Epitra 1 mg Tablet

Overview

Epitra 1 mg Tablet contains Clonazepam, a long-acting benzodiazepine with anticonvulsant, anxiolytic, sedative, and muscle-relaxant properties, manufactured by Square Pharmaceuticals PLC. Clonazepam potentiates the inhibitory action of GABA by binding to the benzodiazepine receptor site on the GABA-A receptor complex. It is used in the treatment and prevention of epilepsy (absence seizures, myoclonic seizures, Lennox-Gastaut syndrome), panic disorder, and restless legs syndrome.

Dosage and Administration

Adults — epilepsy: initial dose typically 0.5–1 mg three times daily, increasing gradually to achieve seizure control; maximum 20 mg/day. Panic disorder: 0.25 mg twice daily, increasing to 1 mg/day. Elderly: start at the lower end of dose range. All doses must be individualised under physician supervision.

Interaction

CNS depressants, alcohol, opioids, other antiepileptics, sedating antihistamines — additive CNS depression. Phenytoin, carbamazepine, and rifampicin reduce clonazepam levels via enzyme induction. Valproate may increase clonazepam blood levels.

Contraindications

Contraindicated in acute narrow-angle glaucoma, severe hepatic impairment, myasthenia gravis, sleep apnoea, and known hypersensitivity to benzodiazepines.

Side Effects

Sedation, dizziness, ataxia, and cognitive impairment — particularly early in treatment. Tolerance, dependence, and withdrawal syndrome with prolonged use. Paradoxical excitation in some patients.

Pregnancy and Lactation

Avoid during the first trimester if possible — associated with an increased risk of cleft palate. Use during delivery may cause neonatal withdrawal and respiratory depression. Use with caution during breastfeeding — clonazepam passes into breast milk.

Precautions and Warnings

Do not stop abruptly — taper gradually under physician supervision to avoid withdrawal seizures. Impairs driving and operation of machinery. Dependence can develop with prolonged use. Patients and caregivers should be counselled about signs of respiratory depression.

Storage Conditions

Store below 30°C in a cool, dry place, protected from light. Keep out of the reach of children.

Frequently Asked Questions

Why is clonazepam preferred for myoclonic seizures?
Clonazepam has potent anti-myoclonic properties due to its high potency and prolonged action at GABAergic synapses; its long half-life (18–50 hours) provides sustained seizure control with less frequent dosing.

Does clonazepam cause tolerance over time?
Yes — tolerance to the anticonvulsant effect can develop after weeks to months of use, requiring dose adjustments; tolerance to sedation also occurs; long-term management plans and periodic review are essential with anticonvulsant benzodiazepines.

This content is for informational purposes only and does not substitute professional medical advice. Please consult a registered physician before taking any medication.