Clonazolam | The JHI

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Clonazolam

Found in:  

Fentanyl, BZD

Type/Reason added:  

Short acting DBZD

Relative Potency:  

Over twice as potent as alprazolam (19)

Overview

The Effects

Treatment Options

Supportive Care:

Definitive airway management via endotracheal intubation.

Antidote:

In the event of an overdose, medical professionals may administer flumazenil, a benzodiazepine receptor antagonist. However, flumazenil is used with caution due to the risk of precipitating seizures in dependent users.

Pharmacokinetics and Dynamics

Metabolism:

Clonazolam is metabolized by the liver, involving the CYP3A4 enzyme, similar to other benzodiazepines.

Drug-Drug Interactions:

Combining clonazolam with other CNS depressants—like alcohol, opioids, or sedatives—dramatically increases the risk of severe respiratory depression and fatal overdose. Additionally, CYP3A4 inhibitors (e.g., certain antibiotics or grapefruit juice) slow clonazolam’s metabolism, prolonging its effects and heightening overdose risk.