Methylnaltrexone
Severe
Textbook
Increased rates of accidental overdose and death.
Caution is advised, especially for patients with a history of drug abuse.
Source: G&G 14e
Drug reference
Clobazam
Benzodiazepine · Antiepileptic
BenzodiazepineAntiepileptic
CDSCO approvedSchedule H
EXCRETION
—
not curated
INTERACTIONS
12 major
SEVERE in our sources
PREGNANCY
[MHRA/CHM advice].
. Multiple sclerosis p. 893 and Nausea and labyrinth
FDA category + note
Top interactionssee all 12 →
- MethylnaltrexoneSevereTextbookG&G 14e
- NalmefeneSevereTextbookG&G 14e
- NaloxoneSevereTextbookG&G 14e
- NaltrexoneSevereTextbookG&G 14e
Mechanism
Clobazam is a 1,5-benzodiazepine — structurally distinct from classical 1,4-benzodiazepines like diazepam — that acts as a positive allosteric modulator of GABA-A receptors. The 1,5-ring configuration contributes to a more favorable anxiolytic-to-sedative ratio and lower tolerance development. It is metabolized by CYP3A4 to N-desmethylclobazam (norclobazam), an active metabolite that accumulates at steady state and contributes significantly to its sustained antiepileptic activity.
Indications
seizures associated with Dravet syndromeseizures associated with Lennox–Gastaut syndromeFocal seizures with or without secondary generalisationAdjunctive treatment of seizures associated with Lennox-Gastaut syndromeOther types of epilepsiesAnxiety disordersanticonvulsantpartial seizuressecondarily generalized tonic-clonic seizuresabsence seizuresatonic seizuresrefractory epilepsy (as adjuvant to other antiepileptic drugs like phenytoin, carbamazepine or valproate)
Dosing
- Adult
- Epilepsy: 20-30 mg daily, increased if necessary up to 60 mg daily.
- Hepatic adjustment
- not recommended in patients with severe hepatic impairment
- Max dose
- 60 mg daily
Pharmacokinetics
Half-life
36–42
Bioavailability
~90% oral
Contraindications
- Patients with severe hepatic impairment
- obstructive sleep apnoea
Side effects
Common
Tolerance develops to anticonvulsant effectssedation (less prominent)psychomotor retardation (less prominent)side effect profile similar to other BZDs
Serious
- Potentially fatal respiratory depression
- Antiepileptic hypersensitivity syndrome
Pregnancy & lactation
Pregnancy
[MHRA/CHM advice]. . Multiple sclerosis p. 893 and Nausea and labyrinth
Lactation
Associated with an established risk of drowsiness in breast-fed babies and caution is required.
Drug interactions
Nalmefene
Severe
Textbook
Increased rates of accidental overdose and death.
Caution is advised, especially for patients with a history of drug abuse.
Source: G&G 14e
Naloxone
Severe
Textbook
Increased rates of accidental overdose and death.
Caution is advised, especially for patients with a history of drug abuse.
Source: G&G 14e
Naltrexone
Severe
Textbook
Increased rates of accidental overdose and death.
Caution is advised, especially for patients with a history of drug abuse.
Source: G&G 14e
Other Cns Depressants
Severe
Textbook
Typically fatal if combined in overdose.
Use with extreme caution; avoid if possible.
Source: G&G 14e
Alcohol
Severe
Database
Profound sedation, respiratory depression, coma, and potentially death.
Advise patients to avoid alcohol consumption while taking clobazam. Emphasize the dangers of combining these substances.
Alfentanil
Severe
Database
Increased rates of accidental overdose and death.
Caution is advised, especially for patients with a history of drug abuse.
Source: DDInter
Benzhydrocodone
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Brexpiprazole
Severe
Database
Drug interaction classified as: metabolism
Source: DDInter
Buprenorphine
Severe
Database
Increased rates of accidental overdose and death.
Caution is advised, especially for patients with a history of drug abuse.
Source: DDInter
Butorphanol
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Clozapine
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Related guidelines
Initial monotherapy for newly diagnosed epilepsy
IAN · Neurology · 2023
Initial monotherapy for newly diagnosed epilepsy
ILAE · Neurology · 2013
Functional (psychogenic non-epileptic) seizures
AAN · Neurology · 2026
Empirical antimicrobial use in common syndromes
ICMR · Infectious Diseases · 2019
Acute coronary syndrome in chronic kidney disease
CSI · Cardiology · 2020
Other Benzodiazepine drugs
Ask House about Clobazam
Continue into a citation-backed clinical answer with the drug context already attached.
Sources: KD Tripathi 7e, Goodman & Gilman 14e, BNF·Verified: 2026-05-10 · House clinical team