| Drug Index |
| GENERIC NAME : |
| clorazepate |
| BRAND NAMES : |
| Tranxene, Tranxene-SD, GenXene, Novo-Clopate, Apo-Clorazepate, Cloraztabs |
| STREET NAMES : |
| No specific street name is identified for clorazepate, but may be referred to as other benzodiazepines which have street names such as Tranks, Nerve pills, Downers, or Benzos |
| BRIEF DESCRIPTION : |
| Clorazepate is categorized as a sedative/hypnotic and is classified as a benzodiazepine. Clorazepate works on several areas of the central nervous system (CNS). To produce the anxiolytic effect, clorazepate stimulates the inhibitory GABA receptors. It produces skeletal muscle relaxation by inhibiting spinal polysynaptic afferent pathways. To prevent seizures it enhances presynaptic inhibition in the CNS. It is taken by mouth, has an onset of action in 1-2 hours, peaks in 1-2 hours and has a duration of up to 24 hours. Clorazepate is metabolized by the liver and has a half-life of 48 hours (Deglin & Vallerand, 2007). Clorazepate is usually taken one to four times a day, with or without food. Doses should not be skipped or doubled up on missed doses. Clorazepate dosage should be tapered or gradually decreased over several days of weeks. Stopping the drug suddenly may cause withdrawal symptoms (anxiousness, sleepessness, and irritability) or may cause status epilepticus (seizures), tremors, nausea, vomiting and abdominal and muscle cramps. Tranxene tablets are available in 3.75 mg, 7.5 mg, 11.5 mg, 15 mg, and 22.5 mg. Capsules: 3.75 mg, 7.5 mg, and 15 mg. Dosage depends on indication for use. |
| INDICATIONS FOR USE : |
| Chorazepate is used to relieve anxiety, control agitation caused by alcohol withdrawal, and as an anticonvulsant to manage seizures. Additional use is in the treatment of irritable bowel syndrome. Clorazepate has a longer duration of action to treat insomnia in patients with daytime anxiety (http://www.streetdrugs.org/benzodiaz.htm). |
| ABUSE AND ADDICTIVE POTENTIAL : |
| Clorazepate is habit forming. When used for long periods of time, it may not work as well, requiring higher doses to achieve the same effects as before (known as tolerance). Prolonged high-dose therapy may lead to psychological or physical dependence (Deglin & Vallerand, 2007). Individuals who abuse benzodiazepines maintain their drug supply by getting prescriptions from several doctors, forging prescriptions, or buying diverted products on the illicit market. Abuse is frequent among adolescents and young adults who take benzodiazepines to get "high" (http://www.usdoj.gov/dea/concern/benzodiazepines.html). |
| OVERDOSAGE : |
| Signs of overdose of clorazepate include seizures, shuffling walk, persistent fine tremors, inability to sit or stand, fever, difficulty breathing or swallowing, severe skin rash, yellowing of the skin or eyes, irregular heartbeat, loss of consciousness, slow reflexes, confusion, and deep sleep. (http://www.nlm.nih.gov/medlineplus/druginfo/meds/a682052.html and http://www.drugs.com/cdi/tranxene-t-tab.html) |
| CAUTIONS : |
| Clorazepate may cause drowsiness. Alcohol can add to the drowsiness caused by this drug. Clorazepate should not be used by someone with liver problems, narrow-angle glaucoma, severe uncontrollable pain, or with other benzodiazepines. Lab tests for liver and kidney function should be performed while taking this medication. Clorazepate should be used cautiously with other drugs to avoid drug interactions. Avoid use with other antidepressants, antihistamines, and opioid analgesics to prevent further CNS depression. Drugs that interfere with the metabolism of clorazepate or increase its action include cimetidine, hormone contraceptives, disulfiram, fluizetine, isoniazid, ketoconazole, metoprolol, propoxyphene, propranolol, or valproic acid. Levodopa, Rifampin or barbiturates decrease its efficacy and may decrease the metabolism of chorazepate (AHFS Consumer Medication Information, 2009; Deglin, & Vallerand, 2007). Avoid herbal products such as kava, valerian, or chamomile, as these may increase CNS depression (Deglin, & Vallerand, 2007). Cigarette smoking may decrease the effectiveness of this drug. Clorazepate should be used cautiously in the elderly and with extreme caution in children under 9 years of age. Tranxene has shown to cause harm to the fetus if taken during pregnancy. Breastfeeding is discouraged while taking this medication (http://www.drugs.com/cdi/tranxene-t-tab.html). |
| SIDE EFFECTS : |
| The common side effects noted with clorazepate include drowsiness, dizziness, lightheadedness, nervousness, unsteadiness, tiredness, unusual weakness, dry mouth, diarrhea, upset stomach and changes in appetite. More severe symptoms include restlessness, constipation, difficulty urinating, frequent urination, blurred vision and changes in sex drive (http://www.nlm.nih.gov/medlineplus/druginfo/meds/a682052.html) |
| FOR MORE INFORMATION : |
AHFS Consumer Medication Information (2003, May). Clorazepate. Retrieved on July 18, 2009 from American Society of Health-System Pharmacists http://www.nlm.nih.gov/medlineplus/druginfo/meds/a682052.html |
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