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Calmnir (Clonazepam)
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Calmnir

Calmnir is used to prevent and control seizures. This medication is known as an anticonvulsant or antiepileptic drug. It is also used to treat panic attacks. Calmnir works by calming your brain and nerves. It belongs to a class of drugs called benzodiazepines.

Other names for this medication:
Adnil, Almac, Azpax, Cloam, Clonapax, Clonasig, Clonax, Clonaxyl, Clonix, Clonoasig, Clonopam, Clonotril, Closis, Clotas, Cozil, Dipwell, Ection, Eminaz, Epicloz, Epizam, Escimax, Esitor, Estalonix, Jasoclam, Klopam, Nazee, Norep, Nupam, Onapil, Ozepam, Petril, Prasilex, Repam, Sezolan, Sezolep, Ubitpam, Zeficar, Zepam, Zepamax, Zolpidox

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Amoxil, Adalat, Desyrel, Elavil, Azulfidine

Also known as: Clonazepam

Description

Calmnir is a benzodiazepine medication that was initially primarily used for the treatment of seizures occurring in epilepsy and for anxiety, specifically anxiety that occurs in panic disorder. Calmnir is available in tablet form (0.5 mg, 1 mg, 2 mg) and as disintegrating wafers that are taken orally.

While Calmnir is generally prescribed for the treatment of anxiety disorders, such as panic disorder, and seizure control, it is intended as a short-term treatment protocol as opposed to a long-term treatment solution due to issues with tolerance (see below). In addition to treating anxiety and seizures, Calmnir has also been used in the treatment of:

chizophrenia, especially when the individual with schizophrenia has a restless or irritable component and is not responding to antipsychotic medications.

The manic phase of bipolar disorder or for restlessness associated with depression in bipolar disorder.

Tic disorders, such as Tourette's syndrome, by acting as a muscle relaxant and producing sedation.

Restless leg syndrome.

Withdrawal from alcohol or treatment for other substance abuse or addiction issues.

Calmnir has a relatively slow onset of action (it takes a while for the drug to begin working) and a half-life of between 10 and 50 hours. As it has a relatively slow onset of action and is a longer-acting benzodiazepine, Calmnir is more suited for the treatment of anxiety, seizures, and other similar disorders as opposed to being a useful sleep aid, even though it is sometimes prescribed for that purpose. Sleep aids need to work quickly, whereas with Calmnir, a person takes the drug early in the day and doesn't have to worry about monitoring for signs of a seizure or panic attack as it stays in the system a relatively long time. Its effects last longer than those of shorter-acting benzodiazepines, such as Xanax.

As it is a Schedule IV controlled substance, Calmnir can only be legally acquired with a prescription from a physician.

Dosage

Calmnir is indicated for the treatment of panic disorder, with or without agoraphobia, as defined in DSM-V. Panic disorder is characterized by the occurrence of unexpected panic attacks and associated concern about having additional attacks, worry about the implications or consequences of the attacks, and/or a significant change in behavior related to the attacks.

The efficacy of Calmnir was established in two 6-to 9-week trials in panic disorder patients whose diagnoses corresponded to the DSM-IIIR category of panic disorder.

Panic disorder (DSM-V) is characterized by recurrent unexpected panic attacks, ie, a discrete period of intense fear or discomfort in which four (or more) of the following symptoms develop abruptly and reach a peak within 10 minutes: palpitations, pounding heart or accelerated heart rate; sweating; trembling or shaking; sensations of shortness of breath or smothering; feeling of choking; chest pain or discomfort; nausea or abdominal distress; feeling dizzy, unsteady, lightheaded or faint; derealization (feelings of unreality) or depersonalization (being detached from oneself); fear of losing control; fear of dying; paresthesias (numbness or tingling sensations); chills or hot flushes.

The effectiveness of Calmnir in long-term use, that is, for more than 9 weeks, has not been systematically studied in controlled clinical trials. The physician who elects to use Calmnir for extended periods should periodically reevaluate the long-term usefulness of the drug for the individual patient.

Overdose

Symptoms of clonazepam overdosage, like those produced by other CNS depressants, include somnolence, confusion, coma and diminished reflexes.

Treatment includes monitoring of respiration, pulse and blood pressure, general supportive measures and immediate gastric lavage. Intravenous fluids should be administered and an adequate airway maintained. Hypotension may be combated by the use of levarterenol or metaraminol. Dialysis is of no known value.

Flumazenil, a specific benzodiazepine-receptor antagonist, is indicated for the complete or partial reversal of the sedative effects of benzodiazepines and may be used in situations when an overdose with a benzodiazepine is known or suspected. Prior to the administration of flumazenil, necessary measures should be instituted to secure airway, ventilation and intravenous access. Flumazenil is intended as an adjunct to, not as a substitute for, proper management of benzodiazepine overdose. Patients treated with flumazenil should be monitored for resedation, respiratory depression and other residual benzodiazepine effects for an appropriate period after treatment. The prescriber should be aware of a risk of seizure in association with flumazenil treatment, particularly in long-term benzodiazepine users and in cyclic antidepressant overdose. The complete flumazenil package insert, including CONTRAINDICATIONS, WARNINGS AND PRECAUTIONS, should be consulted prior to use.

Flumazenil is not indicated in patients with epilepsy who have been treated with benzodiazepines. Antagonism of the benzodiazepine effect in such patients may provoke seizures.

Serious sequelae are rare unless other drugs or alcohol have been taken concomitantly.

Storage

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website for more information if you do not have access to a take-back program.

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach.

Side effects

The most common side effects associated with Calmnir are:

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Side effect occurrence does not only depend on medication you are taking, but also on your overall health and other factors.

Contraindications

Before taking Calmnir,

tell your doctor if you have or have ever had glaucoma (increased pressure in the eye that may cause vision loss) or liver disease. Your doctor may tell you not to take Calmnir.

tell your doctor if you drink or have ever drunk large amounts of alcohol, use or have ever used street drugs or have overused prescription medications. Also tell your doctor if you have or have ever had lung or kidney disease.

tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. Calmnir may harm the fetus. If you become pregnant while taking Calmnir, call your doctor.

talk to your doctor about the risks and benefits of taking this medication if you are 65 years of age or older. Older adults should receive low doses of Calmnir because higher doses may not work better and may cause serious side effects.

if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking Calmnir.

you should know that this medication may make you drowsy. Do not drive a car or operate machinery until you know how this medication affects you.

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