Disopan 1 mg

Description

Indications
Disopan is prescribed for the treatment of panic disorder, whether or not accompanied by agoraphobia. Panic disorder is characterized by sudden, unexpected panic attacks and the ongoing concern about future attacks, including worries about their possible consequences.

Disopan is also used alone or as an adjunct therapy for treating Lennox-Gastaut Syndrome (petit mal variant), as well as akinetic and myoclonic seizures. Additionally, it may be beneficial in treating absence seizures (petit mal) that have not responded to succinimides.

The long-term effectiveness of Disopan, particularly for durations longer than 9 weeks, has not been thoroughly studied in controlled clinical trials. Physicians opting to prescribe Disopan for extended periods should regularly assess the long-term effectiveness for the individual patient.

Use as directed by a registered physician.

Pharmacology
Clonazepam, the active ingredient in Disopan, belongs to the benzodiazepine class of medications, exhibiting properties such as anticonvulsant, sedative, muscle relaxant, and anxiolytic effects. The central actions of benzodiazepines occur through the enhancement of GABAergic neurotransmission at inhibitory synapses. This enhances the GABA receptor’s affinity for the neurotransmitter, resulting in increased chloride ion flux across the postsynaptic membrane.

Animal studies have also indicated that clonazepam may influence serotonin levels. Both animal studies and human electroencephalographic (EEG) investigations show that clonazepam rapidly suppresses various types of paroxysmal brain activity, including spike and wave discharges in absence seizures, as well as other generalized and focal epileptic discharges. It is especially effective in suppressing generalized EEG abnormalities.

Dosage & Administration
Oral:

• Adults: For seizure disorders, the initial dose should not exceed 1.5 mg/day, divided into three doses. The dose can be gradually increased by 0.5 to 1 mg every 3 days until seizures are controlled or side effects become intolerable. The maximum recommended daily dose is 20 mg.
  For panic disorder, start with 0.25 mg in two divided doses, increasing to 1 mg/day after 3 days for most patients.

• Pediatric Patients: To minimize sedation, the initial dose for children (up to 10 years or 30 kg) should range between 0.01 and 0.03 mg/kg/day, not exceeding 0.05 mg/kg/day, divided into two or three doses.

Injection:

• Infants and children: Administer half of a vial (0.5 mg) via slow IV injection or infusion.
• Adults: Administer 1 vial (1 mg) via slow IV injection or infusion. Doses may be repeated if necessary (1–4 mg are typically sufficient to reverse status). For adults, the injection rate should not exceed 0.25 – 0.5 mg per minute, and the total dose should not exceed 10 mg.

Use as directed by a registered physician.

Interaction
Disopan does not appear to alter the pharmacokinetics of phenytoin, carbamazepine, or phenobarbital. The impact of Disopan on the metabolism of other drugs has not been studied.

Contraindications
Disopan should not be used in patients who have a history of hypersensitivity to benzodiazepines or those with significant liver disease. It may be used in patients with open-angle glaucoma, provided appropriate therapy is in place, but is contraindicated in those with acute narrow-angle glaucoma.

Side Effects
The most common side effects are related to central nervous system (CNS) depression, such as drowsiness, ataxia, and behavioral changes. Other potential side effects include abnormal eye movements, tremors, vertigo, confusion, depression, amnesia, hallucinations, psychosis, increased libido, insomnia, and palpitations. In some cases, side effects may lessen over time.

Pregnancy & Lactation

• Pregnancy: Clonazepam may pose a risk of congenital malformations based on preclinical studies. Anticonvulsant drugs have been identified as teratogens, but determining which specific drug is responsible for defects in newborns is difficult. Clonazepam should only be used during pregnancy if the benefits outweigh the risks.
• Nursing Mothers: Although clonazepam passes into breast milk in small amounts, mothers should avoid breastfeeding while using this medication.

Precautions & Warnings

• In patients with multiple types of seizure disorders, Disopan may increase the frequency or precipitate generalized tonic-clonic seizures. The addition of appropriate anticonvulsants or dosage adjustments may be required.
• Co-administration of Disopan with valproic acid may lead to absence status.

Use in Special Populations

• Pediatric Use: Special attention is needed to maintain airway patency in infants and young children, as they may experience increased saliva and bronchial secretion.
• Geriatric Use: Elderly patients may experience enhanced pharmacologic effects of benzodiazepines due to age-related changes in drug-receptor interactions and organ function.
• Renal Impairment: No dose adjustment is required for patients with renal impairment.
• Hepatic Impairment: Disopan’s plasma protein binding is affected in patients with liver cirrhosis, which may reduce the clearance of the unbound drug.

Overdose Effects
Overdose symptoms of Disopan include drowsiness, ataxia, dysarthria, nystagmus, and in severe cases, apnoea, hypotension, and coma. If overdose occurs, supportive care and monitoring are necessary. In severe CNS depression cases, flumazenil, a benzodiazepine antagonist, may be used under medical supervision.

Therapeutic Class
Adjunct anti-epileptic drugs, Benzodiazepine hypnotics.

Storage Conditions
Store in a dry place, away from light and heat. Keep out of reach of children.

Common Questions About Disopan 1 mg Tablet

• Is Disopan a sleeping pill?
  Disopan is not a sleeping pill and may, in fact, interfere with sleep in some cases.

• Can Disopan be taken long-term?
  Follow your doctor’s instructions on the duration of use. Stopping or adjusting the dose suddenly can lead to seizures.

• Withdrawal Symptoms:
  Withdrawal symptoms may include difficulty sleeping, mood changes, sweating, muscle pain, shaking, restlessness, and anxiety.

• Can I take Disopan with other medications?
  Combining Disopan with zolpidem or quetiapine can increase the risk of side effects like drowsiness, confusion, and difficulty breathing. Always consult with your doctor before combining medications.

Quick Tips

• Disopan has a high potential for dependence. Always follow the prescribed dose and duration.
• Avoid alcohol while taking Disopan as it may increase drowsiness and dizziness.
• Do not stop Disopan abruptly without consulting your doctor to avoid withdrawal symptoms.

Use as directed by a registered physician.