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Clorazepate is a benzodiazepine used as an anticonvulsant as adjunctive therapy in management of epilepsy and as an anxiolytic for therapy of anxiety and alcohol withdrawal. 

Liver safety of Clorazepate

Therapy with clorazepate is not associated with serum aminotransferase elevations, and cases of clinically apparent liver injury from clorazepate have been reported but are very rare.

Mechanism of action of Clorazepate

Clorazepate (klor az' e pate) is a benzodiazepine with particular activity against spread of seizure activity in several animal models.  The antiseizure activity of the benzodiazepines is mediated by their ability to enhance gamma-aminobutryic acid (GABA) mediated inhibition of synaptic transmission through binding to the GABA A receptor. 

FDA approval information for Clorazepate

Clorazepate is used both as an anticonvulsant and anxiolytic agent.  Clorazepate was approved in the United States in 1972 and currently more than 3 million prescriptions are filled yearly. 

Clinical use of Clorazepate

Current indications are as adjunctive therapy in management of partial seizures and for treatment of anxiety disorders and acute alcohol withdrawal. 

Dosage and administration for Clorazepate

Clorazepate is available in generic forms and under the brand name Tranxene in tablets and capsules in concentrations of 3.75, 7.5, 11.25, 15 and 22.5 mg.  Delayed release formulations are also available.  The recommended initial dose for adults with seizures is 7.5 mg three times daily, with gradual dose increases generally to an average dose of 30 to 60 mg daily and not in excess of 90 mg daily. 

Side effects of Clorazepate

Common side effects of clorazepate include drowsiness, lethargy, ataxia, dysarthria and dizziness.  Tolerance develops to these side effects, but tolerance can also develop to the therapeutic effects.

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