What is the active ingredient in Klonopin (Clonazepam)?

What is Klonaza (Klonopin/Clonazepam)?

Clonazepam is a long-acting benzodiazepine medication with the chemical name 5-(2-chlorophenyl)-1,3-dihydro-7-nitro-2H-1,4-benzodiazepin-2-one, available as oral tablets in 0.5 mg, 1 mg, and 2 mg strengths. 1

Chemical Composition and Formulation

• The active ingredient is clonazepam, a light yellow crystalline powder with a molecular weight of 315.72. 1

• Inactive ingredients include anhydrous lactose, lactose monohydrate, magnesium stearate, microcrystalline cellulose, and corn starch, with color additives varying by strength (FD&C Yellow No. 6 Lake for 0.5 mg tablets, FD&C Blue No. 2 Lake for 1 mg tablets). 1

Mechanism of Action

• Clonazepam promotes GABAergic inhibition by increasing the frequency of chloride channel opening as a long-acting benzodiazepine. 2

• The elimination half-life is 30-40 hours, which contributes to its long-acting properties but also increases risk of daytime sedation. 3

FDA-Approved Indications

• Clonazepam is FDA-approved for treating certain types of seizure disorders (epilepsy) in adults and children. 1

• It is also approved for panic disorder with or without agoraphobia in adults. 1

• The medication is not FDA-approved for treating panic disorder in children younger than 18 years old. 1

Controlled Substance Status

• Clonazepam is classified as a federal controlled substance (Schedule C-IV) because it can be abused or lead to dependence. 1

• It is restricted to prescription-only use by most governmental regulating bodies. 2

• Physical dependence develops with prolonged use, and abrupt discontinuation can cause serious withdrawal symptoms including seizures that will not stop (status epilepticus). 1

Common Off-Label Uses

• Clonazepam has been widely used for REM sleep behavior disorder (RBD), where it reduces dream enactment with typical doses of 0.25-1.0 mg at bedtime. 2

• The American Academy of Sleep Medicine provides conditional recommendations for clonazepam use in isolated RBD, though it is listed on the American Geriatrics Society Beers Criteria as potentially inappropriate in older adults. 2