Clobazam (Adverse Reactions)

Clobazam is a benzodiazepine used as an anxiolytic and in some cases of epilepsy. Clobazam is mostly metabolized by the cytochrome CYP2C19 and polymorphic variants of this cytochrome may have an impact on treatment.

Clobazam is a long-acting benzodiazepine used as an anxiolytic and in combination with other medications to treat seizures caused by epilepsy.

Its mechanism of action consists of increasing GABA activity by facilitating its binding to the GABAergic receptor.


CONTRAINDICATIONS

Hypersensitivity to clobazam and benzodiazepines.

Myasthenia gravis, sleep apnea syndrome, severe respiratory insufficiency, severe hepatic insufficiency, narrow-angle glaucoma.

Do not ingest during lactation.


PRECAUTIONS

Do not administer to children under 3 years of age, except in exceptional cases where treatment is essential, nor to the elderly. Psychiatric and paradoxical reactions are more frequent in children and the elderly.

Ingestion of clobazam can cause hepatic insufficiency, renal insufficiency, and chronic or acute respiratory insufficiency.

Individuals who are poor metabolizers of clobazam (see technical report) may require dose adjustment.

In patients suffering from pre-existing muscle weakness or spinal or cerebellar ataxia, special monitoring and a reduction in the drug's dosage should be carried out.

After continued use of the drug, there is a risk of tolerance and physical-psychic dependence. Abrupt discontinuation after continued use causes withdrawal syndrome. Do not use in anxiety associated with depression or as a primary treatment for psychotic illness.


SIDE EFFECTS

Somnolence, affective blunting, reduced alertness, confusion, fatigue, headache, dizziness, vertigo, muscle hypotonia, muscle weakness, ataxia, diplopia, amnesia, depression, psychiatric and paradoxical reactions, dry mouth, constipation, decreased appetite, nausea, weight gain, and dependence.


TRADE NAMES

  • Noiafen ®
  • Onfi ®

Genes analyzed

CYP2C19

Bibliography

Tolbert D, Larsen F. A Comprehensive Overview of the Clinical Pharmacokinetics of Clobazam. J Clin Pharmacol. 2019 Jan;59(1):7-19.

Yamamoto Y, Takahashi Y, Imai K, et al. Influence of CYP2C19 polymorphism and concomitant antiepileptic drugs on serum clobazam and N-desmethyl clobazam concentrations in patients with epilepsy. Ther Drug Monit. 2013 Jun;35(3):305-12.

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