Description
Rivotril (Clonazepam) 1 mg
Rivotril is a brand name used for clonazepam, a benzodiazepine medicine. The 1 mg tablet strength identifies the product form and amount of active ingredient, which is clonazepam 1 mg per tablet. In regulatory medicine information, clonazepam is presented as an antiepileptic benzodiazepine and, in some markets, is also used for panic disorder.
Active Ingredient and Medicine Class
The verified active ingredient is clonazepam. It belongs to the benzodiazepine class and is classified pharmacologically as an antiepileptic, with additional sedative, muscle-relaxant and anxiolytic properties. Clonazepam is a prescription medicine and is subject to controlled-medicine restrictions in many countries.
Established Medical Uses
Official product information for clonazepam tablets supports use in seizure disorders, including absence seizures and other generalized or partial seizure types. In U.S. prescribing information, clonazepam tablets are also indicated for panic disorder, with or without agoraphobia, in adults. The exact approved uses can vary by country and product licence.
How It Works
Clonazepam is a benzodiazepine that enhances the effect of gamma-aminobutyric acid, or GABA, the main inhibitory neurotransmitter in the brain. This reduces excessive neuronal firing and helps suppress seizure activity. The same central nervous system depressant action also explains its calming and muscle-relaxing effects.
Important Safety Information
Clonazepam should not be used in people with hypersensitivity to benzodiazepines or clonazepam, severe liver impairment, severe respiratory insufficiency, sleep apnoea syndrome, myasthenia gravis, or acute narrow-angle glaucoma in the U.S. label. Regulatory information also warns against use in coma and in people abusing alcohol or drugs. It should be used cautiously in older adults and in people with respiratory disease, liver disease, depression, or a history of substance misuse.
Important interactions include alcohol, other central nervous system depressants, antiepileptic medicines, sedatives, some antidepressants, antipsychotics, antihistamines, muscle relaxants and opioids. The combination with opioids is specifically associated with increased risk of profound sedation, respiratory depression, coma and death. Benzodiazepines can also cause dependence, and abrupt stopping or rapid dose reduction may precipitate withdrawal symptoms, including seizures.
Possible Side Effects
Common adverse effects include somnolence, dizziness, slowed reaction time, muscular hypotonia and ataxia. Other reported effects include fatigue, headache, slurred speech, impaired coordination, memory problems and behavioural changes. Less common but clinically important reactions include respiratory depression, paradoxical agitation, depression, confusion, hallucinations, blood pressure or heart-rate effects, and allergic reactions. Long-term or higher-dose use may increase the risk of dependence and withdrawal symptoms.
Scientific Evidence
Clinical trials in panic disorder found clonazepam superior to placebo for reducing panic attacks and associated anxiety symptoms over short-term treatment periods. One placebo-controlled study reported significant benefit in patients with panic disorder, and another multicentre dose-response trial found clinically meaningful improvement with fixed daily doses. In epilepsy, authoritative product information supports efficacy across several seizure types, although response can vary and loss of effect may occur in some patients.
Medical Information Notice
This page is an educational summary based on official and scientific sources available at the time of review. It does not replace the official patient leaflet, the full prescribing information, or individual assessment by a qualified health professional.
Medical Sources
- EMA clonazepam: list of nationally authorised medicinal products, including Rivotril names in several countries. View official EMA document
- electronic Medicines Compendium (emc) Clonazepam Neuraxpharm 1 mg tablets, Summary of Product Characteristics. View official SmPC
- DailyMed / U.S. National Library of Medicine Clonazepam tablet prescribing information. View official label
- Beauclair L et al. Clonazepam in the treatment of panic disorder: a double-blind, placebo-controlled trial investigating the correlation between clonazepam concentrations in plasma and clinical response. PubMed, 1994. View scientific article
- Clonazepam Panic Disorder Dose-Response Study Group Clonazepam in the treatment of panic disorder with or without agoraphobia: a dose-response study of efficacy, safety, and discontinuance. PubMed, 1997. View scientific article
