Tranxene (clorazepate) for Anxiety: Side Effects & Interactions

Generic drug: clorazepate dipotassium

Brand name: Tranxene

What is Tranxene (clorazepate dipotassium), and how does it work?

Tranxene is a prescription medicine used:

to treat anxiety disorders
with other medicines to treat partial seizures
to treat the symptoms of sudden alcohol withdrawal

It is not known if Tranxene is safe and effective in children less than 9 years of age.

What are the side effects of Tranxene?

The most common side effects of Tranxene include:

These are not all the possible side effects of Tranxene. For more information, ask your healthcare provider or pharmacist.

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What is the dosage for Tranxene?

For The Symptomatic Relief Of Anxiety

Tranxene T-TAB tablets are administered orally in divided doses. The usual daily dose is 30 mg. The dose should be adjusted gradually within the range of 15 to 60 mg daily in accordance with the response of the patient. In elderly or debilitated patients it is advisable to initiate treatment at a daily dose of 7.5 to 15 mg.
Tranxene tablets may also be administered in a single dose daily at bedtime; the recommended initial dose is 15 mg. After the initial dose, the response of the patient may require adjustment of subsequent dosage. Lower doses may be indicated in the elderly patient. Drowsiness may occur at the initiation of treatment and with dosage increment.

For the symptomatic relief of acute alcohol withdrawal:

The following dosage schedule is recommended:

1st 24 hours (Day 1)
30 mg initially; followed by 30 to 60 mg in divided doses

2nd 24 hours (Day 2)
45 to 90 mg in divided doses

3rd 24 hours (Day 3)
22.5 to 45 mg in divided doses

Day 4
15 to 30 mg in divided doses

Thereafter, gradually reduce the daily dose to 7.5 to 15 mg. Discontinue drug therapy as soon as patient's condition is stable.
The maximum recommended total daily dose is 90 mg. Avoid excessive reductions in the total amount of drug administered on successive days.

As An Adjunct To Antiepileptic Drugs

In order to minimize drowsiness, the recommended initial dosages and dosage increments should not be exceeded.

Adults

The maximum recommended initial dose in patients over 12 years old is 7.5 mg three times a day. Dosage should be increased by no more than 7.5 mg every week and should not exceed 90 mg/day.

Children (9-12 years)

The maximum recommended initial dose is 7.5 mg two times a day. Dosage should be increased by no more than 7.5 mg every week and should not exceed 60 mg/day.

What drugs interact with Tranxene?

The concomitant use of benzodiazepines and opioids increases the risk of respiratory depression because of actions at different receptor sites in the CNS that control respiration. Benzodiazepines interact at GABA_A sites and opioids interact primarily at mu receptors.
When benzodiazepines and opioids are combined, the potential for benzodiazepines to significantly worsen opioid-related respiratory depression exists. Limit dosage and duration of concomitant use of benzodiazepines and opioids, and monitor patients closely for respiratory depression and sedation.
If Tranxene is to be combined with other drugs acting on the central nervous system, careful consideration should be given to the pharmacology of the agents to be employed.
Animal experience indicates that clorazepate dipotassium prolongs the sleeping time after hexobarbital or after ethyl alcohol, increases the inhibitory effects of chlorpromazine, but does not exhibit monoamine oxidase inhibition. Clinical studies have shown increased sedation with concurrent hypnotic medications. The actions of the benzodiazepines may be potentiated by barbiturates, narcotics, phenothiazines, monoamine oxidase inhibitors or other antidepressants.
If Tranxene tablets are used to treat anxiety associated with somatic disease states, careful attention must be paid to possible drug interaction with concomitant medication.
In bioavailability studies with normal subjects, the concurrent administration of antacids at therapeutic levels did not significantly influence the bioavailability of Tranxene tablets.

QUESTION

Panic attacks are repeated attacks of fear that can last for several minutes.
See Answer

Is Tranxene safe to use while pregnant or breastfeeding?

An increased risk of congenital malformations associated with the use of minor tranquilizers (chlordiazepoxide, diazepam, and meprobamate) during the first trimester of pregnancy has been suggested in several studies.
Clorazepate dipotassium, a benzodiazepine derivative, has not been studied adequately to determine whether it, too, may be associated with an increased risk of fetal abnormality.
Because use of these drugs is rarely a matter of urgency, their use during this period should almost always be avoided. The possibility that a woman of childbearing potential may be pregnant at the time of institution of therapy should be considered.
Patients should be advised that if they become pregnant during therapy or intend to become pregnant they should communicate with their physician about the desirability of discontinuing the drug. Tranxene tablets should not be given to nursing mothers since it has been reported that nordiazepam is excreted in human breast milk.