Clonazepam for preventing seizures

Name of medicine

Clonazepam

Brand name: Rivotril

Why is it important for my child to take Clonazepam?

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)

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 two or three times a day.

• Two times 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 7am and 8am and between 7pm and 8pm.
• Three times a day: This should be first thing in the morning, early afternoon and at bedtime. Ideally, these times should be at least 6 hours apart.

Give the medicine at about the same time(s) each day so that this becomes part of your child’s daily routine, which will help you to remember.

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.

Your doctor may suggest that your child starts with a low dose. They may then increase the dose as your child gets used to the medicine and depending on how they respond to it. Your doctor will explain what to do. If you are not sure how much to give, check with your doctor, nurse or pharmacist.

How should I give Clonazepam?

Tablets

• Tablets should be swallowed with a glass of water, squash or juice. Your child should not chew the tablets.
• You can crush the tablet and mix it with a small amount of soft food such as yogurt, honey, or mashed potato. Make sure your child swallows it straight away, without chewing.

Liquid medicine

• Shake the medicine well.
• Measure out the right amount using an oral syringe or a medicine spoon. 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 may take a few days or even weeks for Clonazepam to work properly, so your child may still have their symptoms for a while. 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 having a dose of Clonazepam, give them the same dose again.
• If your child is sick more than 30 minutes after having a dose of Clonazepam, do not give them another dose. Wait until the next normal dose.

If your child is sick again, seek advice from your family doctor, nurse, pharmacist, or hospital. They will decide what to do based on your child’s condition and the specific medicine involved.

What if I forget to give it?

If you usually 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 about 7am, you can give the missed dose at any time up to 11am. If you remember after that time, do not give the missed dose. Give the next dose as usual.

If you usually give it three times a day: Do not give the missed dose. Just give the next dose as usual.

Are there any possible side effects?

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

Side effects you must do something about

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.

There may sometimes be other side effects that are not listed above. If you notice anything unusual and are concerned, contact your doctor. You can report any suspected side effects to a UK safety scheme at mhra.gov.uk/yellowcard

Can other 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 and 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 thinks that she may be pregnant, it is important that she sees your family doctor as early as possible. Your daughter should keep taking her medicine 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

Advice about medicines for seizures

• If your doctor decides to stop a particular medicine, they will discuss this with you. They will usually reduce the dose bit by bit.
• 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 each day, to help you remember.

• Only give this medicine to your child. Never give it to anyone else, even if their condition appears to be the same, as this could do harm.

• 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 should I 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.

Who to contact for more information?

Your child’s doctor, pharmacist or nurse will be able to give you more information about Clonazepam and about other medicines used to treat epilepsy.

Copyright disclaimer

Version [2]. © NPPG, RCPCH and WellChild, all rights reserved. Review by October 2015.

The primary source for the information in this leaflet is the British National Formulary for Children. For details on any other sources used for this leaflet, please contact us through our website, www.medicinesforchildren.org.uk.

We take great care to make sure that the information in this leaflet is correct and up-to-date. However, medicines can be used in different ways for different patients. It is important that you ask the advice of your doctor or pharmacist if you are not sure about something. This leaflet is about the use of these medicines in the UK, and may not apply to other countries. The Royal College of Paediatrics and Child Health (RCPCH), the Neonatal and Paediatric Pharmacists Group (NPPG), WellChild and the contributors and editors cannot be held responsible for the accuracy of information, omissions of information, or any actions that may be taken as a consequence of reading this leaflet.