Clobazam Medication: Uses, Dosage, and Side Effects Explained

Summary of Key Points

Clobazam is a prescription medication primarily used to manage seizure disorders, including Lennox-Gastaut syndrome. It may also be prescribed for conditions such as anxiety, insomnia, and others. Clobazam belongs to the benzodiazepine class, which works by calming the brain and nerves. Since Clobazam can cause side effects, it’s essential to follow your doctor’s instructions carefully. If you have any concerns, consult one of our telemedicine providers for guidance.

Names of Medication

US Brand Name: Onfi (Clobazam)

Generic Name: Clobazam

The generic name refers to the chemical composition of the medication, while the brand name is assigned by the manufacturer. In this article, the generic name is listed in parentheses.

Pharmacologic Category

Clobazam is classified as a benzodiazepine anticonvulsant.

Other medications in this category include diazepam, lorazepam, and clonazepam.

Clobazam Dosage

Clobazam is prescribed for various conditions. Always follow your doctor’s instructions and consult with one of our telemedicine providers before making any changes to your dosage.

Clobazam for Epilepsy

Initial dose: 5 mg to 10 mg once daily, depending on body weight.

Maintenance dose: May be increased by 5 mg increments every 5 to 7 days, up to a maximum of 40 mg per day.

Frequency: Once or twice daily.

Length of treatment: Long-term use, as directed by your doctor.

Clobazam for Lennox-Gastaut Syndrome

Initial dose: 5 mg to 10 mg once daily, depending on body weight.

Maintenance dose: May be increased by 5 mg increments every 5 to 7 days, up to a maximum of 40 mg per day.

Frequency: Once or twice daily.

Length of treatment: Long-term use, as directed by your doctor.

Clobazam for Seizure Disorders

Initial dose: 5 mg to 10 mg once daily.

Maintenance dose: May be increased by 5 mg increments every 5 to 7 days, up to a maximum of 40 mg per day.

Frequency: Once or twice daily.

Length of treatment: Long-term use, as directed by your doctor.

Clobazam for Anxiety Disorders

Initial dose: 10 mg once daily.

Maintenance dose: May be increased by 10 mg increments every 7 days, up to a maximum of 30 mg per day.

Frequency: Once or twice daily.

Length of treatment: Short-term use, typically 2 to 4 weeks, unless otherwise directed by your doctor.

Clobazam for Panic Disorder

Initial dose: 10 mg once daily.

Maintenance dose: May be increased by 10 mg increments every 7 days, up to a maximum of 30 mg per day.

Frequency: Once or twice daily.

Length of treatment: Short-term use, typically 2 to 4 weeks, unless otherwise directed by your doctor.

Clobazam for Insomnia

Initial dose: 5 mg to 10 mg at bedtime.

Maintenance dose: May be increased by 5 mg increments every 7 days, up to a maximum of 20 mg per day.

Frequency: Once daily at bedtime.

Length of treatment: Short-term use, typically 2 to 4 weeks, unless otherwise directed by your doctor.

Clobazam for Alcohol Withdrawal Syndrome

Initial dose: 10 mg once daily.

Maintenance dose: May be increased by 10 mg increments every 7 days, up to a maximum of 30 mg per day.

Frequency: Once or twice daily.

Length of treatment: Short-term use, typically 2 to 4 weeks, unless otherwise directed by your doctor.

Clobazam for Muscle Spasms

Initial dose: 5 mg to 10 mg once daily.

Maintenance dose: May be increased by 5 mg increments every 7 days, up to a maximum of 30 mg per day.

Frequency: Once or twice daily.

Length of treatment: Short-term use, typically 2 to 4 weeks, unless otherwise directed by your doctor.

Clobazam for Neuropathic Pain

Initial dose: 5 mg to 10 mg once daily.

Maintenance dose: May be increased by 5 mg increments every 7 days, up to a maximum of 30 mg per day.

Frequency: Once or twice daily.

Length of treatment: Short-term use, typically 2 to 4 weeks, unless otherwise directed by your doctor.

Clobazam for Restless Legs Syndrome

Initial dose: 5 mg to 10 mg at bedtime.

Maintenance dose: May be increased by 5 mg increments every 7 days, up to a maximum of 20 mg per day.

Frequency: Once daily at bedtime.

Length of treatment: Short-term use, typically 2 to 4 weeks, unless otherwise directed by your doctor.

Dosage Forms and Strengths

Clobazam is available in the following forms:

1. Tablets: 10 mg, 20 mg
2. Oral Suspension: 2.5 mg/mL

How to Take Clobazam Safely

Clobazam can be taken with or without food. If you are using the oral suspension, shake the bottle well before each dose. Be sure to measure the dose accurately using the provided device—avoid using a household spoon, as it may lead to an incorrect dose. If you miss a dose, take it as soon as you remember, unless it’s close to the time of your next dose. Do not take two doses at once. Always follow your doctor’s instructions carefully.

Contraindications for Clobazam

A contraindication is a condition where a medication should not be used due to potential harm. For Clobazam, the following conditions are contraindicated:

1. Severe liver disease: Clobazam is processed by the liver. If you have severe liver disease, your body may not metabolize the medication properly, increasing the risk of side effects or toxicity.
2. Allergic reaction to Clobazam or benzodiazepines: If you’ve had an allergic reaction to Clobazam or other benzodiazepines (e.g., diazepam, lorazepam), taking Clobazam could trigger a severe allergic reaction, including difficulty breathing or swelling.
3. Respiratory depression: Clobazam can slow breathing. If you have respiratory conditions such as severe COPD or sleep apnea, Clobazam may worsen these issues.
4. History of drug or alcohol abuse: Clobazam is a benzodiazepine and can be habit-forming. If you have a history of substance abuse, you may be at a higher risk for dependence or misuse.

Drug to Drug Interactions

Clobazam can interact with other medications, potentially increasing the risk of side effects or reducing the effectiveness of either drug. It’s important to inform your healthcare provider about all the medications you are taking, including prescription drugs, over-the-counter products, and supplements. Some significant Clobazam interactions include:

1. Opioids: Medications such as oxycodone (OxyContin) or hydrocodone (Vicodin) can significantly increase the risk of severe drowsiness, respiratory depression, and even life-threatening complications when combined with Clobazam.
2. Antidepressants: Selective serotonin reuptake inhibitors (SSRIs) like fluoxetine (Prozac) or sertraline (Zoloft) may enhance the sedative effects of Clobazam, leading to increased drowsiness or dizziness.
3. Antifungal medications: Drugs like ketoconazole (Nizoral) or itraconazole (Sporanox) can raise Clobazam levels in your body, which may result in more pronounced side effects.
4. Anticonvulsants: Other seizure medications, such as phenytoin (Dilantin) or carbamazepine (Tegretol), may interact with Clobazam, potentially altering the effectiveness of both drugs.
5. Alcohol: Consuming alcohol while taking Clobazam can increase drowsiness, dizziness, and the risk of overdose.

Clobazam in Pregnancy

Is it Safe to Take Clobazam During Pregnancy?

Clobazam is generally not recommended during pregnancy, particularly in the first trimester, as it may increase the risk of birth defects. Taking Clobazam later in pregnancy can also lead to withdrawal symptoms in the newborn, such as difficulty breathing, irritability, or feeding issues. If you are pregnant or planning to become pregnant, it’s essential to discuss the risks and benefits of continuing Clobazam with your healthcare provider. If you are already taking Clobazam and discover you are pregnant, do not stop the medication abruptly, as this could trigger seizures or other complications. Consult with one of our providers through telemedicine to determine the best course of action for both you and your baby.

Clobazam while Breastfeeding

Is it Safe to Take Clobazam While Breastfeeding?

Clobazam can pass into breast milk and may affect a nursing infant, potentially causing drowsiness, feeding difficulties, or breathing problems. If you are breastfeeding, it’s important to carefully weigh the risks and benefits of continuing Clobazam with your healthcare provider. In some cases, your doctor may recommend an alternative medication or suggest discontinuing breastfeeding while taking Clobazam. If you have concerns, schedule a telemedicine appointment with one of our providers to discuss your options.

Estimated Cost of Clobazam Medication

The cost of a 30-day supply of Clobazam without insurance can vary depending on the pharmacy and location. With a GoodRX coupon, the estimated price for a 30-day supply of Clobazam (10 mg tablets) ranges from $50 to $150. Prices may fluctuate, so it’s a good idea to check with your local pharmacy or use a prescription discount service like GoodRX to find the best price.

Possible Alternatives to Clobazam

If Clobazam is not the right medication for you, there are alternative treatments and lifestyle changes that may help manage your condition. Always consult your healthcare provider before making any changes to your treatment plan. You can also schedule a telemedicine appointment with one of our providers to explore these options.

1. Epilepsy: Alternative medications include levetiracetam (Keppra), lamotrigine (Lamictal), or valproate (Depakote). Lifestyle changes, such as managing stress, getting adequate sleep, and following a ketogenic diet, may also help reduce seizures.
2. Lennox-Gastaut syndrome: Other treatment options include rufinamide (Banzel), topiramate (Topamax), or cannabidiol (Epidiolex). A vagus nerve stimulator (VNS) or dietary modifications may also be considered.
3. Seizure disorders: In addition to Clobazam, medications like carbamazepine (Tegretol) or oxcarbazepine (Trileptal) may be effective. Regular exercise and avoiding known seizure triggers can also help.
4. Anxiety disorders: Selective serotonin reuptake inhibitors (SSRIs) like escitalopram (Lexapro) or cognitive behavioral therapy (CBT) may be helpful alternatives.
5. Panic disorder: SSRIs such as sertraline (Zoloft) or benzodiazepines like alprazolam (Xanax) may be considered. Relaxation techniques, such as deep breathing exercises, may also help manage symptoms.
6. Insomnia: Non-benzodiazepine sleep aids like zolpidem (Ambien) or lifestyle changes, such as improving sleep hygiene, may be beneficial.
7. Alcohol withdrawal syndrome: Medications like diazepam (Valium) or gabapentin (Neurontin) may be used. It is crucial to seek medical supervision during alcohol withdrawal.
8. Muscle spasms: Baclofen (Lioresal) or tizanidine (Zanaflex) are alternative medications. Stretching exercises and physical therapy may also provide relief.
9. Neuropathic pain: Medications like gabapentin (Neurontin) or pregabalin (Lyrica) may be effective. Acupuncture or physical therapy may also help alleviate symptoms.
10. Restless legs syndrome: Dopamine agonists like pramipexole (Mirapex) or lifestyle changes, such as regular exercise and avoiding caffeine, may help manage symptoms.

Recent Updates on Clobazam Research

Recent studies have focused on the long-term safety and effectiveness of Clobazam, particularly in treating Lennox-Gastaut syndrome and other seizure disorders. A 2022 study found that Clobazam remains effective for seizure control over extended periods, although some patients may develop tolerance, requiring dose adjustments. Researchers are also exploring the potential for Clobazam to be used in combination with newer anticonvulsants for improved seizure management. Ongoing clinical trials are investigating Clobazam’s use in pediatric epilepsy patients, with early results showing promise for its safety and efficacy in younger populations.

As new research continues to emerge, staying informed about the latest findings is essential. If you have questions about how these updates might affect your treatment plan, schedule a telemedicine appointment with one of our providers to discuss your options.

James Kingsley

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