Drug Monograph

Clobazam

Brand names: Onfi (tablet, oral suspension); Sympazan (oral film); Frisium (international)
1,5-Benzodiazepine Anticonvulsant · Oral · Schedule IV (CIV)

Quick Facts

Pharmacokinetic Profile
Half-Life (Clobazam)
36–42 h
Half-Life (N-DMC, active metabolite)
71–82 h
Metabolism
CYP3A4 (major to N-DMC); CYP2C19 metabolizes N-DMC
Protein Binding
Clobazam 80–90%; N-DMC 70%
Bioavailability
~100% (tablet vs oral solution)
Volume of Distribution
~100 L (steady state)
Clinical Information
Drug Class
1,5-Benzodiazepine
Available Strengths
Tablet 10 mg, 20 mg (scored); oral suspension 2.5 mg/mL; oral film 5, 10, 20 mg
Route
Oral
Renal Adjustment
No adjustment for mild–moderate; no data for severe / ESRD
Hepatic Adjustment
Mild–moderate: lower dose; severe: no recommendation
Pregnancy
Animal data show fetal harm; human data inconclusive; late pregnancy → neonatal sedation/withdrawal
Lactation
Excreted in breast milk; monitor infant for sedation, poor feeding, weight gain
Schedule / Legal
Schedule IV (CIV) controlled substance
Generic Available
Yes
Boxed Warning
Opioid co-use; abuse, misuse, addiction; dependence and withdrawal
Rx

Indications

IndicationApproved PopulationTherapy TypeStatus
Seizures associated with Lennox–Gastaut syndrome (LGS)≥2 years of ageAdjunctiveFDA Approved

Clobazam is the only 1,5-benzodiazepine in clinical use; the substitution of the nitrogen at position 5 (rather than 4, as in diazepam, lorazepam, and other 1,4-benzodiazepines) is thought to underlie its relatively favourable ratio of anticonvulsant to sedative effect compared with conventional benzodiazepines. In the United States it is approved only as adjunctive therapy for LGS in patients aged 2 years and older; in many other countries it has additional approvals for anxiety disorders and refractory epilepsies.

Clobazam was approved in the US in 2011 on the basis of two randomized trials in LGS — the Phase II OV-1002 study and the pivotal Phase III OV-1012 (CONTAIN) study — which demonstrated a dose-dependent reduction in weekly drop-seizure frequency. Most patients in pivotal trials were already receiving valproate, lamotrigine, levetiracetam, or topiramate.

Off-Label Uses

Refractory focal and generalized epilepsies (other than LGS): Used as adjunctive therapy in adults and children with seizures not adequately controlled on other antiepileptic drugs. Clobazam has been marketed for general epilepsy use in many countries (including Canada, the UK, and EU) for decades. Evidence: moderate quality.

Dravet syndrome: Frequently used as adjunctive therapy alongside valproate, stiripentol, fenfluramine, or cannabidiol. Evidence: moderate quality (consensus recommendations and observational data).

Anxiety disorders, including generalized anxiety: Approved indication outside the US (e.g., as Frisium); off-label in the US, where other benzodiazepines and SSRIs are first-line. Evidence: moderate quality.

Catamenial epilepsy: Sometimes used cyclically around menses for seizure clustering. Evidence: low quality (small case series).

Dose

Dosing

Dosing is by body weight, divided into two strata at the 30 kg cutoff. Any total daily dose above 5 mg should be split into two divided doses; a 5 mg total daily dose may be given once daily. Titration should not proceed faster than weekly, because clobazam reaches steady state in approximately 5 days but its more abundant active metabolite, N-desmethylclobazam, takes about 9 days. The tables below organize dosing by clinical scenario rather than by tablet strength.

Standard LGS Dosing — Adults & Pediatric Patients ≥2 Years

Clinical ScenarioStarting DoseMaintenance DoseMaximum DoseNotes
LGS adjunctive therapy — body weight ≤30 kg5 mg/day (single or divided)Day 7: 10 mg/day in 2 divided doses20 mg/day in 2 divided doses (from day 14)Effectiveness increases with increasing dose
Do not escalate faster than weekly
LGS adjunctive therapy — body weight >30 kg10 mg/day in 2 divided dosesDay 7: 20 mg/day in 2 divided doses40 mg/day in 2 divided doses (from day 14)Same titration schedule applies regardless of age (≥2 y)
Tablet may be taken whole, broken on the score, or crushed in applesauce
Discontinuation / dose reductionReduce total daily dose by 5–10 mg/day on a weekly basisAvoid abrupt cessationIf withdrawal symptoms develop, pause taper or return to prior dose, then reduce more slowly
Abrupt withdrawal may precipitate status epilepticus or other life-threatening reactions

Dose Adjustment in Special Populations

PopulationStarting DoseMaintenance DoseMaximum DoseNotes
Geriatric (≥65 years)5 mg/day (regardless of weight)Titrate to half the standard weight-based maintenance, as toleratedSame as standard (20 or 40 mg/day by weight); additional titration may begin on day 21Plasma concentrations are higher in the elderly at any given dose
Proceed slowly; increased fall and sedation risk
Known CYP2C19 poor metabolizers5 mg/dayTitrate to half the standard weight-based maintenanceStandard maximum (20 or 40 mg/day); additional titration may begin on day 21N-desmethylclobazam levels are 3–5× higher in poor metabolizers — dose-related adverse-event risk is correspondingly higher
Genotyping not routine; consider in patients with disproportionate sedation
Mild–moderate hepatic impairment (Child–Pugh 5–9)5 mg/day (both weight groups)Titrate to half the standard weight-based maintenanceStandard maximum; additional titration may begin on day 21Limited PK data — proceed slowly
Severe hepatic impairment: no dosing recommendation can be given
Renal impairment (mild–moderate)Standard starting doseStandard maintenanceStandard maximumNo dose adjustment required
Severe renal impairment / ESRD: essentially no clinical experience; dialysability of clobazam and N-desmethylclobazam is unknown
Clinical Pearl — Why Steady State Takes ~9 Days

Although clobazam itself accumulates over about 5 days, its principal pharmacologically active species in blood is the metabolite N-desmethylclobazam (N-DMC). At therapeutic doses, plasma N-DMC concentrations are 3–5× those of the parent compound and require approximately 9 days to reach steady state. Adverse events that emerge a week or more after a dose change typically reflect rising N-DMC, not parent drug — a useful framing when counselling families during titration.

Tablets can be administered whole, broken along the functional score, or crushed in applesauce, and all formulations may be taken with or without food. The oral suspension must be shaken before each dose and dispensed in its original bottle with the supplied dosing syringe; discard any remainder 90 days after first opening.

PK

Pharmacology

Mechanism of Action

Clobazam is the only 1,5-benzodiazepine in clinical use; classical agents such as diazepam, lorazepam, and midazolam are 1,4-benzodiazepines. Like other benzodiazepines it potentiates GABAergic neurotransmission by binding the benzodiazepine site of the GABAA receptor, increasing the frequency of chloride channel opening in response to GABA and thereby enhancing inhibitory tone in the cortex and limbic system. The 1,5 substitution pattern is associated with a different conformational fit that may favour anticonvulsant over hypnotic activity at clinically used doses, although sedation remains a prominent and dose-related effect.

The principal active species in plasma is N-desmethylclobazam, formed by hepatic N-demethylation. N-DMC is one-fifth to equipotent with parent clobazam at the GABAA receptor on a molar basis, but circulates at 3–5× higher concentrations at therapeutic doses, so it accounts for a substantial share of clinical effect. Variability in CYP2C19 — the main enzyme that clears N-DMC — is a major determinant of inter-individual differences in efficacy and tolerability.

ADME Profile

ParameterValueClinical Implication
AbsorptionRapid and extensive after oral dosing; tablet Tmax 0.5–4 h, oral suspension Tmax 0.5–2 h; relative bioavailability of tablet vs solution ~100%; food does not significantly affect absorptionTablet, suspension, and oral film are interchangeable on a milligram basis under fasted conditions; can be given with meals to manage GI upset
DistributionHighly lipophilic; apparent Vd at steady state ~100 L; clobazam ~80–90% protein-bound, N-DMC ~70%Wide tissue distribution including CNS; protein binding is moderate, so displacement interactions are uncommon
MetabolismExtensively hepatic. N-demethylation primarily by CYP3A4, with lesser contributions from CYP2C19 and CYP2B6. The active metabolite N-desmethylclobazam is then metabolized mainly by CYP2C19. Clobazam is a weak CYP3A4 inducer and a CYP2D6 inhibitor in vivoStrong/moderate CYP2C19 inhibitors and CYP2C19 poor-metabolizer status raise N-DMC exposure several-fold; CYP2D6 substrates (e.g., dextromethorphan) may need lower doses
Elimination~82% of a radiolabelled dose excreted in urine, ~11% in feces; only ~2% of parent recovered unchanged in urine. Mean t½: clobazam 36–42 h; N-DMC 71–82 h. Time to steady state: ~5 days clobazam, ~9 days N-DMCLong half-lives mean dose changes take days to fully manifest in plasma — wait at least a week between escalations; abrupt cessation drives a slow but sustained withdrawal

Therapeutic drug monitoring is not routinely required, but combined plasma clobazam plus N-DMC concentrations are sometimes useful in patients with disproportionate sedation, suspected CYP2C19 poor-metabolizer status, or significant interactions (e.g., concomitant cannabidiol). In a population PK/PD analysis from CONTAIN, clobazam was approximately three times more potent than N-DMC by EC50, but high N-DMC concentrations strongly drive sedation-type adverse events.

SE

Side Effects

Adverse-event data below are drawn from the placebo-controlled Phase III CONTAIN trial (Study 1), in which 179 patients with LGS received clobazam at one of three target dose levels (low, medium, high) and 59 received placebo over 15 weeks. Frequencies are presented for the highest-dose group (closest to the typical maintenance dose of 20 mg/day or 40 mg/day) where the absolute incidence is most relevant; the all-ONFI rate is shown when more representative.

≥10% Very Common (CONTAIN, ≥1 dose group)
Adverse EffectIncidenceClinical Note
Somnolence or sedation (combined)High dose 32% · all-ONFI 26% · placebo 15%Dose-related; usually emerges in the first month and may diminish with continued treatment. Listed in the PI as one of the adverse reactions occurring ≥10% more often than placebo at any dose
Pyrexia (fever)Low dose 17% · all-ONFI 13% · placebo 3%Among the reactions singled out in the PI as occurring ≥10% more frequently than placebo
Upper respiratory tract infectionHigh dose 14% · all-ONFI 12% · placebo 10%Modest absolute increase over placebo
LethargyHigh dose 15% · all-ONFI 10% · placebo 5%Top single reason for treatment discontinuation in the LGS placebo-controlled trial
Drooling (sialorrhea)High dose 14% · all-ONFI 9% · placebo 3%Identified in the PI as occurring ≥10% more often than placebo at any dose
AggressionHigh dose 14% · all-ONFI 8% · placebo 5%Behavioural reactions are well-recognized with benzodiazepines and may be more common in pediatric and intellectually disabled populations
IrritabilityMedium dose 11% · all-ONFI 7% · placebo 5%Often coincident with insomnia or aggression
ConstipationHigh dose 10% · all-ONFI 5% · placebo 0%Listed in the PI as occurring ≥10% more often than placebo at the high dose
AtaxiaHigh dose 10% · all-ONFI 5% · placebo 3%Suggests excess GABAergic effect; review concomitant CNS depressants and consider dose reduction
1–10% Common
Adverse EffectIncidenceClinical Note
Vomitingall-ONFI 7% · placebo 5%Modest dose-related increase
Insomniaall-ONFI 5% · placebo 2%Paradoxical reaction; consider dose redistribution toward bedtime
Coughall-ONFI 5% · placebo 0%
Sedation (recorded separately from somnolence)High dose 9% · all-ONFI 5% · placebo 3%Distinguished in trial coding from somnolence; clinical management is the same
Fatigueall-ONFI 5% · placebo 2%
PneumoniaHigh dose 7% · all-ONFI 4% · placebo 2%Possibly related to sedation, drooling, and aspiration risk in this population
Urinary tract infectionall-ONFI 4% · placebo 0%
Psychomotor hyperactivityall-ONFI 4% · placebo 3%Paradoxical agitation
Decreased appetiteHigh dose 7% · all-ONFI 3% · placebo 3%Monitor weight in pediatric patients
Increased appetiteHigh dose 5% · all-ONFI 3% · placebo 0%Monitor weight
DysarthriaHigh dose 5% · all-ONFI 3% · placebo 0%Suggests level at upper end of range
DysphagiaHigh dose 5% · all-ONFI 2% · placebo 0%Aspiration concern, particularly in patients with pre-existing swallowing dysfunction
BronchitisHigh dose 5% · all-ONFI 2% · placebo 0%
Serious Serious — Regardless of Frequency
Adverse EffectEstimated FrequencyTypical OnsetRequired Action
Profound sedation, respiratory depression, coma, or death (especially with concomitant opioids or other CNS depressants)Frequency not established; risk ↑ with opioid co-useHours to daysReserve combination for patients with no adequate alternative; use lowest effective doses; monitor closely; counsel on overdose risk
Stevens–Johnson syndrome / toxic epidermal necrolysisPostmarketing reports — frequency not establishedEspecially within first 8 weeks of initiation or re-introductionDiscontinue at the first sign of rash unless clearly not drug-related; do not resume if SCAR suspected
Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) / multi-organ hypersensitivityPostmarketing reports — frequency not established; some fatalVariable; often weeksDiscontinue if no alternative cause for fever, rash, lymphadenopathy, hepatitis, or other organ involvement
Acute withdrawal reactions on abrupt discontinuation (seizures, status epilepticus, delirium, psychosis, suicidality, life-threatening reactions)Frequency not established; risk ↑ with higher doses, longer use, abrupt stop, or flumazenilDays after dose reduction or cessationAlways taper; if withdrawal emerges, return to prior dose then taper more slowly
Protracted withdrawal syndrome (anxiety, cognitive impairment, depression, insomnia, paresthesia, motor symptoms)VariablePersists weeks to >12 months after withdrawalCounsel before initiation; consider very slow taper; specialist support for severe cases
Suicidal ideation and behaviour (AED class effect)~0.43% on any AED vs ~0.24% on placebo (FDA pooled meta-analysis)As early as 1 week into therapyCounsel patients/caregivers; assess mood at each contact
Neonatal sedation and/or withdrawal syndrome (use late in pregnancy)Not quantifiedFirst days of lifeAnticipate respiratory depression, lethargy, hypotonia, hyperreflexia, irritability, tremors, feeding difficulties; arrange neonatal monitoring
Angioedema, urticaria, facial/lip edema, anaphylactoid reactionsPostmarketingMinutes to hoursDiscontinue immediately and provide emergency care
Hematologic abnormalities (anemia, eosinophilia, leukopenia, thrombocytopenia)PostmarketingVariableInvestigate any unexplained fever, bruising, fatigue; eosinophilia may be a DRESS marker
Severe psychiatric reactions (delirium, depression, hallucination, delusion, paradoxical agitation)PostmarketingVariableReduce or discontinue clobazam; specialist mental-health input
Aspiration / respiratory depressionPostmarketing; risk ↑ in LGS population (drooling, dysphagia)VariableAssess swallowing and airway; cautious dose escalation in patients with pre-existing aspiration risk
Discontinuation Treatment Discontinuation Due to Adverse Reactions (CONTAIN)
Reactions leading to discontinuation in ≥1% of clobazam-treated LGS patients (in decreasing order of frequency)
Lethargy > somnolence > ataxia > aggression > fatigue > insomnia
Specific percentages for each reason are not provided in the prescribing information.
Pediatric vs adult discontinuation
Similar profile across age groups
Post hoc analyses of OV-1012 (pediatric and adult subgroups) and the OV-1004 open-label extension found generally similar safety and tolerability across age strata.
Management Pearl — Sedation, Drooling, and Aspiration in LGS

Patients with LGS frequently have baseline cognitive, motor, and swallowing impairment, and sedation plus drooling on clobazam can compound aspiration risk. If sedation persists or worsens, review concomitant CNS depressants (especially opioids), screen for occult CYP2C19 inhibition (e.g., omeprazole, fluconazole), consider whether the patient is a CYP2C19 poor metabolizer, and reduce dose before discontinuing — most sedation is dose-related and dissipates with a smaller daily dose.

Int

Drug Interactions

Clobazam interacts pharmacodynamically (additive CNS depression) and pharmacokinetically (CYP2C19 metabolism of N-desmethylclobazam, weak CYP3A4 induction, in vivo CYP2D6 inhibition). Strong or moderate inhibition of CYP2C19 raises N-DMC exposure by up to five-fold and is the most clinically important PK interaction class. The cards below highlight the most relevant pairings; the full medication list (including OTC and supplements) should be reviewed at every visit.

Boxed Opioids (all)
MechanismAdditive CNS and respiratory depression at distinct receptor sites (GABAA + μ-opioid)
EffectProfound sedation, respiratory depression, coma, death
ManagementReserve combination for patients with no adequate alternative; use lowest effective doses for the shortest duration; monitor closely
FDA PI · Boxed Warning
Major Alcohol
MechanismPharmacodynamic CNS depression plus a ~50% increase in clobazam Cmax
EffectExcess sedation, cognitive impairment, respiratory depression
ManagementCounsel against alcohol use; advise caregivers explicitly
FDA PI
Major Other CNS depressants (sedating antihistamines, sedating antidepressants, antipsychotics, sedative hypnotics)
MechanismAdditive CNS depression
EffectExcess somnolence, ataxia, fall risk, respiratory depression
ManagementAvoid where possible; if combined, use the lowest effective doses and counsel on impaired driving and machinery use
FDA PI
Major Cannabidiol (Epidiolex)
MechanismCBD inhibits CYP2C19 metabolism of N-desmethylclobazam, raising N-DMC Cmax and AUC by ~3-fold (parent clobazam unchanged)
EffectIncreased sedation and other clobazam-related adverse reactions in patients on combined LGS or Dravet therapy
ManagementPer the Epidiolex label, consider clobazam dose reduction if clobazam-related adverse reactions emerge
Epidiolex FDA PI
Major Strong CYP2C19 inhibitors (fluconazole, fluvoxamine, ticlopidine)
MechanismInhibition of CYP2C19-mediated N-DMC clearance — N-DMC exposure may rise up to 5-fold (extrapolated from pharmacogenomic data)
EffectDose-related adverse reactions, particularly sedation and ataxia
ManagementClobazam dose adjustment may be necessary — consider initiating at the lower end of the dose range and titrating slowly
FDA PI
Moderate Moderate CYP2C19 inhibitors (omeprazole, esomeprazole)
MechanismReduced N-DMC clearance; magnitude similar to that extrapolated for strong inhibitors
EffectIncreased sedation
ManagementClobazam dose adjustment may be necessary; consider switching PPI to pantoprazole or an H2 blocker if appropriate
FDA PI
Moderate Strong CYP3A4 inhibitors (e.g., ketoconazole)
MechanismReduced clearance of parent clobazam — ketoconazole increased clobazam AUC by ~54% with no significant effect on N-DMC
EffectIncreased clobazam exposure; sedation
ManagementMonitor for sedation; clinical relevance smaller than CYP2C19 inhibition because parent contributes less to total activity
FDA PI
Moderate CYP2D6 substrates (e.g., dextromethorphan, metoprolol, codeine, atomoxetine, paroxetine)
MechanismClobazam inhibits CYP2D6 in vivo — dextromethorphan AUC and Cmax rose ~90% and ~59% respectively in a probe-substrate study
EffectHigher exposure to CYP2D6 substrates; for codeine and tramadol, reduced conversion to active metabolite
ManagementLower doses of CYP2D6 substrates may be required
FDA PI
Moderate Hormonal contraceptives
MechanismClobazam is a weak CYP3A4 inducer; some hormonal contraceptives are CYP3A4 substrates
EffectPossibly diminished contraceptive efficacy
ManagementCounsel use of additional non-hormonal contraception during clobazam therapy and for 28 days after discontinuation
FDA PI
Moderate Stiripentol
MechanismStiripentol inhibits CYP3A4 and CYP2C19; published studies report 1.1–1.2× increase in median clobazam and 5.2–8.2× increase in N-DMC plasma concentrations
EffectSedation and other dose-related effects in Dravet syndrome combination therapy
ManagementLower clobazam doses are usually required when initiating stiripentol; titrate to clinical effect
Published PK studies · Diacomit PI
Moderate Flumazenil
MechanismCompetitive antagonism at the benzodiazepine site precipitates acute withdrawal in physically dependent users
EffectWithdrawal seizures, including status epilepticus
ManagementAvoid in patients on long-term clobazam, particularly those with epilepsy; flumazenil is contraindicated when a benzodiazepine is being used to control a potentially life-threatening condition
Flumazenil PI
Minor Concomitant AEDs (phenobarbital, phenytoin, carbamazepine, valproate, felbamate, oxcarbazepine, lamotrigine)
MechanismPopulation PK analyses found no clinically significant alteration of clobazam or N-DMC steady-state pharmacokinetics by these AEDs
EffectNo expected change in clobazam levels; pharmacodynamic CNS depression remains additive
ManagementNo PK-driven dose change required; monitor for additive sedation
FDA PI
Mon

Monitoring

Routine therapeutic drug monitoring is not required, but clinical monitoring during titration, dose changes, addition or discontinuation of CYP2C19 inhibitors (especially cannabidiol), and any reduction in clobazam dose is essential. The schedule below combines initiation-phase, ongoing chronic-therapy, and triggered checks.

  • Sedation, drowsiness, ataxia At each titration step; first month then periodically
    Routine
    Most sedation begins in the first month and may diminish with continued therapy. Persistent sedation should prompt review of concomitant CNS depressants and CYP2C19 inhibitors before considering dose reduction.
  • Seizure diary (drop and total seizures) Continuous; review at each visit
    Routine
    Maintenance dose can be individualized within each weight band according to seizure response; effectiveness increased with higher doses in CONTAIN.
  • Mood & suicidality At each visit
    Routine
    AED class effect — ask about new or worsening depression, anxiety, agitation, intrusive thoughts, or behavioural changes. Aggression and irritability are also recognized clobazam-specific reactions.
  • Skin examination Especially during first 8 weeks of initiation or re-introduction
    Routine
    Discontinue at first sign of rash unless clearly not drug-related. Mucosal involvement, blistering, fever, lymphadenopathy, or facial swelling warrants emergency evaluation for SJS/TEN, DRESS, or angioedema.
  • Aspiration / swallowing risk Baseline and after dose escalation
    Routine
    LGS patients commonly have baseline dysphagia; drooling and sedation from clobazam may compound aspiration risk. Speech and language therapy review where appropriate.
  • Respiratory status When opioids or other CNS depressants are added
    Trigger-based
    Counsel on signs of respiratory depression (shallow/slowed breathing, excessive sleepiness). Consider naloxone supply for households where opioid use is anticipated.
  • CBC and LFTs Baseline; with rash, fever, or unexplained systemic symptoms
    Trigger-based
    Eosinophilia or hepatic enzyme rise with rash suggests DRESS — discontinue and evaluate.
  • Plasma clobazam & N-DMC levels Selected scenarios
    Trigger-based
    Consider when sedation is disproportionate to dose, when adding/removing strong or moderate CYP2C19 inhibitors (including cannabidiol), in suspected CYP2C19 poor metabolizers, or in hepatic impairment. Routine TDM is not required.
  • Abuse / misuse / addiction risk Before prescribing and throughout therapy
    Routine
    Schedule IV controlled substance — assess risk using a standardized tool, counsel on safe storage and disposal, and avoid combining with other agents associated with abuse.
  • Withdrawal symptoms During and after any taper
    Routine
    Anxiety, insomnia, tremor, paresthesia, headache, GI symptoms; severe forms include seizures and delirium. Pause taper or return to prior dose if symptoms emerge.
  • Body weight (pediatric) Each visit
    Routine
    Dosing thresholds are weight-banded (≤30 kg vs >30 kg); reassess when a child crosses the threshold. Also monitors for appetite-related effects.
Practical Pearl — When to Suspect a CYP2C19 Issue

Disproportionate sedation, ataxia, or drooling at modest clobazam doses (e.g., 5–10 mg/day) — especially in a patient also taking omeprazole, fluconazole, fluvoxamine, or cannabidiol — is far more likely to reflect elevated N-desmethylclobazam exposure than the parent compound. Reducing the clobazam dose by half, or replacing the offending CYP2C19 inhibitor where feasible, usually solves the problem without abandoning the drug.

CI

Contraindications & Cautions

FDA Boxed Warning Risks From Concomitant Opioid Use; Abuse, Misuse, and Addiction; Dependence and Withdrawal

Opioid co-use: Concomitant use of benzodiazepines and opioids may result in profound sedation, respiratory depression, coma, and death. Reserve concomitant prescribing for patients with no adequate alternative; use lowest effective doses and shortest durations; monitor closely.

Abuse, misuse, and addiction: Use of benzodiazepines, including clobazam, exposes users to risks of abuse, misuse, and addiction, which can lead to overdose or death. Assess each patient’s risk before prescribing and throughout treatment.

Dependence and withdrawal: Continued use may cause clinically significant physical dependence. Abrupt discontinuation, rapid dose reduction, or administration of flumazenil may precipitate acute withdrawal reactions, which can be life-threatening (including seizures). Use a gradual taper. A protracted withdrawal syndrome lasting weeks to more than 12 months has been reported.

Absolute Contraindications

  • Hypersensitivity to clobazam or any product ingredient, including a history of serious dermatologic reactions (such as SJS or TEN) attributable to clobazam.

Note: hypersensitivity is the only absolute contraindication listed in the Onfi prescribing information. The cautions below reflect class-wide benzodiazepine risk and clinical practice.

Relative Contraindications — Specialist Input Recommended

  • Concomitant opioid therapy — combine only when no adequate alternative exists (see Boxed Warning).
  • History of substance use disorder, particularly with benzodiazepines, alcohol, or opioids — risk of misuse and addiction; if used, structured prescribing and monitoring are required.
  • Severe hepatic impairment — no dosing recommendation can be given; consider alternative therapy.
  • Severe renal impairment or end-stage renal disease — essentially no clinical experience; dialysability of clobazam and N-DMC is unknown.
  • Pregnancy — animal studies show developmental toxicity at clinically relevant exposures; use late in pregnancy may cause neonatal sedation and/or withdrawal. Use only when potential benefit justifies fetal risk; coordinate with neurology and obstetrics; consider enrollment in the North American Antiepileptic Drug (NAAED) Pregnancy Registry.
  • Severe respiratory disease — additive risk of respiratory depression, particularly with concurrent opioids or other CNS depressants.
  • Myasthenia gravis — class-wide benzodiazepine caution due to potential worsening of muscle weakness.
  • Acute narrow-angle glaucoma — class-wide benzodiazepine caution.

Use With Caution

  • Elderly patients — higher plasma exposures, greater fall and sedation risk, slower phenytoin/benzodiazepine clearance; start at 5 mg/day regardless of weight.
  • Known or suspected CYP2C19 poor metabolizers — N-DMC concentrations are 3–5× higher; reduce starting and target doses (see Dosing).
  • Concomitant strong or moderate CYP2C19 inhibitors (fluconazole, fluvoxamine, ticlopidine, omeprazole, esomeprazole, cannabidiol) — exposure to N-DMC may rise several-fold; titrate cautiously.
  • Patients with significant baseline aspiration or swallowing risk (common in LGS) — drooling and sedation may compound risk.
  • Patients with depression or active suicidality — AED class effect on suicidality plus benzodiazepine disinhibition; monitor mood closely.
  • Operators of vehicles or hazardous machinery — counsel on impaired alertness particularly during titration and after dose changes.
Pt

Patient Counselling

Purpose of Therapy

Explain that clobazam is being added to existing seizure medicines to help reduce drop attacks and other seizures associated with Lennox–Gastaut syndrome. It is not a cure and works alongside other antiepileptic drugs. Clobazam is a long-acting benzodiazepine and produces an active substance in the body (N-desmethylclobazam) that lasts even longer than the parent drug — which is why dose changes can take a week or more to fully take effect.

How to Take

Take clobazam exactly as prescribed. Doses above 5 mg per day are split into two doses (typically morning and evening). Tablets can be taken whole, broken along the score, or crushed and mixed in a spoonful of applesauce. The oral suspension must be shaken well before each dose and measured only with the supplied syringe; throw away any leftover suspension 90 days after the bottle is first opened. Take with or without food.

Sleepiness, Drooling, and Unsteadiness
Tell patient Sleepiness, sedation, and increased drooling are common — especially in the first month — and often improve as the body adjusts. Avoid driving, operating machinery, or other activities needing alertness until you know how clobazam affects you.
Call prescriber If sleepiness is severe or persistent after several weeks, if walking becomes very unsteady, if speech is markedly slurred, or if breathing seems shallow.
Never Stop Suddenly
Tell patient Stopping clobazam abruptly can cause serious problems including breakthrough seizures, status epilepticus, anxiety, hallucinations, and very rarely life-threatening reactions. Any change in dose must be gradual and supervised. Some withdrawal effects can last weeks to months even with a careful taper.
Call prescriber Before changing or stopping the medicine for any reason, even temporarily.
Opioids, Alcohol, and Other Sedating Medicines
Tell patient Combining clobazam with opioid pain medicines, alcohol, or other sedating drugs can cause severe drowsiness, slowed breathing, and even death. Always tell every doctor and pharmacist that you are taking clobazam, including in emergencies, before dental procedures, and when filling new prescriptions.
Call prescriber Before starting any new medicine — including over-the-counter cold and allergy medicines, sleep aids, herbal products, or cannabis-derived products.
Skin Reactions
Tell patient Rare but serious skin reactions have been reported with clobazam, mostly in the first 8 weeks of treatment. Any new rash should be reported promptly, even if it seems minor.
Call prescriber For any rash with fever, mouth or eye sores, blistering, peeling, swollen face or glands, or feeling generally unwell. Stop the next dose and seek emergency evaluation.
Mood, Behaviour, and Suicidal Thoughts
Tell patient Antiepileptic medicines as a class slightly raise the risk of new or worsening depression, anxiety, irritability, agitation, and rarely thoughts of self-harm. Clobazam can also occasionally cause aggression or behavioural changes, particularly in children and patients with developmental disability.
Call prescriber For new or worsening depression, anxiety, agitation, severe irritability, panic attacks, aggression, or any thoughts of self-harm.
Misuse, Abuse, and Safe Storage
Tell patient Clobazam is a federally controlled substance because it can be misused or lead to dependence. Take it only as prescribed, never share it, and store it securely out of children’s and visitors’ reach. Dispose of unused medication safely (e.g., DEA take-back programs).
Call prescriber If you or a family member feel a strong urge to take more than prescribed, are using it recreationally, or have a personal or family history of substance use issues.
Pregnancy & Contraception
Tell patient Clobazam can lower the effectiveness of birth control pills, so an additional non-hormonal method (e.g., condoms, copper IUD) is recommended during therapy and for 28 days after stopping. Use late in pregnancy can cause sedation or withdrawal in the newborn. Plan any pregnancy with the neurology team and consider enrolling in the North American AED Pregnancy Registry if you become pregnant.
Call prescriber If pregnancy occurs or is being planned. Do not stop clobazam abruptly even when pregnant — sudden withdrawal can trigger severe seizures.
Breastfeeding
Tell patient Clobazam passes into breast milk. Breastfed infants may experience sleepiness, poor feeding, or poor weight gain. Discuss the best feeding plan with your team — for many parents, breastfeeding can continue with infant monitoring.
Call prescriber If the infant is unusually sleepy, feeding poorly, or not gaining weight as expected.
Ref

Sources

Regulatory (PI / SmPC)
  1. Lundbeck. Onfi (clobazam) tablets and oral suspension — full prescribing information. Revised March 2024. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2024/202067s008,203993s010lbl.pdf Authoritative source for indication, dosing, the Boxed Warning (opioids, abuse/misuse/addiction, dependence/withdrawal), pharmacokinetics, adverse-reaction tables, and CYP2C19 guidance.
  2. U.S. Food and Drug Administration. DailyMed: Onfi (clobazam) tablet and oral suspension labelling. Available at: https://dailymed.nlm.nih.gov/ Maintained repository of current FDA-approved labelling for branded and generic clobazam products.
  3. Aquestive Therapeutics. Sympazan (clobazam) oral film — full prescribing information. Available at: https://dailymed.nlm.nih.gov/ Labelling for the oral-film formulation, which shares clobazam’s clinical profile but differs in administration.
Key Clinical Trials
  1. Ng YT, Conry JA, Drummond R, Stolle J, Weinberg MA; OV-1012 Study Investigators. Randomized, phase III study results of clobazam in Lennox–Gastaut syndrome (CONTAIN). Neurology. 2011;77(15):1473–1481. doi: 10.1212/WNL.0b013e318232de76 Pivotal Phase III trial demonstrating dose-dependent reduction of weekly drop seizures versus placebo; basis for FDA approval and the dose data in the Onfi PI.
  2. Conry JA, Ng YT, Paolicchi JM, et al. Clobazam in the treatment of Lennox–Gastaut syndrome. Epilepsia. 2009;50(5):1158–1166. doi: 10.1111/j.1528-1167.2008.01935.x Phase II OV-1002 trial — one of the two studies that supported FDA approval.
  3. Ng YT, Conry J, Paolicchi J, et al. Long-term safety and efficacy of clobazam for Lennox–Gastaut syndrome: interim results of an open-label extension study. Epilepsy Behav. 2012;25(4):687–694. Open-label extension (OV-1004) data informing long-term tolerability and the absence of meaningful tolerance over multi-year therapy.
Guidelines
  1. Cross JH, Auvin S, Falip M, Striano P, Arzimanoglou A. Expert opinion on the management of Lennox–Gastaut syndrome: treatment algorithms and practical considerations. Front Neurol. 2017;8:505. doi: 10.3389/fneur.2017.00505 International expert consensus positioning clobazam alongside valproate, lamotrigine, rufinamide, and topiramate in LGS treatment algorithms.
  2. National Institute for Health and Care Excellence (NICE). Epilepsies in children, young people and adults (NG217). London: NICE; April 2022. Available at: https://www.nice.org.uk/guidance/ng217 UK guidance on AED selection in LGS, Dravet syndrome, and other refractory epilepsies, including a role for clobazam.
  3. U.S. Food and Drug Administration. Drug Safety Communication: FDA requiring Boxed Warning updated to improve safe use of benzodiazepine drug class. September 23, 2020. Available at: https://www.fda.gov/drugs/drug-safety-and-availability/fda-requiring-boxed-warning-updated-improve-safe-use-benzodiazepine-drug-class Class-wide labelling change adding abuse/misuse/addiction and dependence/withdrawal language to all benzodiazepines, including clobazam.
Mechanistic / Basic Science
  1. Sankar R. GABAA receptor physiology and its relationship to the mechanism of action of the 1,5-benzodiazepine clobazam. CNS Drugs. 2012;26(3):229–244. doi: 10.2165/11599020-000000000-00000 Mechanistic review explaining the structural and pharmacodynamic differences between 1,5- and 1,4-benzodiazepines.
  2. Anderson LL, Absalom NL, Abelev SV, et al. Coadministered cannabidiol and clobazam: preclinical evidence for both pharmacodynamic and pharmacokinetic interactions. Epilepsia. 2019;60(11):2224–2234. doi: 10.1111/epi.16355 Mechanistic and preclinical study demonstrating CBD inhibition of CYP3A4 (clobazam) and CYP2C19 (N-DMC), and a separate pharmacodynamic synergy at GABAA.
Pharmacokinetics / Special Populations
  1. Sankar R, Wheless JW, Dravet C, et al. Pharmacokinetic and pharmacodynamic considerations for the clinical use of clobazam in pediatric epilepsy. Epilepsia. 2014;55 Suppl 1:S1–S25. Comprehensive pediatric PK/PD review covering N-DMC kinetics, CYP2C19 polymorphism, and dosing in children.
  2. Greenwich Biosciences. Epidiolex (cannabidiol) oral solution — full prescribing information. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2025/210365s023lbl.pdf Source for the quantified CBD–clobazam PK interaction (~3-fold increase in N-DMC AUC and Cmax) and the recommendation to consider clobazam dose reduction.
  3. Klotz U, Antonin KH. Pharmacokinetics and bioavailability of sodium valproate and clobazam — a basis for clinical use. Eur J Clin Pharmacol. 1977;12(6):443–450. Early human PK characterization of clobazam supporting its long half-life and active metabolite profile.
  4. U.S. Food and Drug Administration. Statistical review and evaluation: antiepileptic drugs and suicidality. May 23, 2008. Available via FDA archives. Source for the AED-class suicidality risk estimate (~0.43% on AEDs versus ~0.24% on placebo) cited throughout AED labelling, including the Onfi PI.