by Dr. Manura Nanayakkara

Created on: July 05, 2010

Rivotril® is a drug manufactured by the pharmaceutical company Roche®. Its generic name is Clonazepam. It is commonly prescribed as an anti epileptic agent and as an anti panic drug. Some doctors use this medication to calm down and to induce sleep in disturbed psychiatric patients. Main side effects are dizziness, fatigue and drowsiness.

 Rivotril® Modulate GABA (type A) receptors in the brain and increases their action. This increases the inhibitory neuro - transmission in the brain, which alleviates anxiety, prevent/ treat seizures and cause side effects such as drowsiness.

 Some clinicians believe side effects are lower in Rivotril compared to the generic variety. But it is controversial.

 What the doctor should know, before prescribing

 If a patient has kidney disease, liver disease, respiratory disorder, ataxia (poor control of body movements), clinical depression or myasthenia gravis then he/she should inform it to the doctor before prescribing Rivotril. The doctor may assess patient’s suicide risk before prescribing this medication.

 The doctor will ask about the over the counter medications patient is currently taking. If the patient is pregnant, the doctor may not prescribe this medication, especially in the last three months. Doctor should know patient’s sober habits before prescribing Rivotril as well.

 This medication is available as tablets and injections. Tablets should be taken with full glass of water without crushing, to minimize side effects. It can be taken with or without meals. Injections are used in uncontrolled epilepsy.

 Common side effects

Main side effect is drowsiness. Since this medication is a longer acting benzodiazepine, drowsiness may continue to the next day. This makes operating machinery and driving pretty dangerous. Taking alcohol with this medication can have serious consequences as well.

 Other common side effects are fatigue and dizziness. Reduced muscle strength and co-ordination problems in movements are common side effects as well. Poor mental concentration, restlessness, confusion and memory loss are other side effects.

 One of the main problems with Rivotril/benzodiazepines is dependence, withdrawal symptoms and tolerance. Dependence and withdrawal means getting adverse effects when a drug is stopped. These are sweating, muscle pains, apprehension and fits. Tolerance means requiring increased amount of the dose to achieve same benefit.

Relatively rare side effects

 Rarely patients can get gastro intestinal effects such as nausea, vomiting and diarrhea. Certain patients may get respiratory depression. Headache is another rare side effect. Rarely some patients may complain sexual dysfunction with this medication as well.

 Very rarely few patients may get urinary incontinence. Some patients complain reversible hair loss as well. Difficulty in articulating speech can occur rarely in some patients. Allergic reactions to this medication occur rarely. These include hives, itchiness and shortness of breath.

 Sources

British National Formulary

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