Clonazepam for preventing seizures

This leaflet is about the use of clonazepam to prevent epileptic seizures. (Seizures may also be called convulsions or fits.)

Do not stop giving clonazepam suddenly, as your child may have more seizures.

This leaflet has been written specifically about the use of this medicine in children. The information may differ from that provided by the manufacturer. Please read this leaflet carefully. Keep it somewhere safe so that you can read it again.

Name of drug

Clonazepam

Brand name: Rivotril^®

Why is it important for my child to take this medicine?

It is important that your child takes clonazepam regularly so that they have fewer seizures.

What is clonazepam available as?

tablets: 2 mg (white), 0.5 mg (light brown)
a liquid medicine can be ordered specially from your pharmacist but it may take up to 3 weeks to supply

When should I give clonazepam?

Clonazepam is usually given twice or three times a day.

If it is to be given twice a day, this should be once in the morning and once in the evening. Ideally, these times are 10–12 hours apart, for example sometime between 7 and 8 am and between 7 and 8 pm.

If it is to be given three times a day, this should be first thing in the morning, early afternoon and at bedtime. Ideally, these times should be at least 4 hours apart.

How much should I give?

Your doctor will work out the amount of clonazepam (the dose) that is right for your child. The dose will be shown on the medicine label.

When you first start giving clonazepam to your child, you will give them a small amount and then increase the dose bit by bit over a few days or weeks. This helps your child to get used to the medicine. Your doctor will explain what to do.

It is important that you follow your doctor’s instructions about how much to give.

How should I give it?

Tablets: These should be swallowed whole with a glass of water, milk or juice. Your child should not chew the tablets.

You can crush the tablet and mix it with a small amount of soft food (e.g. yogurt, honey or jam) or a drink (water or juice). Your child should swallow the food without chewing. Make sure they take all the food or drink.

Liquid medicine: measure out the right amount using a proper medicine spoon or oral syringe. You can get these from your pharmacist. Do not use a kitchen teaspoon as it will not give the right amount.

When should the medicine start working?

It will take a few days or up to a week for clonazepam to work properly, so your child may still have seizures during this time. This is because the amount of medicine has to be increased slowly. Continue to give the medicine as you have been told to by your doctor.

What if my child is sick (vomits)?

If your child is sick less than 30 minutes after taking a dose of clonazepam, give the same dose again.
If your child is sick more than 30 minutes after taking a dose of clonazepam, you do not need to give them another dose. Wait until the next normal dose.

What if I forget to give it?

If you normally give it twice a day

If you remember up to 4 hours after you should have given a dose, give your child the missed dose. For example, if you usually give a dose at 7 am, you can give the missed dose at any time up to 11 am. If you remember after that time, do not give the missed dose. Wait until it is time to give the next normal dose.

If you normally give it three times a day

If you miss a dose, wait until the next normal dose. Do not give the missed dose.
Never give a ‘double’ dose of clonazepam.

What if I give too much?

If you think you may have given your child too much clonazepam, contact your doctor or NHS Direct (0845 4647) or take your child to hospital.

Take the medicine container or pack with you, even if it is empty. This will be useful to the doctor. Have the packet with you if you telephone for advice.

Are there any possible side-effects?

We use medicines to make our children better, but sometimes they cause effects that we don’t want (side-effects).

Side-effects that you must do something about

Clonazepam occasionally affects the blood. If your child seems to be getting more infections than usual (e.g. bad colds, chest or skin infections, stomach upsets), or they seem to bruise more easily, or bleeding doesn’t stop quickly, contact your doctor straight away.

Other side-effects you need to know about

Your child is likely to be drowsy (sleepy) and unsteady when they first take clonazepam. They may also get double vision and their speech may be slurred. These symptoms should get better after a week or so. If they don’t, contact your doctor.
Some children are more irritable for the first few weeks. If this continues, contact your doctor.
Young children in particular may dribble.
These side effects are more likely if your child is already taking another medicine for epilepsy called sodium valproate.

Can other common medicines be given at the same time as clonazepam?

You can give your child medicines that contain paracetamol or ibuprofen, unless your doctor has told you not to.
Check with your doctor or pharmacist before giving any other medicines to your child. This includes herbal or complementary medicines.

Epilepsy and pregnancy

Pregnancy presents a risk to both the mother with epilepsy and her unborn baby. If your daughter has sex, it is essential that she uses adequate contraception to prevent an unplanned pregnancy.
If your daughter is worried that she may be pregnant, it is important that she sees your family doctor as early as possible. Your daughter should keep taking her medication until she sees her doctor.

Clonazepam and pregnancy

Clonazepam may harm an unborn baby.
The oral contraceptive pill can be used safely by women or girls who are taking clonazepam.

Is there anything else I need to know about this medicine?

If your child is going to have treatment in hospital, it is important that you tell the doctor that your child is taking clonazepam.

General advice about medicines for seizures

Do not suddenly stop giving any of these medicines to your child, as they may have a seizure. If you are worried, talk to your doctor but carry on giving the medicine to your child as usual.
If your child seems to have more seizures than usual, contact your doctor or epilepsy nurse.
If your doctor decides to stop a particular medicine, they will discuss this with you. You will usually reduce the dose bit by bit.
Do not change the dose of any drug without talking to your doctor first.
It is best that your child always has the same brand of each medicine, as there may be differences between brands. Keep a record of which medicines your child has.
Try to give medicines at about the same times every day, to help you remember.
Only give the medicine(s) to your child. Never give them to anyone else, even if their condition appears to be the same, as this could do harm.
If you think someone else may have taken the medicine by accident, contact your doctor straight away.
Make sure that you always have enough medicine. Order a new prescription at least 2 weeks before you will run out.
Make sure that the medicines you have at home have not reached the ‘best before’ or ‘use by’ date on the packaging. Give old medicines to your pharmacist to dispose of.

Where I should keep this medicine?

Keep the medicine in a cupboard, away from heat and direct sunlight. It does not need to be kept in the fridge.
Make sure that children cannot see or reach the medicine.
Keep the medicine in the container it came in.