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Clobazam
Clobazam is a medicine from the benzodiazepine class. Clobazam is used for its anxiolytic effect, and
as adjunctive therapy in epilepsy. In Canada, it is used as adjunctive therapy in the treatment of
complex partial seizures, status epilepticus like a myoclonic, myoclonic-absent, simple partial, complex
partial, tonic, non-status absence seizures, and for the treatment of anxiety.
Clobazam is sold under the brand name Frisium among others.
Boehringer Ingelheim GmbH was awarded the patented for Clobazam in 1968. It has been used since
1970 as an enantioselective anxiolytic and since 1984, as an anticonvulsant. Clobazam's development
goal was to find better alternatives to benzodiazepine and provide better anxiolytic, anti-obsessive
effects, and fewer benzodiazepine-related side effects. In 2011, the FDA approved an oral
preparation and an oral suspension in 2013.
Dosage Forms & Strengths
Clobazam is a Schedule IV drug and sold as a scored tablet in 10mg and 20mg strengths. Its oral
suspension has 2.5mg/mL and the oral soluble film has doses from 5mg to 20mg. In the treatment of
Seizures, it is used for the adjunctive treatment of seizures associated with Lennox-Gastaut
syndrome. The initial dose for treatment starts at 5 mg taken orally every 12 hours and the dose can
titrate as tolerated up to 40 mg a day, divided into doses taken 12 hours apart. The dose increase
should not be done more than once a week.
In children, the initial dose is 5 mg per day and titrated according to weight, but maintained at half
the adult dose. If needed, additional titration to the maximum dose of 20 mg per day or 40 mg per
day is done depending on the weight group and is started on day 21 of the therapy.
The price of Clobazam
In the USA, the consumer pays an average retail price of $823.20 for a generic 60 tablet of 10mg
strength. This medicine is much cheaper in the developing parts of the world, where the costs are
down due to local manufacturing of the generic version. In India, a supply of 60 tablets of 10mg,
costs around USD 1.2.
How does Clobazam work?
Clobazam's actions are not fully understood. However, it has been postulated that it is involved in
the potentiation of GABAergic neurotransmission. This is an outcome of binding at the
benzodiazepine site at the GABA(A) receptor. It has the ability to bind at distinct binding sites
associated with the chloride ionophore at the post-synaptic GABA receptor in various locations in the
CNS. Here clobazam increases the length of time for which the chloride ionophore stays open. As the
postsynaptic inhibitory effect of GABA increases, these series of actions result in hyperpolarization
and stabilization of the membrane.
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