Clorazepate Dipotassium (Tranxene) Clinical Pharmacology:rxlist:"Pharmacologically, clorazepate dipotassium has the characteristics of the benzodiazepines. It has depressant effects on the central nervous system. The primary metabolite, nordiazepam, quickly appears in the blood stream. The serum half-life is about 2 days. The drug is metabolized in the liver and excreted primarily in the urine. Studies in healthy men have shown that clorazenate dipotassium has depressant effects on the central nervous system. Prolonged administration of single daily doses as high as 120 mg was without toxic effects. Abrupt cessation of high doses was followed in some patients by nervousness, insomnia, irritability, diarrhea, muscle aches, or memory impairment. Since orally administered clorazepate dipotassium is rapidly decarboxylated to form nordiazepam, there is essentially no circulating parent drug. Nordiazepam, the primary metabolite, quickly appears in the blood and is eliminated from the plasma with an apparent half-life of about 40 to 50 hours. Plasma levels of nordiazepam increase proportionally with TRANXENE dose and show moderate accumulation with repeated administration. The protein binding of nordiazepam in plasma is high (97-98%)."
http://rxlist.com/cgi/generic2/clorazepate_cp.htm

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Possible side effects of Clorazepate Dipotassium (Tranxene):Support4Hope Inc. :"Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Tranxene. More common side effects may include: Drowsiness Less common or rare side effects may include: Blurred vision, depression, difficulty in sleeping or falling asleep, dizziness, dry mouth, double vision, fatigue, genital and urinary tract disorders, headache, irritability, lack of muscle coordination, mental confusion, nervousness, tremors, skin rashes, slurred speech, stomach and intestinal disorders, tremor Side effects due to rapid decrease or abrupt withdrawal from Tranxene may include: Abdominal cramps, convulsions, diarrhea, difficulty in sleeping or falling asleep, hallucinations, impaired memory, irritability, muscle aches, nervousness, tremors, vomiting Do not take this medication if you have the eye condition known as acute narrow-angle glaucoma. Anxiety or tension related to everyday stress usually does not require treatment with such a strong drug. Discuss your symptoms thoroughly with your doctor. Tranxene is not recommended for use in more serious conditions such as depression or severe psychological disorders."
http://support4hope.com/medications/index.htm

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Clorazepate Dipotassium (Tranxene)- interactions with food and other compounds (page contains chart):Healthnotes, Inc.:"Alcohol Drinking alcohol while taking clorazepate may enhance drowsiness and slow reaction time,3 and, according to animal studies, prolong sleep time.4 Consequently, people taking clorazepate dipotassium should avoid alcoholic beverages. Smoking Cigarette smoking decreases the amount of time clorazepate is in the body, lowers blood levels of the drug, and reduces the beneficial effects;5 therefore, people should avoid smoking while taking the drug. People who quit smoking while taking clorazepate might experience unwanted side effects due to increased blood levels of the drug; gradual reduction in nicotine is preferred. For the convenience of the reader, the information in the summary is categorized as follows: “Depletion or interference” indicates the drug may deplete or interfere with the absorption or function of the supplement or herb. “Adverse interaction” indicates that the supplement or herb used together with the drug may result in undesirable effects. “Side effect reduction/prevention” indicates the supplement or herb may reduce the likelihood and/or severity of a potential side effect caused by the drug. “Supportive interaction” indicates the supplement or herb may support or aid the function of the drug. “Reduced drug absorption/bioavailability” indicates that the supplement or herb may decrease the absorption and/or activity of the drug in the body. An asterisk (*) next to an item in the summary indicates that the interaction is supported only by weak, fragmentary, and/or contradictory scientific evidence."
http://www.gnc.com/health_notes/Drug/Clorazepate_Dipotassium.htm

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Clorazepate Dipotassium (Tranxene) Nursing Implications:elsevierhealth.com:"BASELINE ASSESSMENT: Anxiety: Assess autonomic response (cold, clammy hands, sweating) and motor response (agitation, trembling, tension). Offer emotional support to anxious pt. Seizures: Review history of seizure disorder (intensity, frequency, duration, LOC). Observe frequently for recurrence of seizure activity. Initiate seizure precautions. INTERVENTIONS/EVALUATION: For those on long-term therapy, liver/renal function tests, blood counts should be performed periodically. Assess for paradoxical reaction, particularly during early therapy. Assist with ambulation if drowsiness, dizziness occur. Evaluate for therapeutic response: Anxiety: A calm facial expression; decreased restlessness. Seizures: A decrease in intensity or frequency of seizures. PATIENT/FAMILY TEACHING: Do not abruptly withdraw medication following long-term use (may precipitate seizures). Strict maintenance of drug therapy is essential for seizure control. Drowsiness usually disappears during continued therapy. If dizziness occurs, change positions slowly from recumbent to sitting position before standing. Avoid tasks that require alertness, motor skills until response to drug is established. Smoking reduces drug effectiveness. Avoid alcohol"
http://www3.us.elsevierhealth.com/SIMON/SaundersNDH/archive/clorazepate_dipotassium.html

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Clorazepate Dipotassium (Tranxene) Special Precautions and warnings:medbroadcast.com:"Occupational hazards: Since clorazepate dipotassium causes drowsiness and sedation, engaging in potentially hazardous activities requiring mental alertness and physical coordination, such as driving or operating dangerous machinery, is not recommended. The effects of alcohol on such activities may be increased. Medical conditions: Clorazepate dipotassium is not recommended alone for people with depression or psychosis. Using alcohol or other drugs that cause drowsiness or sedation is also not recommended. People who have an addiction to alcohol or other drugs should not take clorazepate dipotassium, except in rare situations under medical supervision. Withdrawal: Clorazepate dipotassium can become habit-forming. Withdrawal symptoms similar to those occurring with other drugs of this class, including alcohol, have been observed after stopping the drug suddenly (after having taken the drug regularly over a period of time)."
http://drugs.medbroadcast.com/ASP/DrugInfo.asp?BrandNameID=345

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Clorazepate Dipotassium (Tranxene)- How it works & range and frequency:wholehealthmd:"In general, clorazepate produces mild sedation by depressing activity in the central nervous system. In particular, clorazepate appears to enhance the effect of gamma-aminobutyric acid (GABA), a natural chemical that inhibits the firing of neurons and dampens the transmission of nerve signals, thus decreasing nervous excitation. Range and Frequency For anxiety: Usual dose is 7.5 to 15 mg, 2 to 4 times a day. The dosage may be increased or decreased depending on an individual's response. Older adults are usually started at a total dose of 7.5 to 15 mg a day."
http://www.wholehealthmd.com/refshelf/drugs_view/1,1524,149,00.html

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Medication interactions with Clorazepate Dipotassium (Tranxene):mediresource.com:"Using alcohol or other drugs that cause drowsiness or sedation while taking clorazepate is not recommended. If you are taking any of these drugs, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to: stop taking one of the medications, change one of the medications to another, change how you are taking one or both of the medications, or leave everything as is. An interaction between two medications does not always mean that you must stop taking one of them. In many cases, interactions are intended or are managed by close monitoring. Speak to your doctor about how any drug interactions are being managed or should be managed. Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications that you are taking. Also tell them about any supplements you take. Since caffeine, decongestants, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them"
http://www.mediresource.com/pages/DrugInfo.asp?BrandNameID=345

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Clorazepate Dipotassium (Tranxene) description:athealth.com:"Chemically, Tranxene (clorazepate dipotassium) is a benzodiazepine. Tranxene T-TAB tablets contain either 3.75 mg, 7.5 mg, or 15 mg of clorazepate dipotassium. Tranxene-SD and Tranxene-SD half strength tablets contain 22.5 mg and 11.25 mg of clorazepate dipotassium respectively. Tranxene-SD and Tranxene-SD half strength tablets gradually release clorazepate and are designed for once-a-day administration in patients already stabilized on Tranxene T-TAB tablets."
http://www.athealth.com/Consumer/mcabinet/mcname_brand.cfm?brand=Tranxene

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Clorazepate Dipotassium (Tranxene) withdrawl information:wholehealthmd:"Missed Dose Take it as soon as you remember, unless the time for your next scheduled dose is within 2 hours. If so, skip the missed dose and resume your regular dosage schedule. Do not double the next dose. Stopping the Drug Do not stop taking the drug abruptly, as this can cause withdrawal symptoms (seizures, sleep disruption, nervousness, irritability, diarrhea, abdominal cramps, muscle aches, memory impairment). Dosage should be reduced gradually as directed by your doctor. Prolonged Use Clorazepate may slowly lose its effectiveness with prolonged use. See your doctor for periodic evaluation if you must take this drug for an extended time."
http://www.wholehealthmd.com/print/view/1,1560,DR_149,00.html#Missed_Dose

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Clorazepate Dipotassium (Tranxene) is a benzodiazepine learn what the risks are to pregnancy while taking this class of drug:Pharmacy Medicine Information Web Site:"It is important to consider that there will be a risk to you and your child from taking a medicine during pregnancy but also a possible risk from stopping the medicine e.g. getting ill again. Unfortunately, no decision is risk-free. It will be for you to decide which is the least risk. All we can do here is to help you understand some of the issues, so you can make an informed decision. For your information, major malformations occur "spontaneously" in about 2-4% of all pregnancies, even if no drugs are taken. The main problem with medicines is termed "teratogenicity" i.e. a medicine causing a malformation in the unborn child. A medicine causing teratogenicity is called a "teratogen". Since a baby has completed it's main development between days 17 and 60 of the pregnancy (the so-called "first trimester") these first 2-16 weeks are the main concern. After that, there may be other problems e.g. some medicines may cause slower growth. The infant may also be affected after birth e.g. withdrawal effects are possible with some drugs. If possible, the best option is to plan in advance. If you think you could become pregnant, discuss this with your doctor and it may be possible to switch to medicines thought to carry least risk, and take other risk-reducing steps e.g. adjusting doses, taking vitamin supplements etc. If you have just discovered you are pregnant, don't panic, but seek advice from your GP within the next few days if possible. He or she may also want to refer you on to someone with more specialist knowledge of your medicine"
http://www.nmhct.nhs.uk/pharmacy/anx1.htm



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Tranxene ®, Recovery First:"Tranxene ®, or Clorazepate, is a benzodiazepine used to treat anxiety disorders and convulsive disorders such as epilepsy. Use of Tranxene ® can cause addiction and physical dependence; withdrawal symptoms may occur if the drug is discontinued. Withdrawal symptoms can range from sleeplessness and anxiety to seizures and even death. Tolerance develops when the drug is taken over time, meaning that higher doses must be used to achieve the same effect."
Recovery First
2701 West Oakland Park Blvd Suite 240
Fort Lauderdale, Fl 33311
800-734-5192 Fax: 954-735-6033
http://www.recoveryfirst.net/tranxene.htm

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