What is Klonopin?

Klonopin is the brand name of the generic medication clonazepam. It is used to treat panic disorder (with or without agoraphobia—an anxiety disorder where a person avoids or fears places or situations that could cause panic). Klonopin is sometimes also prescribed for “off-label” use (taking a medication for a condition it has not been approved to treat by the FDA—a common and acceptable medical practice). Benzodiazepines—the class of medications that includes Klonopin—are sometimes used “off-label” for sleep problems.

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Benzodiazepines like Klonopin may be prescribed to treat anxiety, panic disorder, and insomnia (as well as seizures). These medications work by slowing down selected areas of your brain’s activity by attaching to gamma-aminobutyric (GABA) neuroreceptors. GABA is a type of neurotransmitter, or small molecule in your brain, that relays messages between nerves. Because they slow down your brain’s activity at the GABA receptors, benzodiazepines can help you feel drowsy and/or calm.  

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One thing to keep in mind when considering Klonopin or other benzodiazepines is that they are usually prescribed for short-term use—typically several weeks or months. You might have heard that taking these types of medications can come with a risk of psychological or physical dependence—or addiction—to them. The Drug Enforcement Agency has classified benzodiazepines as controlled substances due to the increased risk of dependence or abuse in people who have a prior history of a substance use disorder in addition to not taking these medications as prescribed.

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Klonopin is available in both regular tablets and orally disintegrating tablets (wafers):

Klonopin tablet

• 0.5 mg
• 1 mg
• 2 mg

Klonopin orally disintegrating tablet

• 0.125 mg
• 0.25 mg
• 0.5 mg
• 1 mg
• 2 mg

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A typical starting Klonopin dosage for panic disorder is 0.25 mg taken twice daily. If this dose does not provide sufficient symptom relief, your prescribing doctor, nurse practitioner, or Minded psychiatry provider may increase your dose every few days, up to 4 mg, which is the maximum recommended daily dose.

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A typical Klonopin dosage for sleep may range from 0.25 to 2 mg, taken 30 minutes before bed.

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Klonopin can be taken daily at regularly scheduled times or on an as-needed basis. Your prescribing healthcare professional will provide you with details on when to take this medication, how often, and the maximum amount that can be taken per day.

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You can take Klonopin with or without food—though if you find that taking it without food causes an upset stomach, you may want to take it with food going forward.

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The oral disintegrating Klonopin tablets should always be kept in their original packaging rather than removed and stored in a pillbox. Once the packaging is opened, they should be taken immediately. Oral disintegrating tablets dissolve in your mouth in seconds and do not need to be taken with liquids.

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No matter which version you take—the regular tablets or the oral disintegrating tablets—if you miss a dose of Klonopin you should either take the missed dose as soon as you remember, or if it is closer to when you would take your next dose, go ahead and take the next dose.

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For more information:

• Klonopin for sleep: dosage, uses, benefits, and side effects
• How long does Klonopin stay in my system?

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Klonopin side effects, warnings, and interactions

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Klonopin side effects

Common side effects of Klonopin include:

• Depression
• Difficulty with walking and coordination
• Dizziness
• Drowsiness
• Fatigue
• Irritability
• Memory problems

These and similar side effects typically decrease during the first few weeks of taking Klonopin.

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Always let your prescribing doctor, nurse practitioner, or Minded psychiatry provider know if you experience these or any other side effects.

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Rare or serious side effects of Klonopin include:

• Difficulty speaking
• Extreme tiredness or dizziness
• Dependence
• Increased heart rate
• Passing out (fainting)
• Severe allergic reaction and facial swelling, which can occur even with the first dose
• Respiratory depression
• Thoughts of self-harm or suicide

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In some cases, people who take benzodiazepines to help with sleep problems may end up engaging in activities (such as making phone calls, eating, or even driving) while they are either asleep or not fully awake. They have no memory of having done these activities once they awaken.

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Seek immediate medical attention if you experience these (or any other) serious Klonopin side effects.

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Klonopin warnings

Klonopin comes with an FDA “Black Box” warning, which means that the FDA has identified certain serious safety risks that may occur from taking this medication. These safety warnings are very serious, though their actual risk may be low.

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The Black Box warning for Klonopin states that:

• Taking benzodiazepines (such as Klonopin) in addition to opioids may lead to serious, possibly fatal, interactions
• Using benzodiazepines comes with a risk of abuse, misuse, and/or addiction
• Continuing to use benzodiazepines may lead to physical dependence on them and/or cause withdrawal if these medications are discontinued abruptly

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Klonopin and pregnancy

Always discuss your treatment plan with your prescribing doctor, nurse practitioner, or Minded psychiatry provider if you are planning to become pregnant and/or breastfeed. Klonopin may harm your baby during pregnancy and can be passed to your baby through breast milk.

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Klonopin withdrawal symptoms

Klonopin should not be stopped abruptly. Doing so can cause withdrawal symptoms that can be life-threatening. If you need to go off of Klonopin, work with your prescribing doctor or nurse practitioner to develop a plan to safely taper down your dose to avoid withdrawal symptoms.

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Symptoms of withdrawal from Klonopin can be life-threatening and include:

• Changes in blood pressure
• Dizziness
• Irritability
• Nausea
• Rapid heart rate
• Seizures
• Tremors 

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Klonopin interactions

Always let your prescribing healthcare professional know about any and all other medications and/or supplements you are taking so that they can see if Klonopin may have any negative interactions with them.

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Klonopin may interact with:

• Antihistamines, such as Benadryl (diphenhydramine)
• Antipsychotic medications
• Luvox (fluvoxamine)
• Narcotic pain medications, such as morphine, OxyContin (oxycodone), Lortab (hydrocodone), or Vicodin (hydrocodone)
• Nizoral (ketoconazole)
• Norvir (ritonavir)
• Opioid cough medications, such as codeine cough syrup
• Other anti-anxiety medications
• Other benzodiazepines
• Serzone (nefazodone)
• Sleep medications, such as Ambien (zolpidem)
• Some antiepileptic medications, such as Dilantin (phenytoin), Luminal (phenobarbital), or Tegretol (carbamazepine)
• Sporanox (itraconazole)
• Tagamet (cimetidine)
• Tricyclic antidepressants, such as Elavil (amitriptyline)

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Klonopin and alcohol

You should not drink alcohol while taking Klonopin (or most other medications for anxiety, depression, or insomnia). Alcohol can decrease the benefits of these medications and increase their negative side effects. And because alcohol can impair both judgment and memory, it may also increase your risk of accidentally overdosing on Klonopin.

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Symptoms of a Klonopin overdose include:

• Confusion
• Coma
• Decreased coordination
• Slowed reflexes
• Death

An overdose of Klonopin can be fatal—seek immediate medical attention if you are experiencing any overdose symptoms.

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