Clonazepam Auden 2 mg Tablets

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1 NAME OF THE MEDICINAL PRODUCT

Where can I buy Clonazepam Auden 2mg online UK. Clonazepam Auden 2 mg Tablets

2 QUALITATIVE AND QUANTITATIVE COMPOSITION

Each tablet contains 2 mg clonazepam. Excipients with known effect:
Each tablet contains 142mg lactose monohydrate For the full list of excipients, see section 6.1.

3 PHARMACEUTICAL FORM

Tablet
Round white tablets with cross-score break line, marked ‘CLN 2’.

4 CLINICAL PARTICULARS

4.1 Therapeutic indications

All clinical forms of epileptic disease and seizures in infants, children and adults, especially absence seizures (petit mal), including atypical absence; primary or secondarily generalised tonic-clonic seizures (grand mal); partial (focal) seizures with elementary or complex symptomatology; various forms of myoclonic seizures, myoclonus and associated abnormal movements. Where can I buy Clonazepam Auden 2mg online UK

4.2 Posology and method of administration

Posology

Mode of administration:

Treatment should be started with low doses. The dose may be increased progressively until the maintenance dose suited to the individual patient has been found. The cross- scored tablets facilitate the administration of lower daily doses in the initial stages of treatment. Where can I buy Clonazepam Auden 2mg online UK

The dosage of clonazepam must be adjusted to the needs of each individual and depends on the individual response to therapy. The maintenance dosage must be determined according to clinical response and tolerance.

The daily dose should be divided into 3 or 4 doses throughout the day. If doses are not equally divided, the largest dose should be given before retiring. Once the

maintenance dose level has been reached, the daily amount may be given in a single dose in the evening.

Simultaneous administration of more than one antiepileptic drug is a common practice in the treatment of epilepsy and may be undertaken with clonazepam. The dosage of each drug may be required to be adjusted to obtain the optimum effect. If status epilepticus occurs in a patient receiving oral clonazepam, intravenous clonazepam may still control the status. Before adding clonazepam to an existing anticonvulsant regimen, it should be considered that the use of multiple anticonvulsants may result in an increase of undesired effects. If necessary, larger doses may be given at the discretion of the physician, up to a maximum of 20 mg daily. The maintenance dose should be attained after 2-4 weeks of treatment. Where can I buy Clonazepam Auden 2mg online UK

Where can I buy Clonazepam Auden 2mg online UK – Adults

Initial dose not to exceed 1 mg/day.

The maintenance dosage for adults normally falls with the range 4 – 8 mg.

Elderly

Initial dose should not exceed 0.5 mg/day. The elderly are particularly sensitive to the effects of centrally depressant drugs and may experience confusion.

Children and Infants
Children should receive the 0.5 mg tablets to ensure optimum dosage adjustment. Initial dose should not exceed 0.25 mg/day for infants and small children (1-5 yrs). Initial dose should not exceed 0.5 mg/day for older children.
The maintenance dosage normally falls within the ranges:

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Infants (0 – 1 year)
Small children (1 – 5 years) School children (5-12 years)

0.5 – 1 mg/day 1 – 3 mg/day 3 – 6 mg/day

In some forms of childhood epilepsy, certain patients may cease to be adequately controlled by clonazepam. Control may be re-established by increasing the dose or interrupting treatment with clonazepam for 2 or 3 weeks. During the interruption in therapy, careful observation and other drugs may be needed. Where can I buy Clonazepam Auden 2mg online UK

Hepatic Impairment

In patients with mild to moderate hepatic impairment the dose should be adjusted to individual requirements and will probably be lower.

Method of administration For oral administration.

4.3 Contraindications – Where can I buy Clonazepam Auden 2mg online UK

Hypersensitivity to the active substance or any of the excipients listed in section 6.1.Acute pulmonary insufficiency; severe respiratory insufficiency, sleep apnoea syndrome, myasthenia gravis, severe hepatic insufficiency.

Clonazepam must not be used in patients in a coma, or in patients known to be abusing pharmaceuticals, drugs or alcohol.

Special warnings and precautions for use

Where can I buy Clonazepam Auden 2mg online UK – Suicidal behaviour:

Suicidal ideation and behaviour have been reported in patients treated with anti- epileptic agents in several indications. A meta-analysis of randomised placebo controlled trials of anti-epileptic drugs has also shown a small increased risk of suicidal ideation and behaviour. The mechanism of this risk is not known and the available data do not exclude the possibility of an increased risk for clonazepam. Where can I buy Clonazepam Auden 2mg online UK

Therefore patients should be monitored for signs of suicidal ideation and behaviours and appropriate treatment should be considered. Patients (and caregivers of patients) should be advised to seek medical advice should signs of suicidal ideation or behaviour emerge.

Patients with a history of depression and/or suicide attempts should be kept under close supervision.

Use with caution in patients with chronic pulmonary insufficiency, or with renal or hepatic function impairment, and in the elderly or debilitated. In these cases dosage should generally be reduced.

Carefully adjust dosage to individual requirements in patients with pre-existing disease of the liver or the respiratory system (e.g. chronic obstructive pulmonary disease) and in patients undergoing treatment with other centrally acting medications or anticonvulsant (antiepileptic) agents (see Section 4.5. Interaction with other medicinal products and other forms of interaction). Where can I buy Clonazepam Auden 2mg online UK

Do not interrupt treatment abruptly. As with all other antiepileptic drugs, treatment must be withdrawn gradually, by reducing the dose due to the risk of precipitating status epilepticus. This precaution must also be taken when withdrawing another drug while the patient is still receiving clonazepam therapy.

Prolonged use of benzodiazepines may result in dependence with withdrawal symptoms on cessation of use.

Some loss of effect may occur during the course of clonazepam long-term treatment.

Use with particular caution in patients with spinal or cerebellar ataxia, in the event of acute intoxication with alcohol or drugs and in patients with severe liver damage (e.g. cirrhosis of the liver).

The concomitant use of Clonazepam with alcohol or/and CNS depressants should be avoided. Such concomitant use has the potential to increase the clinical effects of Clonazepam possibly including severe sedation, clinically relevant respiratory and/or cardio-vascular depression (see 4.5). Where can I buy Clonazepam Auden 2mg online UK

Use with extreme caution in patients with a history of alcohol or drug abuse.

Where can I buy Clonazepam Auden 2mg online UK – Risk from concomitant use of opioids:

Concomitant use of Clonazepam and opioids may result in sedation, respiratory depression, coma and death. Because of these risks, concomitant prescribing of sedative medicines such as benzodiazepines or related drugs with opioids should be reserved for patients for whom alternative treatment options are not possible. If a decision is made to prescribe Clonazepam concomitantly with opioids, the lowest effective dose should be used, and the duration of treatment should be as short as possible. Where can I buy Clonazepam Auden 2mg online UK

The patients should be followed closely for signs and symptoms of respiratory depression and sedation. In this respect, it is strongly recommended to inform patients and their caregivers (where applicable) to be aware of these symptoms (see section “Interaction with other medicinal products and other forms of interaction“).

Clonazepam may cause increased production of saliva and bronchial secretion in infants and small children. Therefore special attention must be paid to maintaining patency of the airways.

Effects on the respiratory system may be aggravated by pre-existing airways obstruction or brain damage or if other medications which depress respiration have been given. As a rule, this effect can be avoided by careful adjustment of the dose to individual requirements.

Clonazepam is considered to be probably non porphyrinogenic, although there is some conflicting evidence. In rare cases, clonazepam has induced convulsions in patients with porphyria. Where can I buy Clonazepam Auden 2mg online UK

Like all drugs of this type, clonazepam may, depending on dosage, administration and individual susceptibility, modify the patient’s reactions (e.g. driving ability, behaviour in traffic) (See section 4.7).

Where can I buy Clonazepam Auden 2mg online UK – Use in epileptic patients

As a general rule, epileptic patients are not allowed to drive. Even when adequately controlled on Clonazepam, it should be remembered that any increase in dosage or alteration in timings of dosage may modify patients’ reactions, depending on individual susceptibility.

In cases of loss or bereavement, psychological adjustment may be inhibited by benzodiazepines.

Dependence

Use of benzodiazepines may lead to the development of physical and psychological dependence upon these products (see 4.8). In particular long-term or high-dose treatment, may lead to reversible disorders such as dysarthria, reduced coordination of movements and gait disorder (ataxia), nystagmus and double vision (diplopia). Where can I buy Clonazepam Auden 2mg online UK

Furthermore, the risk of anterograde amnesia, which may occur using benzodiazepines at therapeutic dosages, increases at higher dosages. Amnestic effects may be associated with inappropriate behaviour. With certain forms of epilepsy, an increase in the frequency of seizures (see 4.8) during long-term treatment is possible. The risk of dependence increases with dose and duration of treatment; it is also greater in patients with a medical history of alcohol and/or drug abuse.

Once physical dependence has developed, abrupt termination of treatment will be accompanied by withdrawal symptoms. During long-term treatment, withdrawal symptoms may develop after a lengthy period of use, especially with high doses or if the daily dose is reduced rapidly or abruptly discontinued. The symptoms include tremor, sweating, agitation, sleep disturbances and anxiety, headaches, muscle pain, extreme anxiety, tension, restlessness, confusion, irritability and epileptic seizures which may be associated with the underlying disease. In severe cases the following symptoms may occur: derealisation, depersonalisation, hyperacusis, numbness and tingling of the extremities, hypersensitivity to light, noise and physical contact or hallucinations. Since the risk of withdrawal symptoms is greater after abrupt discontinuation of treatment, abrupt withdrawal of the drug should therefore be avoided and treatment – even if only of short duration – should be terminated by gradually reducing the daily dose. The risk of withdrawal symptoms is increased when benzodiazepines are used together with day-time sedatives (crossed tolerance). Where can I buy Clonazepam Auden 2mg online UK

Excipients

Lactose
Patients with rare hereditary problems of galactose intolerance, total lactase deficiency or glucose-galactose malabsorption should not take this medicine.

Sodium
This medicinal product contains less than 1 mmol sodium (23 mg) per tablet, that is to say essentially ‘sodium-free’.

Interaction with other medicinal products and other forms of interaction

Coadministration with alcohol

Alcohol in combination with clonazepam may modify the effects of the drug, compromise the success of therapy or give rise to unpredictable side-effects. Under no circumstances should alcohol be consumed while under treatment with clonazepam.

Antiepileptic drugs

When used in conjunction with other antiepileptic drugs, side-effects such as sedation and apathy, and toxicity may be more evident, particularly with hydantoins or phenobarbital and combinations including them. This requires extra care in adjusting dosage in the initial stages of treatment. The combination of clonazepam and sodium valproate has, rarely, been associated with the development of absence status epilepticus. Although some patients tolerate and benefit from this combination of drugs, this potential hazard should be borne in mind when its use is considered. Where can I buy Clonazepam Auden 2mg online UK

The antiepileptic drugs phenytoin, phenobarbital, carbamazepine and valproate may increase the clearance of clonazepam thereby decreasing the plasma concentrations of the latter during combined treatment.

Pharmacokinetic interactions: Clonazepam itself does not induce the enzymes responsible for its own metabolism.

The SSRI (selective serotonin reuptake inhibitors) sertraline and fluoxetine do not affect the pharmacokinetics of clonazepam when administered concomitantly.

Special Precautions

Where can I buy Clonazepam Auden 2mg online UK. The plasma concentration of clonazepam is often reduced by carbamazepine, phenobarbital, phenytoin or primidone, and possibly by theophylline.

Concurrent treatment with phenytoin or primidone can change the plasma concentration of phenytoin or primidone (usually increases).

There is an increased risk of prolonged sedation and respiratory depression when clonazepam is given with amprenavir.

Metabolism of clonazepam is inhibited (i.e. increased plasma concentration) by cimetidine, disulfiram, fluvoxamine and ritonavir.

Metabolism of clonazepam may possibly be accelerated by rifampicin. Clonazepam may possibly antagonise effects of levodopa.

There are enhanced hypotensive and sedative effects when clonazepam is given with alpha-blockers or with moxonidine.

There is an enhanced hypotensive effect when clonazepam is given with ACE inhibitors, adrenergic neurone blockers, angiotensin-II receptor antagonists, beta- blockers, calcium channel blockers, clonidine, diazoxide, diuretics, hydralazine, methyldopa, minoxidil, nitrates or nitroprusside. Where can I buy Clonazepam Auden 2mg online UK

There is an increased sedative effect when clonazepam is given with alcohol, general anaesthetics, tricyclic and tricyclic-related antidepressants, antihistamine (less so for non-sedating antihistamines and not usually for topically applied antihistamines), antipsychotics, baclofen, lofexidine, mirtazapine, nabilone, opioid analgesics, tizanidine.

Opioids:

The concomitant use of sedative medicines such as benzodiazepines or related drugs such as Clonazepam with opioids increases the risk of sedation, respiratory depression, coma and death because of additive CNS depressant effect. The dosage and duration of concomitant use should be limited (see section “ Special warnings and precautions for use ”).