Clorazepate (Tranxene): Uses, Side Effects, Warnings, & More

What Is Clorazepate (Tranxene)?

Clorazepate, marketed as Tranxene, belongs to the benzodiazepine class of medications. It acts on the central nervous system, enhancing the effects of a GABA neurotransmitter.² FDA approval signifies that Tranxene has undergone rigorous evaluation to ensure its safety and effectiveness. Clinically, it is prescribed to manage anxiety disorders and provides relief by calming overactive brain functions.

Is Tranxene the Same Thing as Xanax?

Tranxene (clorazepate) and Xanax (alprazolam) are both benzodiazepines, but they differ in their chemical structures and durations of action. While they share similarities in treating anxiety, Tranxene has a longer duration, requiring less frequent dosing than Xanax.

Are Clonazepam & Clorazepate the Same Thing?

Clonazepam and clorazepate are distinct benzodiazepines. While they both affect GABA receptors in the brain to treat anxiety, they differ in their chemical structures and the way they work. Patients should consult their healthcare providers to determine the most suitable medication based on their needs and medical history.

How Does Clorazepate Work?

Clorazepate eases anxiety by boosting the activity of a brain chemical called GABA. Think of GABA as a calming messenger in your brain. By enhancing its effects, clorazepate helps to settle the excessive electrical activity that can lead to anxiety. This calming action is what provides relief from the symptoms associated with anxiety disorders, offering a sense of tranquility to those who take it.¹

What Is Clorazepate Used to Treat?

Clorazepate is FDA-approved for the treatment of anxiety disorders. FDA approval ensures that the medication has undergone thorough evaluation for safety and effectiveness in managing these conditions.²

Additionally, healthcare providers may sometimes prescribe clorazepate off-label, meaning for uses not officially approved by the FDA, based on their professional judgment when they believe it may offer benefits beyond its approved indications. An off-label use might occur when a clinician considers it beneficial for specific conditions not covered by the initial FDA approval.

Common Side Effects of Clorazepate

Common side effects of clorazepate may include various symptoms such as drowsiness, dizziness, and blurred vision, among others. It’s essential to be aware of these potential effects, as some individuals, particularly older persons, may experience heightened sedation or impaired alertness. Medical attention may be necessary if these side effects persist or worsen.

Common side effects of clorazepate include:²

• Drowsiness
• Dizziness
• Blurred vision
• Dry mouth
• Headache
• Constipation

*All medications, including clorazepate, can cause side effects which can be mild or serious. This is not a comprehensive list of all possible side effects. You should talk with your doctor about any questions you have and to understand the potential side effects and benefits of any medication.

Serious Side Effects of Clorazepate

Clorazepate may lead to serious side effects that warrant prompt medical attention. These adverse reactions affect various aspects of health and require immediate intervention. It is crucial for individuals taking clorazepate to be aware of these potential complications and seek medical help if they experience any concerning symptoms.

Serious side effects of clorazepate include:²

• Severe drowsiness
• Slowed breathing
• Coma
• Profound sedation
• Confusion
• Slurred speech
• Weakness in arms or legs
• Trouble walking
• Loss of coordination
• Very stiff muscles
• High fever
• Suicidal thoughts or behavior
• Unusual changes in mood or behavior
• Signs of overdose, such as catatonia, convulsions, or delirium tremens

*All medications, including clorazepate, can cause side effects which can be mild or serious. This is not a comprehensive list of all possible side effects. You should talk with your doctor about any questions you have and to understand the potential side effects and benefits of any medication.

Clorazepate Warnings & Precautions

When considering clorazepate, an anxiolytic medication, it’s essential to be aware of certain warnings and precautions associated with its use. Individuals should exercise caution if they have a history of substance abuse or respiratory issues, as clorazepate can potentiate the effects of alcohol and depress respiratory function. Always consult with a healthcare provider for proper guidance.

Avoid taking clorazepate if you:

• Are diagnosed with a history of major depressive disorder (MDD): Individuals with a history of major depression should exercise caution, as clorazepate may interact with existing conditions or treatments. Consultation with a healthcare provider is advised.²
• Have allergic reactions: Those who have experienced allergic reactions to clorazepate or its components should refrain from taking the medication. Allergic responses can range from mild to severe, requiring immediate medical attention.²
• Have a history of substance abuse: Individuals with a history of substance abuse should be cautious when using clorazepate. The medication may exacerbate dependency issues, and close monitoring is necessary.²
• Are pregnant or planning to become pregnant: Pregnant individuals or those planning pregnancy should discuss the potential risks and benefits of clorazepate with their healthcare provider. The medication may pose risks to the developing fetus, and alternative treatments should be considered.²
• Have liver disease: Clorazepate is metabolized in the liver, and individuals with liver disease may experience altered drug metabolism. Close monitoring and possible dosage adjustments are recommended.²
• Have a history of glaucoma: Clorazepate may exacerbate symptoms of glaucoma or increase intraocular pressure. Regular eye examinations are essential for individuals with a history of glaucoma.²

Clorazepate Dosages for FDA-Approved Treatment

Clorazepate dosages are highly individualized, considering factors such as the patient’s age, the specific condition being treated, and overall health. The typical dosage range for clorazepate varies widely. For generalized anxiety disorder, the initial adult dose may range from 7.5 to 15 mg, taken orally in divided doses. It’s important to note that dosages can be adjusted based on individual response and tolerance.

Clorazepate is FDA-approved for adults and geriatric patients but is not typically prescribed for children. Factors such as age-related sensitivity and potential interactions with other medications may influence the prescribed dosage, highlighting the necessity for personalized medical assessments to determine the most appropriate and effective treatment plan.

Clorazepate Forms & Strengths

Clorazepate is available in various forms and strengths to accommodate individual patient needs. The most suitable form and strength are determined by factors such as the nature and severity of the anxiety disorder, the patient’s response to treatment, and the prescriber’s judgment. The selection may also be influenced by considerations of the desired onset of action, duration of therapeutic effect, and the presence of comorbid conditions.

Prescribers may opt for different forms, including oral tablets, to facilitate convenient dosing. The choice between immediate-release and extended-release formulations depends on the patient’s requirements for symptom control throughout the day. The dosage is individualized based on factors like the patient’s age, overall health, and response to therapy. In cases where rapid relief is essential, immediate-release formulations may be favored, while extended-release formulations are chosen for a more sustained effect.

Clorazepate is available in the following forms and strengths:²

• 3.75 mg oral tablet
• 7.5 mg oral tablet
• 15 mg oral tablet
• 22.5 mg oral tablet

How Should I Take Clorazepate?

To take clorazepate effectively, follow your prescriber’s instructions carefully. Typically, it’s taken orally, with or without food, depending on personal preference. For the extended-release tablet form, swallowing it whole is recommended to ensure a gradual release of the medication. It’s best to adhere to the prescribed dosage and schedule, taking the medication at the same times each day.

What Happens If I Miss a Dose of Clorazepate?

If you miss a dose of clorazepate, taking it as soon as you remember is important. However, if it’s close to the time for your next scheduled dose, skip the missed dose and continue with your regular dosing schedule. Do not double the dose to compensate for the missed one, as this can increase the risk of side effects.

Consult your healthcare provider for guidance if you have questions or concerns about missed doses or your medication schedule. Maintaining a consistent dosing routine is essential for the safe and effective management of your condition.

Can You Overdose on Clorazepate?

Yes, it is possible to overdose on clorazepate, a benzodiazepine medication. An overdose can be life-threatening and may occur if clorazepate is taken in excessive amounts, especially when combined with other substances such as alcohol, opioid medications, or drugs that cause drowsiness or respiratory depression. The signs and symptoms of a clorazepate overdose may include extreme drowsiness, confusion, slowed or shallow breathing, weakness, and even coma.

What Should You Do If You Take Too Much Clorazepate?

If you accidentally take too much clorazepate, it’s crucial to seek medical attention immediately. Overdosing on clorazepate can lead to serious health risks. Contact your local poison control center or go to the nearest emergency room. Be prepared to provide information about the amount of clorazepate ingested, the time of ingestion, and any symptoms you may be experiencing. Prompt medical intervention is vital to address potential overdose symptoms and ensure your safety.²

What to Avoid When Taking Clorazepate

Clorazepate, while effective, can interact with various medications, substances, and herbs, potentially leading to adverse effects or reduced effectiveness. It’s essential to be mindful of these interactions and avoid specific substances when taking clorazepate. Interactions can range from intensified sedation to altered drug metabolism, impacting the overall treatment outcome. Always consult your healthcare provider before starting any new medication or supplement while on clorazepate, and maintain an open dialogue about any substances you may consider.

10 substances you should avoid while taking clorazepate include:²

• Alcohol: Drinking alcohol while on clorazepate can exacerbate drowsiness and impair cognitive functions, heightening the risk of accidents and adverse effects.
• Opioids: Combining clorazepate with opioids can result in severe respiratory depression and increased sedation.
• Herbal supplements (e.g., Valerian): Valerian and similar herbal supplements can increase the sedative effects of clorazepate, leading to drowsiness and reduced alertness.
• St. John’s wort: St John’s wort supplement can interfere with the effectiveness of clorazepate.
• Kava: Usage of kava alongside clorazepate can cause sedation and elevate the risk of side effects.
• Other benzodiazepines: Concurrent use of multiple benzodiazepines can lead to overdose, extreme sedation, and other adverse reactions.
• Sleep medications: Medications prescribed for sleep disorders can cause sedation and increase the risk of side effects when taken with clorazepate.
• Antiepileptic drugs: Certain antiepileptic medications can interact with clorazepate, affecting its effectiveness or increasing the risk of side effects.
• Medications affecting liver enzymes (e.g., Cimetidine): Drugs like cimetidine can impact clorazepate’s metabolism in the liver, potentially altering its effectiveness or increasing side effects.
• Anxiety medications: Combining clorazepate with other anxiety medications, such as buspirone, can lead to excessive drowsiness and impaired coordination, heightening the risk of side effects.

How to Get a Prescription for Clorazepate

Clorazepate is a prescription-only medication, which means you cannot obtain it without a prescription from a qualified healthcare provider. Typically, it is prescribed by licensed medical professionals, such as physicians, psychiatrists, or neurologists, who are trained to evaluate and diagnose conditions for which clorazepate may be an appropriate treatment. To receive a prescription, you’ll need to undergo a comprehensive evaluation, including a physical examination, a review of your medical history, and a discussion about your symptoms and treatment goals.

This assessment is crucial in determining whether clorazepate is a suitable and beneficial treatment option for your specific needs. It’s important to be open and honest during this evaluation to ensure your healthcare provider can make the most informed decision about your treatment. If clorazepate is prescribed, be sure to follow your healthcare provider’s instructions for its safe and effective use.

Questions to Ask Your Healthcare Provider About Clorazepate

If you are struggling with anxiety or panic disorders, clorazepate might be a good option for you. It is important to talk to your doctor, psychiatrist, or therapist about your symptoms and medical history to determine if clorazepate is the right medication for you. Additionally, if you are in need of a new prescriber, online psychiatry services can be a convenient and effective option to consider.

Questions to ask your care team about clorazepate include:

• How safe is clorazepate, and what potential side effects should I be aware of?
• How long will it take to adjust to clorazepate, and what can I expect during this adjustment period?
• Am I at risk for more serious symptoms or interactions if I am already taking other medications or supplements?
• What is the best dosage to ensure fewer side effects while effectively managing my condition?
• Are there any lifestyle changes or dietary considerations I should know while taking clorazepate?
• How will clorazepate interact with my existing treatment plan, if I have one?
• What are the signs of an adverse reaction or overdose that I should watch out for?
• Can I drink alcohol or engage in specific activities while taking clorazepate?
• Are there any potential long-term effects or risks associated with clorazepate use?
• How often should I follow up with you or a mental health professional to monitor my progress and adjust my treatment plan if necessary?