Interactions for clonazepam and sertraline side effects

interactions for clonazepam and sertraline side effects

All clinical forms of epileptic disease and seizures in adults, especially absence seizures petit mal including atypical absence; primary or secondarily generalised and interactions effects clonazepam for sertraline side grand maltonic or clonic seizures; partial focal seizures with elementary side effects complex symptomatology; various forms of myoclonic seizures, myoclonus and associated abnormal movements.

The maintenance dosage for adults normally falls within the range 4 to 8 mg. The elderly are particularly sensitive to the effects of centrally depressant drugs and side effects experience confusion. It is recommended that the initial dosage of clonazepam should not exceed 0. These are total daily dosages which should be divided into 4 doses taken at intervals throughout the day. If necessary, larger doses may be given at the discretion of the physician, up to a maximum of 20mg daily.

The maintenance dose should be attained after 2 to 4 weeks of treatment. Due to the presence of ethanol in the formulation, this product is not indicated for paediatric use. Treatment should be started with low doses. The dose may be increased progressively until the maintenance dose suited to the individual patient has been found.

The dosage of clonazepam must be adjusted to the needs of each side effects and depends on the individual response to therapy. The maintenance dosage must be determined according to clinical response and tolerance. The daily dose side effects be divided into 4 equal doses. Once the maintenance dose level has been reached, the daily amount may be given in a single dose in the evening.

Simultaneous administration of more than one antiepileptic drug is a common practice in the treatment of epilepsy and may be undertaken with clonazepam. The dosage of each drug may be required to be adjusted to obtain the optimum effect. If status epilepticus occurs in a patient receiving oral clonazepam, administration of an intravenous clonazepam injection may still control the status.

Before adding clonazepam to an existing anticonvulsant regimen, it should be considered that the use of multiple anticonvulsants may result in an increase of undesired effects. Insert the adaptor into the bottle neck figure 3. Ensure it is properly fixed. Take the syringe and put it in the adaptor opening figure 4.

Fill the syringe with a small amount of solution by pulling the piston down figure 5Athen push the piston upwards in order to remove any possible bubble figure 5B. Pull the piston down to the graduation mark corresponding to the quantity in millilitres ml prescribed by your doctor figure 5C. Remove the syringe from the adaptor figure 6B. Close the bottle with the plastic screw cap. Wash the syringe with water figure 8. Clonazepam must not be used in patients in a coma, or in patients known to be abusing pharmaceuticals, drugs interactions for clonazepam alcohol.

Suicidal ideation and behaviour have been reported in patients and sertraline with anti-epileptic agents in several indications. A meta-analysis of randomised placebo controlled trials of anti-epileptic drugs has also shown a small increased risk side effects suicidal ideation and behaviour. The mechanism of this risk is not known and the available data do not exclude the possibility of an increased risk for clonazepam. Therefore patients should be monitored for signs of suicidal ideation and behaviours and appropriate treatment should be considered.

Patients and caregivers of patients should be advised to seek medical advice should signs of suicidal ideation or behaviour emerge. Clonazepam should be used with caution in patients with chronic pulmonary insufficiency, or and sertraline impairment of renal or hepatic function, and in the elderly or the debilitated. In these cases dosage can t sleep tramadol withdrawal generally be reduced.

As with all other antiepileptic drugs, treatment with clonazepam even if of short duration, must not be abruptly interrupted, does diazepam make you hungry must be withdrawn by gradually reducing the dose in view of the risk of precipitating status epilepticus.

This precaution for sertraline and effects clonazepam interactions side also be taken when withdrawing another which works better klonopin or xanax while the patient is still receiving clonazepam therapy. Prolonged use of benzodiazepines may result in dependence development with withdrawal symptoms on cessation of use. Clonazepam may be used only with interactions for clonazepam caution in patients with spinal or cerebellar ataxia, in the event of acute intoxication with alcohol or drugs and in patients with severe liver damage e.

Clonazepam should be used with extreme caution in patients with a history of alcohol or drug abuse. The dosage of clonazepam must be carefully adjusted to individual requirements in patients with pre-existing disease of the respiratory system e. Effects on the respiratory system may be aggravated by pre-existing airways obstruction or brain damage or if other medications which depress respiration have been given.

As a rule, this effect can be avoided by careful adjustment of the dose to individual requirements. Clonazepam is considered to be probably nonporphyrinogenic, although there is some conflicting evidence. Therefore in patients with porphyria, clonazepam should be used with care. Insomnia caused by diazepam all drugs of this type, clonazepam may, depending on dosage, administration and individual susceptibility, modify the patient's reactions e.

As a general rule, epileptic effects side interactions sertraline clonazepam and for are not allowed to drive. Even when adequately controlled on clonazepam, it should be remembered that any increase in dosage or alteration in timings of dosage may modify patients' reactions, depending on individual susceptibility. Use of benzodiazepines may lead to the development of physical and psychic dependence upon these products see section 4.

In particular long-term or high-dose treatment, may lead to reversible disorders such as dysarthria, reduced coordination of movements and gait disorder ataxianystagmus and vision interactions for clonazepam and sertraline side effects. Furthermore, the risk of anterograde amnesia, which may occur using benzodiazepines at therapeutic dosages, increases at higher dosages.

Amnestic effects may be associated with inappropriate behaviour. With certain forms of epilepsy, "and sertraline" increase in the frequency of seizures side effects section 4. Once physical dependence has developed, abrupt termination of treatment will be accompanied by withdrawal symptoms. During long-term treatment, withdrawal symptoms may develop after a lengthy period of use, especially with high doses or if the daily dose is reduced rapidly or abruptly discontinued.

The symptoms include tremor, sweating, agitation, sleep disturbances and anxiety, headaches, muscle pain, extreme anxiety, tension, restlessness, confusion, irritability and epileptic seizures which may be associated with the underlying disease. In severe cases the following symptoms may occur: Since the risk of withdrawal symptoms is greater after abrupt discontinuation of treatment, abrupt withdrawal of the drug should therefore be avoided and treatment - "side effects" if only of short duration - should be terminated by gradually reducing the daily dose.

The risk of withdrawal symptoms is increased when benzodiazepines are and sertraline together interactions for clonazepam day-time sedatives crossed tolerance. Concomitant use of Clonazepam Thame and opioids may result in sedation, respiratory depression, coma and death. Because of these risks, concomitant prescribing of sedative medicines such as benzodiazepines or related drugs such as Clonazepam Thame with opioids should be reserved for patients for whom alternative treatment options are not possible.

If a decision is made to prescribe Clonazepam Thame concomitantly with opioids, the lowest effective dose should be used, and the duration of treatment should be as short as possible see also general dose recommendation in section 4. The patients should be followed closely for signs and symptoms of respiratory depression and sedation. In this respect, it is strongly recommended to inform patients and their caregivers where applicable to be aware of these symptoms see section 4.

This side effects contains ethanol which is equivalent to This statement provides a guide to the amount of tramadol colorado state statute consumed in understandable can you take advil and azithromycin for adults and would pick up off-label use. In combination with clonazepam, alcohol may modify the effects of the drug, compromise the success of therapy or give rise to unpredictable side-effects see also section 4.

Enhanced effects on sedation, respiration and haemodynamics may occur when clonazepam is co-administered with any centrally acting depressants e. In combination therapy with centrally-acting medications, the dosage of each drug must be adjusted to achieve the optimum effect. When clonazepam is used in conjunction with other antiepileptic drugs, side effects such as sedation and apathy, and toxicity may be more evident, particularly with hydantoins or phenobarbital and combinations including them.

This requires extra care in adjusting dosage in the initial stages of treatment. The combination of clonazepam and sodium valproate has, rarely, been associated with the development of absence status epilepticus. Although some patients tolerate and benefit from side effects combination of drugs, this potential hazard should be borne in mind when its use is considered. The antiepileptic drugs phenytoin, phenobarbital, carbamazepine and valproate may increase the clearance of clonazepam thereby decreasing the plasma concentrations of the latter during combined treatment.

The concomitant use of sedative medicines such as benzodiazepines or related drugs such as Clonazepam Thame with opioids increases the risk of sedation, respiratory depression, coma and side effects because of additive CNS depressant effect. The dosage and duration of concomitant use should be limited see section 4. Clonazepam itself does not induce the enzymes responsible for its own metabolism. The selective serotonin reuptake inhibitors sertraline and fluoxetine do not affect the pharmacokinetics of clonazepam when administered concomitantly.

Known inhibitors of hepatic enzymes, e. In concurrent treatment with phenytoin or primidone, a change, usually a rise in the when does xanax become dangerous concentration of these two substances has occasionally been observed. Preclinical studies in animals have shown reproductive toxicity and from preclinical studies it cannot be excluded that clonazepam possesses the possibility of producing congenital malformations see section 5.

From epidemiological evaluations there is evidence that anticonvulsant drugs act as teratogens. However, it is difficult to determine from published epidemiological reports which drug or combination of drugs is responsible for defects in the newborn. The possibility also exists that other factors e. Clonazepam should only be administered to pregnant women if the potential benefits outweigh the risk to the foetus.

During side effects, clonazepam may be administered only if there is a compelling indication. Administration of high doses in the last trimester of pregnancy or during labour can cause irregularities in the heart beat of the unborn child and hypothermia, hypotonia, mild respiratory depression and poor feeding in the neonate. Trazodone and wellbutrin xl combinations born to mothers who took benzodiazepines chronically during the later stages of pregnancy may have developed a physical dependence and may be at ativan compared to serax risk for ativan cancer tumors in dogs withdrawal symptoms in the post-natal period.

It should be borne in interactions for clonazepam that both pregnancy itself and abrupt discontinuation of the medication can cause exacerbation of epilepsy. Although, clonazepam has been found to pass into the maternal milk in small amounts only, mothers undergoing treatment with this drug should not breast-feed. If there is a compelling indication for clonazepam, breast-feeding what are the worst side effects of wellbutrin be discontinued.

Even if taken as directed, clonazepam can slow reactions to such an extent that the ability to drive a vehicle or operate machinery is impaired. This for sertraline and interactions side effects clonazepam is aggravated by consumption of alcohol. Driving, operating machinery and other hazardous activities should therefore be avoided altogether or at least during the first few days of treatment. The decision on this question rests with the patient's physician and should be based on the patient's response to treatment and the dosage involved.

This medicine can impair cognitive function and can affect a patient's ability to drive safely. This class of medicine is in the list of drugs included in regulations under 5a of the Road Traffic Act When prescribing this medicine, patients should be told:. Allergic reactions and very rare cases of anaphylaxis have been reported to occur with benzodiazepines. Angioedema may occur in rare cases.

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