Clonazepam
5-(2-chlorophenyl)-7-nitro-1,3-dihydro-1,4-benzodiazepin-2-one
También conocido como: Klonopin · Antelepsin · Clonagin · Clonapam · Clonax · Clonex · Diocam · Epitril · Iktorivil · Kenoket · Kriadex · Neuryl · Paxam · Rivatril · Rivotril · Solfidin · Linotril · clonazepamum · Ro-5-4023
Revisado por el equipo veterinario de VetSheetActualizado 5 abr 2026Referencia veterinaria basada en la evidencia
Las dosis son una referencia clínica para profesionales veterinarios autorizados. Confirme siempre con el prospecto actual y cada paciente individual.
Dosis por especie
🌎 NA — North America🌍 EU — Europe
Perros
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| Adjunctive medication in the treatment of seizures | 1-2 mg/kg PO q12h | PO | q12h | — | 🌎 NA |
| Adjunctive medication in the treatment of seizures | 0.5 mg/kg PO two to three times a day | PO | q8-12h | — | 🌎 NA |
| Anxiolytic | 0.05-0.25 mg/kg PO q12-24h | PO | q12-24h | — | 🌎 NA |
| Anxiolytic | 0.1-1 mg/kg PO two to three times a day | PO | q8-12h | — | 🌎 NA |
| Muscular hypertonicity (episodic falling) / Anxiolytic | 0.5 mg/kg | PO | q8-12h | — | 🌍 EU |
- Adjunctive medication in the treatment of seizures: May need to lower phenobarbital dose by 10-20%
- Muscular hypertonicity (episodic falling) / Anxiolytic: Suggested starting dose but there is a wide range of recommendations.
Gatos
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| Anxiolytic | 0.05-0.25 mg/kg PO q12-24h | PO | q12-24h | — | 🌎 NA |
| Anxiolytic | 0.02-0.2 mg/kg PO once to two times a day | PO | q12-24h | — | 🌎 NA |
| Anxiolytic | 0.1-0.2 mg/kg PO as needed or up to two times a day | PO | PRN or q12h | — | 🌎 NA |
| Adjunctive medication in the treatment of seizures | Starting dose is 0.5 mg (total dose) PO q12-24h | PO | q12-24h | — | 🌎 NA |
| Adjunctive medication in the treatment of seizures | 1/8th to 1/4 of a 0.5 mg tablet PO two to three times daily | PO | q8-12h | — | 🌎 NA |
| Anxiolytic / Hyperaesthesia / Epilepsy | 0.5 mg/cat | PO | q12-24h | — | 🌍 EU |
- Adjunctive medication in the treatment of seizures: Anecdotally more effective for maintenance and to decrease cluster seizures; acute hepatic necrosis possible
- Anxiolytic / Hyperaesthesia / Epilepsy: Suggested starting dose but there is a wide range of recommendations.
Las dosis son una referencia clínica para profesionales veterinarios autorizados. Confirme siempre con el prospecto actual y cada paciente individual.
Resumen
El clonazepam es una benzodiazepina potente y de acción prolongada utilizada en medicina veterinaria principalmente como anticonvulsivo adyuvante y ansiolítico.
Perla clínica: En perros, su utilidad como anticonvulsivo de mantenimiento a largo plazo es muy limitada debido a que desarrollan tolerancia rápidamente a sus efectos antiepilépticos (a menudo en 1 a 4 semanas). Esto se debe a la regulación a la baja de los receptores y a alteraciones en la farmacocinética. Por lo tanto, es mucho más adecuado para la terapia de pulso a corto plazo o el manejo de convulsiones en racimo (cluster seizures).
- En gatos, puede utilizarse como tratamiento adyuvante a largo plazo para la epilepsia o la ansiedad. Aunque la necrosis hepática aguda idiosincrásica es un riesgo conocido con las benzodiazepinas orales en gatos (especialmente con el diazepam), generalmente se considera menos probable que ocurra con el clonazepam, aunque sigue siendo necesario el monitoreo.
- El clonazepam es una sustancia controlada de Lista IV (C-IV) debido a su potencial de abuso y dependencia en humanos.
Mecanismo de acción
Clonazepam acts as a positive allosteric modulator at the GABA-A receptor complex in the central nervous system.
- It binds to specific benzodiazepine receptors (located primarily in the limbic, thalamic, and hypothalamic regions) → enhances the affinity of the receptor for the inhibitory neurotransmitter gamma-aminobutyric acid (GABA).
- This increases the frequency of chloride channel opening → influx of chloride ions → cellular hyperpolarization → decreased neuronal excitability.
- Additional postulated mechanisms include antagonism of serotonin and diminished release or turnover of acetylcholine in the CNS.
Seguridad y advertencias
Contraindicaciones
- Hypersensitivity to clonazepam or other benzodiazepines
- Significant liver disease or dysfunction
- Acute narrow-angle glaucoma
- Myasthenia gravis (may exacerbate weakness)
- Marked CNS depression
- Respiratory depression
- Severe muscle weakness
- Hepatic impairment (may worsen hepatic encephalopathy)
Efectos adversos
- Sedation and lethargy
- Ataxia (incoordination)
- Paradoxical excitement, hyperactivity, or vocalization
- Increased salivation
- Gastrointestinal upset (vomiting, diarrhea, constipation)
- Dogs: Rapid tolerance to anticonvulsant effects
- Cats: Polyphagia, potential for acute hepatic necrosis (rare)
- Respiratory suppression (at higher doses)
- Acute hepatic necrosis (idiosyncratic in cats)
- Tolerance development
Precauciones
Do not discontinue therapy abruptly, especially in patients on chronic or high-dose therapy, as this may precipitate withdrawal signs or status epilepticus; taper the dose gradually. Use with caution in nursing dams, as benzodiazepines can enter milk and accumulate to toxic levels in neonates. Monitor cats closely for signs of hepatotoxicity.
Interacciones farmacológicas
May increase clonazepam levels by inhibiting its metabolism.
May decrease the metabolism of benzodiazepines, increasing their effects.
Additive CNS depression; may cause profound sedation or respiratory depression.
May decrease the metabolism of benzodiazepines.
May decrease clonazepam concentrations via hepatic enzyme induction.
May decrease clonazepam concentrations.
May decrease clonazepam concentrations.
May induce hepatic microsomal enzymes and decrease the pharmacologic effects of benzodiazepines.
Inhibition of CYP450 enzymes may decrease clonazepam clearance, increasing its plasma levels and risk of toxicity.
Additive sedation and respiratory depression.
Monitorización
- Clinical efficacy (seizure frequency, anxiety levels)
- Adverse effects (sedation, ataxia, paradoxical excitement)
- Therapeutic blood levels (reported target: 0.015-0.07 mcg/mL)
- Cats: Baseline and periodic liver function tests
- Degree of sedation and ataxia
- Respiratory rate and effort
- Hepatic function panel (especially in cats)
- Clinical response (seizure frequency, muscle tone, or behavioral changes)
Farmacocinética
Vida media
Absorción
In dogs, oral bioavailability is variable (20-60%) but absorption is rapid. In humans, it is well absorbed from the GI tract with peak serum levels occurring about 3 hours after oral dosing.
Distribución
Highly lipophilic; rapidly crosses the blood-brain barrier and placenta. Protein binding in dogs is approximately 82%.
Metabolismo
Metabolized in the liver to several metabolites. In dogs, clonazepam exhibits saturation kinetics, meaning elimination rates are dose-dependent.
Eliminación
Metabolites are excreted primarily in the urine.
Sobredosis
Overdoses commonly cause profound sedation, depression, and ataxia.
- Paradoxical Reactions: Some animals may exhibit paradoxical signs such as hyperactivity, disorientation, agitation, and vocalization. Paradoxical excitation can be treated with a mild sedative, such as diphenhydramine.
- Management: Emesis is generally NOT indicated due to the risk of rapid CNS depression and aspiration. Mild to moderate overdoses can often be monitored at home if the animal is rousable and not showing paradoxical signs. Keep the animal confined and minimize stimulation.
- Severe Toxicity: Massive overdoses can lead to respiratory depression or hypotension. Flumazenil (a specific benzodiazepine antagonist) can be used to reverse severe respiratory or CNS depression. Because flumazenil has a short half-life, multiple doses may be required.
Productos disponibles
Formulaciones
- Oral tablets
- Orally disintegrating tablets (ODT)
- Compounded oral suspension
- 0.25 mg tablet
- 0.5 mg tablet
- 1.0 mg tablet
- 2 mg tablet
- 500 mcg tablet
- 500 mcg/5 ml oral solution
- 2 mg/5 ml oral solution
Etiquetado para humanos
- Clonazepam Oral Tablets: 0.5 mg, 1 mg, & 2 mg (Klonopin, generic)
- Clonazepam Orally Disintegrating Tablets: 0.125 mg, 0.25 mg, 0.5 mg, 1 mg & 2 mg (Klonopin Wafers, generic)
- Linotril
- Rivotril
Estado regulador
POM (Prescription Only Medicine). Subject to national controlled drug regulations.
POM. Prescriptions are subject to controlled drug requirements.
Sin datos reguladores para: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
Almacenamiento y estabilidad
Tablets should be stored in airtight, light-resistant containers at room temperature. Compounded oral suspensions (0.1 mg/mL in Ora-Plus/Ora-Sweet) retain >90% potency for 60 days when stored at 5°C or 25°C, but must be protected from light.
Información para el cliente
- La constancia es clave: Un factor importante en el fracaso de la terapia anticonvulsiva es la falta de cumplimiento. Es muy importante administrar las dosis regularmente a las horas prescritas.
- No suspenda el medicamento abruptamente: Nunca suspenda este medicamento repentinamente sin la guía de su veterinario. La retirada abrupta puede desencadenar convulsiones continuas graves que ponen en peligro la vida (estado epiléptico). Si es necesario suspender el medicamento, su veterinario le proporcionará un programa de reducción gradual.
- Efectos secundarios: La somnolencia leve y la torpeza son comunes al comenzar el medicamento, pero a menudo mejoran. Si su mascota se vuelve inusualmente hiperactiva o agitada, contacte a su veterinario.
- Propietarios de gatos: Observe a su gato de cerca para detectar falta de apetito, vómitos o coloración amarillenta en el blanco de los ojos o en las encías (ictericia). Estos pueden ser signos de un problema hepático poco común pero grave. Contacte a su veterinario inmediatamente si nota estos signos.
La referencia de medicamentos de VetSheet está destinada a profesionales veterinarios autorizados como ayuda para la toma de decisiones clínicas, no como sustituto del criterio profesional ni del prospecto actual del fabricante.