Medicines

Rivotril: How it works, Uses, Dosage, Side Effects 

What is Rivotril?

Rivotril is a brand of Clonazepam, a prescription drug that is also available as the brand-name drug Klonopin. It’s also available as a generic drug. Generic drugs usually cost less. In some cases, they may not be available in every strength or form as the brand-name version. Clonazepam comes as both an oral tablet and an oral disintegrating (dissolving) tablet.

There are two common brands of Rivotril produced by two different companies. One is produced by Galenika and the other by Roche. Clonazepam is a controlled substance.

What is Rivotril used for?

Rivotril is used alone or in combination with other medications to control certain types of seizures. It is also used to relieve panic attacks (sudden, unexpected attacks of extreme fear and worry about these attacks). Using Rivotril as part of a combination therapy means a person may need to take it with other medications.

Rivotril is also used to treat symptoms of akathisia (restlessness and a need for constant movement) that may occur as a side effect of treatment with antipsychotic medications (medications for mental illness) and to treat acute catatonic reactions (a state in which a person does not move or speak at all or moves or speaks abnormally). Talk to your doctor about the possible risks of using this medication for your condition.

This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

How does Rivotril works?

Clonazepam the active ingredient in Rivotril belongs to a class of drugs called benzodiazepines. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

Clonazepam works by increasing the activity of gamma aminobutyric acid (GABA). This is a chemical that sends signals throughout a person’s nervous system. If a person does not have enough GABA, their body may be in an excited state. This may cause them to have panic attacks or seizures. When a person takes this drug, they will have more GABA in their body. This will help them have fewer panic attacks and seizures.

How should I take Rivotril?

Clonazepam comes as a tablet and an orally disintegrating tablet (tablet that dissolves quickly in the mouth) to take by mouth. It usually is taken one to three times a day with or without food. Take clonazepam at around the same time(s) every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand.

Do not try to push the orally disintegrating tablet through the foil. Instead, use dry hands to peel back the foil packaging. Immediately take out the tablet and place it in your mouth. The tablet will quickly dissolve and can be swallowed with or without liquid.

Your doctor will probably start you on a low dose of Rivotril and gradually increase your dose, not more often than once every 3 days.

Rivotril may help control your condition, but will not cure it. It may take a few weeks or longer before you feel the full benefit of clonazepam. Continue to take Rivotril even if you feel well. Do not stop taking Rivotril without talking to your doctor, even if you experience side effects such as unusual changes in behavior or mood. If you suddenly stop taking Rivotril, you may experience withdrawal symptoms such as new or worsening seizures, hallucinating (seeing things or hearing voices that do not exist), changes in behavior, sweating, uncontrollable shaking of a part of your body, stomach, or muscle cramps, anxiety, or difficulty falling asleep or staying asleep. Your doctor will probably decrease your dose gradually.

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Overdose symptoms may include extreme drowsiness, confusion, muscle weakness, or coma.

What are the side effects of Rivotril?

Side effects associated with the use of Rivotril, include the following:

•        Drowsiness

•        Sedation

•        Abnormal coordination

•        Loss of control of bodily movements

•        Depression or symptoms of depression

•        Dizziness

•        Fatigue

•        Memory impairment

•        Upper respiratory infection or symptoms

•        Confusion

•        Difficulty speaking

Other side effects associated with the use of this medication may include:

•        Runny nose

•        Coughing

•        Urinary frequency

•        Impotence

•        Decreased libido

•        Increased salivation

•        Worsening tonic-clonic seizures

This document does not contain all possible common side effects and other side effects that may occur. Check with your physician for additional information about the side effects of this drug.

What other drugs interact with Rivotril?

If your doctor has directed you to use this medication, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.

•        Severe interactions include:

o       sodium oxybate

•        Serious Interactions include:

o       hydrocodone

o       idelalisib

o       ivacaftor

o       valerian

•        This medication has moderate interactions with at least 210 different drugs.

•        This medication has mild interactions with at least 39 different drugs.

Tell your doctor and pharmacist if you are allergic to clonazepam, other benzodiazepines such as alprazolam (Xanax), chlordiazepoxide (Librium, in Librax), clorazepate (Gen-Xene, Tranxene), diazepam (Diastat, Valium), estazolam, flurazepam, lorazepam (Ativan), midazolam (Versed), oxazepam, temazepam (Restoril), triazolam (Halcion), any other medications, or any of the ingredients in clonazepam tablets. Ask your pharmacist for a list of the ingredients.

tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, and nutritional supplements you are taking or plan to take. Be sure to mention any of the following: amiodarone (Cordarone, Nexterone, Pacerone); certain antibiotics such as clarithromycin (Biaxin, in Prevpac), erythromycin (Erythrocin, E-mycin, others), and troleandomycin (TAO) (not available in the US); antidepressants; certain antifungal medications such as itraconazole (Onmel. Sporanox) and ketoconazole (Nizoral); antihistamines; certain calcium channel blockers such as diltiazem (Cardizem, Tiazac, others) and verapamil (Calan, Covera, Verelan, in Tarka); cimetidine (Tagamet); HIV protease inhibitors including indinavir (Crixivan), nelfinavir (Viracept), and ritonavir (Norvir, in Kaletra); medications for anxiety, colds or allergies, or mental illness; other medications for seizures such as carbamazepine (Epitol, Tegretol, Teril), phenobarbital, phenytoin (Dilantin, Phenytek), or valproic acid (Depakene); muscle relaxants; nefazodone; rifampin (Rifadin, Rimactane); sedatives; certain selective serotonin reuptake inhibitors (SSRIs) such as fluvoxamine (Luvox); other sleeping pills; and tranquilizers. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.

This information does not contain all possible interactions or adverse effects. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions, concerns, or for more health information about this medicine.

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Dr. Oche Otorkpa PG Cert, MPH, PhD

Dr. Oche is a seasoned Public Health specialist who holds a post graduate certificate in Pharmacology and Therapeutics, an MPH, and a PhD both from Texila American University. He is a member of the International Society of Substance Use Professionals and a Fellow of the Royal Society for Public Health in the UK. He authored two books: "The Unseen Terrorist," published by AuthorHouse UK, and "The Night Before I Killed Addiction."
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