Epizam 2 mg Tablet

Benzodiazepine medicine for:

• Epilepsy: several types of seizures (absence, myoclonic, infantile spasms) and status epilepticus (injection)
• Panic disorder, with or without agoraphobia
• Short-term use for severe anxiety or sleep problems linked to anxiety (on specialist advice)
• Restless legs and some movement disorders (off-label)

Epilepsy (adults): start 0.5–1 mg at night for 4 nights; increase slowly to a usual 4–8 mg daily in 3–4 divided doses (maximum 20 mg/day).

Panic disorder: start 0.25 mg twice daily; usual 1 mg daily (up to 2–4 mg/day).

Elderly: start with 0.25–0.5 mg.

Children: dose by age/weight, as prescribed by a specialist.

• Use the lowest dose for the shortest time for anxiety (usually 2–4 weeks).
• Do not stop suddenly — reduce gradually under medical supervision.

• Allergy to clonazepam or other benzodiazepines
• Severe breathing problems, sleep apnoea, myasthenia gravis
• Severe liver disease
• Coma, acute alcohol or drug intoxication

Common: drowsiness, tiredness, dizziness, poor coordination, memory problems, muscle weakness, increased saliva (infants).

Less common: depression, irritability, confusion, slurred speech.

Serious: dependence and withdrawal (anxiety, sleeplessness, seizures) after sudden stopping, paradoxical agitation or aggression, breathing depression with opioids or alcohol, falls in the elderly, suicidal thoughts.

• Causes drowsiness — do not drive or operate machinery; avoid alcohol.
• Risk of dependence and misuse; keep securely.
• Combination with opioids can be fatal (breathing depression).
• Elderly patients: higher risk of falls and confusion.

Avoid if possible, especially in the first trimester and before delivery (risk of floppy baby and withdrawal); do not stop epilepsy treatment without advice. Passes into breast milk — may cause sedation in the baby; avoid or use only under supervision.

• Opioids, alcohol, other sedatives, antihistamines, antipsychotics (severe drowsiness, breathing depression)
• Antiepileptics: phenytoin, carbamazepine, phenobarbital (change levels)
• Valproate (rarely absence status)
• Strong CYP3A4 inhibitors (fluconazole, ritonavir) increase levels

Severe drowsiness, confusion, poor coordination, slow breathing, coma — especially with alcohol or opioids. Emergency care; flumazenil may be used in hospital.

Store below 30°C, out of reach of children.