Clobazam

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Information about Clobazam

Clobazam is a benzodiazepine that is used as an anticonvulsant in the therapy of severe childhood epilepsy. 

Liver safety of Clobazam

Therapy with clobazam has not been associated with serum aminotransferase elevations, and clinically apparent liver injury from clobazam has yet to be reported and must be rare, if it occurs at all. 

Mechanism of action of Clobazam

Clobazam (kloe' ba zam) is a unique 1,5 benzodiazepine which is used in the United States as an anticonvulsant, but is available in other countries for therapy of anxiety as well as epilepsy.  The anticonvulsant activity of clobazam appears to be mediated by its ability to enhance gamma-aminobutyric acid (GABA) medicated inhibition of synaptic transmission via binding to the GABA-A receptor. 

FDA approval information for Clobazam

Clobazam was approved for use in the United States in 2011 as an anticonvulsant to be used either alone or in combination with other agents as therapy of the severe form of childhood epilepsy known as Lennox-Gastaut syndrome. 

Dosage and administration for Clobazam

Clobazam is available in tablets of 5, 10 and 20 mg under the brand name Onfi in the United States and Frisium and Urbanol elsewhere.  The recommended initial dose is 5 mg once or twice daily, with subsequent increases to a usual maintenance dose of 20 mg twice daily.  The dose should be increased and tapered gradually. 

Side effects of Clobazam

The most common side effects are dose related and include dizziness, somnolence, impaired concentration, nervousness, aggression, antegrade amnesia, headache, fatigue, nausea and weakness.  Clobazam can also lead to physical dependence and sudden discontinuation can cause withdrawal symptoms and rebound seizure activity. Anticonvulsants

Generic Name / Brand Name Liver Toxicity Score Approval Year Major Indications
Brivaracetam / Briviact E 2016 Partial seizures
Carbamazepine / Tegretol A 1968 Partial, mixed and generalized seizures, trigeminal neuralgia
Clobazam / Onfi E 2011 Seizures assocated with Lennox-Gastaut syndrome
Clonazepam / Klonopin D 1975 Absence and myoclonic seizures, anxiety and panic disorders
Clorazepate / Tranxene E 1972 Partial seizures, anxiety disorders, and alcohol withdrawal
Diazepam / Valium E 1963 Convulsions, anxiety disorders, muscle spasms
Eslicarbazepine / Aptiom D 2013 Partial seizures
Ethosuximide / Zarontin E 1960 Absence seizures
Ezogabine / Potiga E 2011 Partial seizures
Felbamate / Febatol B 1993 Refractory or severe epilepsy
Fosphenytoin / Cerebyx A 1996 Tonic-clonic seizures, status epilepticus
Gabapentin / Neurontin C 1993 Partial seizures, post-herpetic neuralgia
Lacosamide / Vimpat D 2008 Partial seizures
Lamotrigine / Lamictal B 1994 Partial and generalized tonic-clonic seizures, bipolar disorder
Levetiracetam / Keppra C 1999 Partial, generalized tonic-clonic, and myoclonic seizures
Methsuximide / Celontin E 1957 Absence seizures
Oxcarbazepine / Trileptal D 2000 Partial seziures
Perampanel / Fycompa E 2012 Partial and generalized tonic-clonic seizures
Phenobarbital / Luminal A 1916 Partial and generalized seizures, anxiety, and irritable bowel syndrome
Phenytoin / Dilantin A 1938 Generalized tonic-clonic and partial onset seizures, status epilepticus
Pregabalin / Lyrica C 2004 Partial seizures, fibromyalgia, and neuropathic pain
Primidone / Mysoline E 1954 Partial and generalized tonic-clonic seizures
Rufinamide / Banzel E 2008 Seizures associated with Lennox-Gastaut syndrome
Tiagabine / Gabitril E 1997 Partial seizures
Topiramate / Topamax C 1996 Partial and generalized tonic-clonic seizures, migraine headaches
Valproate / Depakene A 1978 Absence and complex partial seizures
Vigabatrin / Sabril D 2009 Refractory, complex partial seizures, and infantile spasms
Zonisamide / Zonegran D 2000 Partial seizures

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