clorazepate (Rx)

Brand and Other Names:Tranxene SD, Tranxene T-Tab
  • Print

Dosing & Uses

AdultPediatricGeriatric

Dosage Forms & Strengths

tablet: Schedule IV

  • 3.75mg
  • 7.5mg
  • 15mg
more...

Anxiety

30 mg/day PO in divided doses; adjust dose gradually within range of 15-60 mg/day

When administered as single daily HS dose, initial dosage is 15 mg; after initial dose, response of patient may require subsequent dosage adjustment

Seizure

7.5 mg PO q8hr; increase by < 7.5 mg/week; 90 mg/day maximum

Acute Alcohol Withdrawal

Day 1: Initial 30 mg PO once, THEN 30-60 mg in divided doses, no more than 90 mg

Day 2: 45-90 mg PO in divided doses

Day 3: 22.5-45 mg PO in divided doses

Day 4: 15-30 mg PO in divided doses

Day 5 onwards: 7.5-15 mg PO in divided doses

Discontinue when stable

Dosage Forms & Strengths

tablet: Schedule IV

  • 3.75mg
  • 7.5mg
  • 15mg
more...

Partial Seizures

<9 years: Not recommended

9-12 years: 7.5 mg PO BID initially; increase by <7.5 mg qWeek to 60 mg/day maximum

>12 years: As in adults

Not drug of choice in elderly because of long-acting metabolite; long-acting benzodiazepines associated with falls in elderly

Anxiety

7.5 mg PO qDay or q12hr

Next:

Interactions

Interaction Checker

and clorazepate

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

            All Interactions Sort By:
             activity indicator 
            Previous
            Next:

            Adverse Effects

            Frequency Not Defined

            Drowsiness

            Dizziness

            Nervousness

            Headache

            Confusion

            GI complaints

            Dry mouth

            Blurred vision

            Previous
            Next:

            Warnings

            Contraindications

            Documented hypersensitivity

            Breastfeeding

            Narrow-angle glaucoma

            Caution

            Anterograde amnesia may occur

            May cause CNS depression

            May experience aggressive behavior

            Caution in patients with a history of drug abuse; tolerance, psychological, and physical dependence may occur with prolonged use

            Caution in patients with gag reflex

            Caution in patients with respiratory disease

            Caution in hepatic impairment

            Previous
            Next:

            Pregnancy & Lactation

            Pregnancy Category: Not available. An increased risk of congenital malformations associated with the use of minor tranquilizers during the first trimester of pregnancy has been suggested in several studies. Pregnant patients taking clorazepate should enroll in the North American Antiepileptic Drug (NAAED) Pregnancy Registry by calling 1-888-233-2334. More information can be found at http://www.aedpregnancyregistry.org

            Lactation: enters breast milk; do not nurse

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

            more...
            Previous
            Next:

            Pharmacology

            Mechanism of Action

            Enhances the inhibitory effect of GABA on neuronal excitability by increasing neuronal membrane permeability to chloride ions

            Pharmacokinetics

            Half-Life: 50-70 hr

            Time to peak: ~ 1 hr

            Protein Bound: 97-98%

            Metabolism: Hydroxylation, glucuronic acid conjugation

            Metabolites: Desmethyldiazepam (nordiazepam), oxazepam

            Excretion: Urine

            Onset of action: 1-2 hr

            Duration: Variable 8-24 hr

            Previous
            Next:

            Images

            Previous
            Next:

            Formulary

            FormularyPatient Discounts

            Adding plans allows you to compare formulary status to other drugs in the same class.

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

            Adding plans allows you to:

            • View the formulary and any restrictions for each plan.
            • Manage and view all your plans together – even plans in different states.
            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
            Additional Offers
            Email to Patient

            From:

            To:

            The recipient will receive more details and instructions to access this offer.

            By clicking send, you acknowledge that you have permission to email the recipient with this information.

            Email Forms to Patient

            From:

            To:

            The recipient will receive more details and instructions to access this offer.

            By clicking send, you acknowledge that you have permission to email the recipient with this information.

            Previous