Xorest 1 mg Tablet
Xorest 1, a benzodiazepine medication, exhibits anticonvulsive, sedative, muscle-relaxing, and anxiolytic effects. It works by enhancing GABAergic neurotransmission, which reduces brain excitability. This positive allosteric modulation increases the affinity of GABA receptors, resulting in increased inhibitory action, providing calming and therapeutic effects. Clonazepam’s efficacy in epilepsy treatment is evident through animal data and human EEG investigations.
It rapidly suppresses various types of paroxysmal activity, including spike and wave discharges seen in absence seizures, slow spike waves, and irregular spikes and waves. It is particularly effective in generalized epilepsies but also shows benefits in focal epilepsies. Despite its therapeutic effects, Clonazepam has potential tolerance, dependence, and withdrawal risks. As such, it should only be used under medical supervision. Due to its versatile pharmacological properties, Clonazepam remains essential in managing epilepsy and certain anxiety disorders.
Uses Of Xorest 1 mg
Xorest is used to treat various medical conditions, including epilepsy and anxiety disorders. All the indications are given below:
- Clonazepam is used to treat panic disorder, with or without agoraphobia, characterized by unexpected panic attacks and fear of additional attacks.
- It is also indicated for Lennox-Gastaut Syndrome (petit mal variant), akinetic, and myoclonic seizures.
- Clonazepam may be considered for patients without seizures who don’t respond to succinimides.
- Long-term effectiveness beyond 9 weeks has yet to be extensively studied.
- Physicians should periodically reassess the drug’s usefulness for patients on long-term treatment.
Dosage and Administration Of Clonazepam
Xorest or Clonazepam should be consumed following the given instructions. But It can vary from patient to patient based on health condition.
- For adults with seizure disorders: Initial dose not to exceed 1.5 mg/day divided into three doses. Incremental increases of 0.5 to 1 mg every 3 days until seizures are controlled or side effects occur. The maximum daily dose is 20 mg.
- For adults with panic disorder: Initial dose is 0.25 mg, given in two divided doses. The target dose for most patients is 1 mg/day after 3 days.
- For infants and children (up to 10 years or 30 kg): Initial dose between 0.01 and 0.03 mg/kg/day, not to exceed 0.05 mg/kg/day, divided into two or three doses.
- Infants and children: Half of a vial (0.5 mg) by slow IV injection or infusion.
- Adults: One vial (1 mg) by slow IV injection or infusion. Repeat as needed (usually 1-4 mg for status reversal). The injection rate must not exceed 0.25 – 0.5 mg per minute, and the total dose should not exceed 10 mg.
Xorest 1 does not alter the pharmacokinetics of phenytoin, carbamazepine, or phenobarbital. However, its effects on the metabolism of other drugs have not been studied. Caution and medical advice are necessary when combining Xorest 1 with other medications. Monitoring and individualized treatment plans are essential.
Xorest 1 should not be used in patients with a history of hypersensitivity to benzodiazepines or those with clinical or biochemical evidence of significant liver disease. It is also contraindicated in acute narrow-angle glaucoma. However, it may be used in patients with open-angle glaucoma who receive appropriate therapy. As with any medication, it is essential to consider contraindications and individual patient factors before prescribing Clonazepam to ensure safety and avoid potential adverse effects.
Xorest 1 mg Price
Xorest 1 mg tablet price is 9.00 tk, and a box of 30 tablets is 270 tk.
Side Effects of Xorest 1 mg
The most common side effects of Xorest 1 are related to CNS depression. Approximately 50% of patients experience drowsiness, and around 30% may have ataxia (loss of muscle coordination). Some of these side effects might improve over time. About 25% of patients may experience behaviour problems. Other possible side effects include:
- Ataxia (loss of muscle coordination)
- Behaviour problems
- Abnormal eye movements
- Aphonia (loss of voice)
- Vertigo (dizziness)
- Increased libido
- Palpitations (rapid heartbeats)
Please note that this is not an exhaustive list, and individual reactions to medication can vary. It is crucial to promptly report any side effects to a healthcare professional for proper evaluation and management.
Precautions & Warnings
When Xorest 1 is used in patients with multiple seizure disorders, it may increase the incidence of generalized tonic-clonic seizures. Additional anticonvulsants or dosage adjustments may be necessary. Combining Xorest 1 with valproic acid can lead to absence status, characterized by prolonged absence seizures. Close monitoring and carefully considering medication interactions are essential for effective seizure management.
Pregnancy and Lactation
Pregnancy: Clonazepam may potentially cause congenital malformations based on preclinical studies, and anticonvulsant drugs, in general, have been linked to teratogenic effects. However, it’s challenging to pinpoint the exact cause of birth defects in newborns due to multiple factors. Pregnant women should only take Clonazepam if the benefits outweigh the risks.
High doses in the last trimester or during labour can lead to irregular heartbeat, hypothermia, hypotonia, mild respiratory depression, and poor feeding in the newborn. Pregnancy itself and abrupt medication discontinuation can worsen epilepsy. Withdrawal symptoms in newborns have been reported with benzodiazepines.
Nursing Mothers: Clonazepam may pass into breast milk, so breastfeeding should be avoided during treatment. If there is a compelling need for Clonazepam, breastfeeding should be discontinued.
Symptoms: Common side effects of benzodiazepines include drowsiness, ataxia (loss of muscle coordination), dysarthria (speech difficulties), and nystagmus (involuntary eye movements). An overdose of Xorest 1 alone is seldom life-threatening but may lead to areflexia (loss of reflexes), apnea (temporary cessation of breathing), hypotension (low blood pressure), cardiorespiratory depression, and coma.
Coma, if it occurs, typically lasts a few hours but may be more prolonged and cyclical in elderly patients. Supratherapeutic plasma concentrations can increase seizure frequency, especially in patients. Respiratory depression caused by benzodiazepines can be more severe in patients with respiratory diseases. Combining benzodiazepines with other central nervous system depressants, including alcohol, can enhance their effects.
Treatment: Monitor vital signs and provide supportive measures based on the patient’s clinical condition. Symptomatic treatment may be necessary for cardiorespiratory and central nervous system effects. Prevent further absorption using methods like activated charcoal within 1-2 hours. Use airway protection for drowsy patients if activated charcoal is given. In cases of mixed ingestion, gastric lavage may be considered, but not as a routine measure.
For severe CNS depression, flumazenil, a benzodiazepine antagonist, may be used with extreme caution and under close monitoring. Flumazenil has a short half-life; patients should be monitored after its effects wear off. Caution is needed if patients are taking drugs that reduce the seizure threshold. Refer to the prescribing information for flumazenil for proper usage of Xorest 1.
Adjunct anti-epileptic drugs, Benzodiazepine hypnotics
Keep in a dry place away from light and heat. Keep out of the reach of children.