase the drowsiness effects and should be avoided. Grapefruit juice: Avoid drinking grapefruit juice while you are taking this medication as it can increase the levels of clonazepam in your blood. Kidney function: Decreased kidney function or kidney disease may cause this medication to build up in the body, causing side effects. If you have kidney disease or reduced kidney function, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. Lactose intolerance: Lactose is one of the ingredients in this medication. If you have a hereditary condition that makes you intolerant to lactose, discuss other alternatives with your doctor. Liver function: If you have liver disease or decreased liver function, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. People with severe liver problems should not take this medication. Memory: This medication may impair recent memory. If you experience this while taking this medication, contact your doctor. Porphyria: If you have porphyria, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. Seizures: For some people taking this medication, seizures may worsen or a new type of seizure can occur. If you experience worsening seizures or the frequency of your seizures does not decrease while taking this medication, contact your doctor. Pregnancy: Taking clonazepam during pregnancy can increase the risk of certain birth defects. This medication should only be used during pregnancy if the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately. Do not stop taking this medication suddenly, as this may result in withdrawal symptoms. Discuss the options with your doctor and follow their instructions closely. Breast-feeding: This medication passes into breast milk. If you are breast-feeding and are taking clonazepam, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding. Children: If long-term use of clonazepam is being considered for a child, discuss with your child's doctor the benefits and the risks of clonazepam use. Long-term use may have an effect on your child's physical and mental development. Seniors: Seniors may be at increased risk for the sedative and impaired coordination effects of this medication. This can increase the risk of falls and fractures. Seniors may require lower doses of this medication. What other drugs could interact with this medication?There may be an interaction between clonazepam and any of the following:
If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:
An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed. Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications that you are taking. Also tell them about any supplements you take. Since caffeine, the nicotine from cigarettes, or street drugs can affect the action of many medications; you should let your prescriber know if you use them. All material copyright MediResource Inc. 1996 – 2022. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/drug/getdrug/pms-Clonazepam |
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