Clonazepam (Klonopin / Rivotril)

Pronunciation: kloe-NAY-ze-pam.

Generic name
clonazepam
Drug class
Benzodiazepine (anticonvulsant / anxiolytic)
Form
Tablet (commonly 0.125 mg to 2 mg depending on market), orally disintegrating tablet, oral solution/drops, and injectable solution, depending on market and manufacturer
Route
Oral (tablet, orally disintegrating tablet, oral solution/drops), or injection (IV, for status epilepticus, depending on market and formulation)
Legal status
Prescription-only, controlled substance (Schedule IV / DEA Schedule CIV in the US; CDSA Schedule IV 'Targeted' substance in Canada; Schedule 4 Prescription Only Medicine in Australia)

Availability and supply rules vary by country

Trade names by country: United States · United Kingdom · Canada · Australia · New Zealand

Australia: Rivotril (tablets, oral liquid/drops, injection) (5) · Full directory

What clonazepam is and how it works

Clonazepam (brand names Klonopin in the US, Rivotril in Canada/Australia/New Zealand and elsewhere) is a prescription benzodiazepine medicine used to treat certain seizure disorders; in the United States it is also approved for panic disorder. (1)

Clonazepam carries a genuine, current boxed warning -- the FDA's strongest safety warning -- covering three real risks: dangerous, potentially fatal breathing problems if combined with opioids; risk of abuse, misuse, and addiction; and risk of physical dependence with life-threatening withdrawal reactions if stopped abruptly or the dose is reduced too quickly. Because of these risks, any change in dose or plan to stop must always be made together with your prescriber -- never on your own.

Mechanism of action: how clonazepam works

Clonazepam is a benzodiazepine that enhances the effect of GABA (gamma-aminobutyric acid), the brain's main inhibitory neurotransmitter, at the GABA-A receptor, producing anticonvulsant and anxiolytic effects. (4) (1)

What clonazepam is used for

Seizure disorders

Used alone or as an adjunct in the management of Lennox-Gastaut syndrome (petit mal variant), akinetic seizures, and myoclonic seizures, and in patients with absence seizures (petit mal) who have not responded to succinimide medicines. Australian and New Zealand sources also describe use in generalised tonic-clonic and focal (partial) seizures, and injectable clonazepam as a medicine of choice for status epilepticus. (1) (4) (5) (6)

Panic disorder (United States only, among the markets reviewed)

In the United States, clonazepam is also approved for the treatment of panic disorder, with or without agoraphobia. This is a genuine, market-specific indication difference: the Canada, Australia, and New Zealand sources reviewed for this dossier list only seizure/epilepsy indications and do not include panic disorder. (1)

Before taking clonazepam

Do not take / not appropriate for

  • Do not take clonazepam if you have a history of sensitivity to benzodiazepines, significant or severe liver disease, or acute narrow-angle glaucoma (open-angle glaucoma with appropriate treatment is not a contraindication in the US source reviewed). (all countries) (1)
  • Additional contraindications confirmed in Canada, Australia, and New Zealand sources: severe respiratory insufficiency, sleep apnea syndrome, and myasthenia gravis. (Canada, Australia, New Zealand (and likely UK/EU, per similar class labelling, though not identically itemised in the US source reviewed)) (4) (5) (6) (2)
  • Do not combine clonazepam with opioid medicines unless your prescriber has specifically decided there is no adequate alternative, because of the real risk of profound sedation, dangerously slowed breathing, coma, and death. (all countries) (1) (4)
  • Do not stop clonazepam abruptly or reduce your dose quickly on your own after regular use, because of the real risk of life-threatening withdrawal reactions. (all countries) (1) (4) (5)

Tell your clinician about

  • Any personal or family history of alcohol or drug misuse, since this increases the risk of abuse, misuse, and addiction with clonazepam.
  • All other medicines you take, especially opioids, other sedatives, or anything affecting breathing.
  • Any history of liver problems, breathing problems, sleep apnea, or glaucoma.
  • Any kidney problems -- Health Canada notes clonazepam's metabolites are excreted by the kidneys and that safety/efficacy in renal impairment has not been formally studied, so caution is advised.
  • Whether you are pregnant, planning pregnancy, or breastfeeding.
  • How long you have been taking clonazepam before considering any dose change, since dependence risk increases with treatment duration and dose.
(1) (4) (5)

How to take clonazepam

  • Take clonazepam exactly as your prescriber directs, for the duration they specify.
  • Never change your own dose, stop abruptly, or take clonazepam more often or in a larger amount than prescribed -- this is central to both the addiction/misuse risk and the withdrawal risk described in the boxed warning.
  • If your prescriber decides it is time to stop clonazepam after regular use, they will plan an individualised, gradual taper -- Australian source material describes tapering periods used from about 4 weeks to 4 months -- rather than stopping it suddenly.
  • If using the oral liquid (drops) formulation, measure the prescribed dose as drops only using the supplied dropper; do not pour the liquid directly into the mouth from the bottle (a specific safety instruction from the Australian Product Information).
(4) (1)

Procedures and treatment changes

Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (1) (2) (3) (4) (5) (6) (7)

Missed dose

Take a missed dose as soon as you notice, unless it is almost time for your next dose, in which case skip the missed dose and continue your regular schedule. Do not take an extra or double dose to make up for a missed one.

Overdose

Seek emergency medical help immediately for a suspected overdose, especially if clonazepam has been combined with opioids, alcohol, or other sedatives. Overdose of clonazepam alone is seldom life-threatening, but can lead to reduced reflexes, breathing problems, low blood pressure, cardiorespiratory depression, and coma; coma usually lasts a few hours but can be more prolonged, particularly in older adults. Overdose risk and severity are substantially increased when clonazepam is combined with opioids or alcohol. (4) (1)

Side effects

Side effects and their urgency vary; report severe, persistent, or concerning symptoms.

Drowsiness (reported in a substantial proportion of patients in clinical trials for panic disorder).

What to notice: Drowsiness (reported in a substantial proportion of patients in clinical trials for panic disorder).

What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (1)

Ataxia (muscle coordination problems).

What to notice: Ataxia (muscle coordination problems).

What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (1)

Dizziness.

What to notice: Dizziness.

What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (2)

Memory disturbance and depression have also been reported.

What to notice: Memory disturbance and depression have also been reported.

What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (1)

Serious warnings

Signs of dangerous breathing problems, especially if combined with opioids — boxed_warning

Symptoms: Severe drowsiness, slow or shallow breathing, extreme difficulty waking up, or loss of consciousness.

Action: Seek emergency medical help immediately -- combining clonazepam with opioids can cause profound sedation, dangerously slowed breathing, coma, and death. (1) (4)

Signs of abuse, misuse, or developing addiction — boxed_warning

Symptoms: Taking clonazepam more often, in a higher amount, or for longer than prescribed; strong urges to keep using it; using it together with alcohol or illicit substances.

Action: Talk to your prescriber promptly -- clonazepam carries a genuine, boxed-warning-level risk of abuse, misuse, and addiction, which can lead to overdose or death. (1)

Signs of withdrawal after stopping or reducing the dose — boxed_warning

Symptoms: Anxiety, tremor, sweating, insomnia, confusion, or seizures after stopping clonazepam or lowering the dose, especially if done abruptly.

Action: Seek urgent medical help for seizures or severe withdrawal symptoms -- abrupt discontinuation or rapid dose reduction of clonazepam can cause acute withdrawal reactions that can be life-threatening. Any change in dose or plan to stop must be directed by your prescriber, using a gradual, individualised taper, never abrupt self-directed stopping. (1) (4) (5)

Injection-specific risk in neonates (New Zealand data sheet) — serious

Symptoms: Not applicable to patients directly -- a formulation-specific manufacturing risk.

Action: Rivotril injection ampoules contain benzyl alcohol; administration to neonates, and especially premature infants, must be avoided because of reports of permanent neuropsychiatric deficits and multiple organ system failure associated with benzyl alcohol. This is directed at clinicians administering the injectable form, not a patient self-care instruction. (6)

Signs of a serious allergic reaction — emergency

Symptoms: Swelling of the face, lips, tongue, or throat; difficulty breathing; widespread rash or hives.

Action: Seek emergency medical help immediately. (1)

Interactions

  • Opioid pain medicines: combining with clonazepam carries a genuine, boxed-warning-level risk of profound sedation, dangerously slowed breathing, coma, and death. (1) (4)
  • Alcohol and other drugs: acute intoxication with alcohol or drugs requires particular caution with clonazepam. (5)
  • Other CNS depressants and sedatives can add to clonazepam's sedating and breathing-suppression effects. (2)
  • Other anticonvulsants used together with clonazepam may increase depressant adverse effects; doses of each may need adjustment by your prescriber. (4)

Pregnancy, breastfeeding, kidney/liver function, age

Pregnancy

Discuss with your prescriber -- benzodiazepine use in pregnancy requires individualised specialist risk-benefit assessment; do not stop or start clonazepam in pregnancy without medical guidance. (1) (2) (3) (4) (5) (6) (7)

Children

Used for certain paediatric seizure disorders under specialist dosing (weight/age-based); not indicated for panic disorder in any market reviewed. Injectable (ampoule) formulation contains benzyl alcohol and must be avoided in neonates, especially premature infants, per New Zealand data sheet guidance. (1) (2) (3) (4) (5) (6) (7)

Elderly

Elderly patients may be more sensitive to benzodiazepines; Health Canada recommends starting with the lowest possible dose, observing closely, and avoiding long-term use where possible, with enhanced monitoring. (1) (2) (3) (4) (5) (6) (7)

Hepatic_impairment

Contraindicated in significant/severe hepatic impairment (risk of hepatic encephalopathy); mild-to-moderate impairment should receive the lowest effective dose, per Health Canada guidance. (1) (2) (3) (4) (5) (6) (7)

Renal_impairment

Health Canada notes that safety and efficacy in renal impairment have not been formally studied; clonazepam's metabolites are excreted by the kidneys, so caution should be exercised to avoid excessive accumulation. This specific caution was not stated with equivalent detail in the US source reviewed. (1) (2) (3) (4) (5) (6) (7)

Source_ids

CA-HEALTHCANADA-RIVOTRIL-PM-2026,NZ-MEDSAFE-RIVOTRIL-DATASHEET-2026 (1) (2) (3) (4) (5) (6) (7)

Monitoring

Before starting

  • Personal/family history of substance misuse
  • Current use of opioids or other sedatives
  • Liver and kidney function
  • Baseline seizure history if being tapered off another anticonvulsant

During treatment

  • Regular review of ongoing need and effect -- up to nearly one-third of patients in some studies showed some loss of anticonvulsant effect over time, often within the first 3 months, and dosage adjustment may re-establish efficacy.
  • Watch for signs of tolerance, misuse, or dependence developing.
  • If stopping after regular use, dose is tapered gradually and individually under your prescriber's direction rather than stopped abruptly.
(4) (5)

Storage

Store at controlled room temperature, in the original container, out of reach of children, and away from anyone who might misuse it. Dispose of unused clonazepam through a medicine take-back program where available, given its abuse/misuse potential.

Study the drug class: Benzodiazepines

Professional information

Clinician-facing context only, sourced from the current US FDA Klonopin prescribing information and the Health Canada, Australia TGA, and New Zealand Medsafe primary sources directly parsed for this dossier, plus the UK SmPC; verify against the current full label before prescribing.

United States

Indication: Seizure disorders; panic disorder

Dose summary: Individualised; panic disorder efficacy established in trials using doses in a titrated range up to several mg/day.

Renal context: No specific hard adjustment described with equivalent detail in the source reviewed; hepatic significant/severe liver disease is contraindicated. (1)

Canada

Indication: Seizure disorders only (no panic disorder indication)

Dose summary: Adults: initial not exceeding 1.5 mg/day in 3 divided doses, titrated by 0.5-1 mg every 3 days to a recommended maintenance of 8-10 mg/day; doses above 20 mg/day used with caution.

Renal context: Not formally studied in renal impairment; caution advised due to renal excretion of metabolites. (4)

Australia / New Zealand

Indication: Seizure disorders only (no panic disorder indication); IV injection specifically for status epilepticus

Dose summary: Individualised dosing; tapering periods for discontinuation described as ranging from about 4 weeks to 4 months in Australian source material.

Renal context: No specific adjustment described in sources reviewed. (5) (6)

Mechanism of action

Hepatic guidance

Contraindicated in significant/severe hepatic impairment (risk of hepatic encephalopathy); clonazepam is hepatically metabolised, so impaired liver function can prolong its effects.

Overdose note

Overdose of clonazepam alone is seldom life-threatening (drowsiness, ataxia, dysarthria, nystagmus most common), but can progress to areflexia, apnea, hypotension, cardiorespiratory depression, and coma, particularly when combined with other CNS depressants, opioids, or alcohol. (4) (1)

Frequently asked questions

Does clonazepam (Klonopin/Rivotril) have a boxed warning?

Yes -- a real, current, three-part FDA boxed warning applies to all benzodiazepines, including clonazepam: (1) combining it with opioids can cause profound sedation, dangerously slowed breathing, coma, and death; (2) it carries a genuine risk of abuse, misuse, and addiction that can lead to overdose or death; (3) continued use can cause physical dependence, and stopping abruptly or reducing the dose too quickly can cause acute, potentially life-threatening withdrawal reactions. Health Canada's Rivotril monograph carries an equivalent 'Serious Warnings and Precautions Box' with the same three risks, added in 2020. (1) (4)

Is clonazepam approved for anxiety or panic attacks everywhere?

No. In the United States, clonazepam (Klonopin) is approved for panic disorder, with or without agoraphobia, in addition to certain seizure disorders. In Canada, Australia, and New Zealand, the sources reviewed for this page list only seizure/epilepsy indications -- panic disorder is not an approved indication in those three markets. This is a genuine, directly-verified difference between markets, not an oversight. (1) (4) (5) (6)

Can I stop taking clonazepam on my own if I feel better?

No -- you should never stop clonazepam abruptly or change your dose on your own after taking it regularly. Doing so can cause a withdrawal reaction that can be life-threatening. Your prescriber will plan an individualised, gradual taper -- Australian source material describes tapering periods used from about 4 weeks to 4 months -- rather than stopping it suddenly. (1) (5)

Why do clonazepam brand names differ between countries?

Clonazepam is an old, generic, multi-manufacturer benzodiazepine. It is sold as Klonopin in the United States and as Rivotril in Canada, Australia, New Zealand, and many other markets (also as PAXAM in New Zealand), plus numerous generic manufacturer brands (e.g. Neuraxpharm, Celix in the UK; APO-Clonazepam in Canada). These are the same active ingredient, clonazepam. (4) (5) (6) (2)

What is the mechanism of action of clonazepam?

Clonazepam is a benzodiazepine that enhances the effect of GABA (gamma-aminobutyric acid), the brain's main inhibitory neurotransmitter, at the GABA-A receptor, producing anticonvulsant and anxiolytic effects. (4) (1)

What is the generic name of Clonazepam (Klonopin / Rivotril)?

The generic name is clonazepam. (1) (4)

What class of drug is clonazepam?

Clonazepam (Klonopin / Rivotril) is classed as: Benzodiazepine (anticonvulsant / anxiolytic). (1) (4)

References

  1. KLONOPIN (clonazepam) tablet -- full prescribing informationU.S. Food and Drug Administration / DailyMed (NIH), full prescribing information · United States · accessed 2026-07-31 · source 1
  2. Clonazepam Neuraxpharm 2 mg Tablets -- Summary of Product Characteristicselectronic medicines compendium (emc), United Kingdom · United Kingdom · accessed 2026-07-31 · source 2
  3. Clonazepam -- list of nationally authorised medicinal products (PSUSA/00000812/202506)European Medicines Agency (EMA) -- Periodic Safety Update Report Single Assessment (PSUSA) list of nationally authorised medicinal products · European Union · accessed 2026-07-31 · source 3
  4. RIVOTRIL (clonazepam) tablets, 0.5 mg and 2 mg -- Health Canada Product Monograph (Date of Revision: April 28, 2022)Health Canada product monograph · Canada · accessed 2026-07-31 · source 4
  5. Rivotril (clonazepam) tablets, oral liquid (drops), and injection -- Australian Product Information (2026-03, v5.0)Therapeutic Goods Administration (TGA), Australia -- Australian Product Information · Australia · accessed 2026-07-31 · source 5
  6. Rivotril (clonazepam) tablets, oral solution (drops), and injection -- New Zealand Data SheetMedsafe (New Zealand Medicines and Medical Devices Safety Authority) · New Zealand · accessed 2026-07-31 · source 6
  7. Reminder: Potential for abuse, dependence and withdrawal with benzodiazepines (June 2022)Medsafe (New Zealand Medicines and Medical Devices Safety Authority) -- Prescriber Update safety communication · New Zealand · accessed 2026-07-31 · source 7

Brand names by country

Single-ingredient clonazepam names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.

Priority countries

United States

  • Klonopin.5 mg, 1 mg, 2 mg · h2-pharma, llc

United Kingdom

  • Clonazepam Neuraxpharm, Clonazepam Celix, Clonazepam Roma (generic; multiple manufacturers) (2)MHRA licensed emc smpc confirmed · 0.5 mg, 1 mg, 2 mg tablet, 0.5 mg/5 mL and 2 mg/5 mL oral solution · Neuraxpharm UK Ltd, Celix, Roma, Rosemont, Thame (multiple UK generic manufacturers)

Canada

  • CLONAPAM
  • CO CLONAZEPAM
  • RIVOTRIL
  • PMS-CLONAZEPAM-R
  • DOM-CLONAZEPAM-R -
  • PHL-CLONAZEPAM-R

Australia

  • Rivotril (tablets, oral liquid/drops, injection) (5)TGA ARTG registered confirmed current PI 2026-03 · 0.5 mg tablet, 2.5 mg/mL oral liquid (drops), 1 mg/1 mL injection · Pharmaco (Australia) Ltd, under license of CHEPLAPHARM Arzneimittel GmbH

New Zealand

  • Rivotril (tablets, oral solution/drops, injection); PAXAM (tablets) (6)Medsafe datasheets confirmed multiple brands · 0.5 mg, 2 mg tablet, 2.5 mg/mL oral solution (drops), 1 mg/1 mL injection · multiple NZ-registered suppliers
View brands in additional countries.

European Union

Rivotril and generic clonazepam (nationally authorised per member state; e.g. Antelepsin in Germany, Clonazepam Biomed in Spain, Clonazepam EG in Italy, Clonazepam Olainfarm in Latvia, Clonazepam Rosemont in Ireland, Aklonil in Cyprus) (3)

This page provides general reference information about clonazepam (Klonopin/Rivotril) and is not a substitute for advice from your prescriber. Clonazepam carries a genuine, serious boxed warning; all dosing, tapering, and stopping decisions should be made with your prescriber, never on your own.

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