Klonopin (Clonazepam) Dosage Guide: Forms, Strengths, & How To Take It

Klonopin Dosage for Adults with Panic Disorder, With or Without Agraphobia

For panic disorder, the starting dose of Klonopin is 0.25 mg tablet twice daily for three days, then the dose may be increased if necessary. The drug is fast-acting and improves symptoms of a panic attack within 1 to 4 hours.

There are no established benefits of taking Klonopin long-term, and your doctor will periodically assess how well it’s working for you while you are taking it. For maximum benefit, the drug must be taken 30 minutes before bedtime.

Here is Klonopin dosage information for panic disorder:¹

• Typical starting dosage: Treatment starts at a dose of 0.25 mg tablets, twice a day by mouth.
• Dosage increases: Typically after three days of initial treatment, the dose may be increased to 0.5 mg tablets twice daily. If individuals need a maximum dose of 4 mg daily, the dose may be increased from 0.125 to 0.25 mg twice daily every three days until the symptoms are controlled. For the best results, take the drug before bedtime.
• Maximum dosage: adults must limit their Klonopin intake to a maximum of 4 mg per day. For individuals aged 65 and up, the daily maximum dose is 1.5 mg. Children weighing up to 30 kg should not exceed a daily maximum dose of 0.2 mg/kg of body weight.

Klonopin for Non-FDA-Approved (Off-Label) Uses

The most common off-label (non-FDA-approved) uses of Klonopin are acute mania, akathisia, restless leg syndrome, bruxism, REM sleep behavior disorder (RBD), and burning mouth syndrome.

Off-label drug use occurs when a drug is prescribed for a purpose other than what the FDA has approved. Doctors may choose to use a drug off-label if they believe it may be beneficial to the individuals based on their clinical judgment.

Conditions Klonopin may be used to treat as an off-label (non-FDA approved) medication:³

• Restless leg syndrome
• Insomnia
• Acute mania
• Tardive dyskinesia
• Confusional arousals
• Sleep terrors and sleepwalking
• Social phobias in adults
• Rapid eye movement sleep behavior disorder
• Burning mouth syndrome
• Tourette syndrome

Klonopin Forms & Strengths

Klonopin is available as an immediate-release tablet of 0.5 mg, 1 mg, 2 mg, and orally disintegrated tablets (ODT) of 0.125 mg, 0.25 mg, 0.5 mg, 1 mg, and 2 mg strength. The dosage for individuals may vary depending on factors such as the severity of the condition, age, weight, other health problems, and the drugs they are taking.

The medication may be administered once at bedtime to minimize the impact of drowsiness, a common effect of taking Klonopin. The right strength for an individual is determined by the disorder being treated, age, weight (children), severity of symptoms, and coexisting health conditions. Klonopin doses may vary depending on the type of disorder, age, weight, and other medical conditions.

Klonopin is available in the following forms and strengths¹

• 0.5 milligrams (mg) oral tablet
• 1mg oral tablet
• 2mg oral tablet
• 0.125 mg dispersible tablet
• 0.25 mg dispersible tablet
• 0.5 mg dispersible tablet
• 1 mg dispersible tablet
• 2 mg dispersible tablet

It is important to always follow the doses the doctor prescribes to avoid potential side effects. Individuals must swallow the whole regular tablet with water, while dispersible tablets can be taken with or without water just after removing it from the packaging.

Klonopin Dosing Considerations

When determining the appropriate dosage, several factors must be taken into consideration, including the individual’s health condition, response to treatment, age, and body weight. Elderly individuals over the age of 65 and those with liver or kidney problems may require a lower dosage.

Additionally, if the individual is taking other prescription medications or experiences weight fluctuations, the dosage may need to be adjusted accordingly.

Conditions that require special Klonopin dosing considerations include:¹

• Pregnancy and breastfeeding: Klonopin use in late pregnancy can lead to poor control of movement, delayed motor skills, inadequate muscle tone, and heart problems. Doctors recommend the drug only if the benefits outweigh the risks to the unborn baby. They may not advise Klonopin if women are breastfeeding as it passes into the breastmilk.
• Kidney problems: The appropriate dose adjustment is based on the individuals’ clinical response and the damage to their kidneys since the drug passes through them.
• Liver problems: Klonopin is not used in severe liver disease as the drug is processed in the liver. Drug accumulation can occur and result in sedation and respiratory problems.
• Elderly population: People aged 65 and over should be started at low doses of Klonopin and observed closely. The drug may cause over-sedation, confusion, cognitive problems, agitation, falls, and fractures in older individuals.
• Pediatric population: The dose varies depending on the age and weight of a child. A lower dose is suggested for children younger than 10 years or less than 30 kilograms.

Can You Overdose on Klonopin?

Yes, Klonopin has the risk for overdose if not taken as directed, misused, or taken frequently in high doses. Even the standard doses may result in overdose when combining Klonopin with alcohol, opioids, barbiturates, and certain illicit and prescription drugs that cause drowsiness or shallow breathing. It is commonly seen in elderly individuals who take multiple prescription and nonprescription substances and have slow drug removal due to age-related kidney and liver problems.

Signs and symptoms of Klonopin overdose include slurred speech, confusion, drowsiness, loss of consciousness, deep sedation, and uncoordinated movements. In severe cases, an overdose can lead to coma or even death.

What Should You Do If You Take Too Much Klonopin?

If someone takes excessive doses of Klonopin and experiences symptoms like fainting or difficulty breathing, it is important to call 911 and seek urgent medical care immediately. The healthcare team may provide general supportive treatment, including intravenous fluids, ventilation, and airway maintenance.

In some cases, they may also consider administering Flumazenil, a benzodiazepine-receptor antagonist, to reverse the sedative effects. For adults and children who have overdosed on Klonopin within one to two hours, activated charcoal with airway protection may be recommended if necessary.¹

Can You Become Addicted to Klonopin?

Klonopin can be addictive when a person abuses or misuses the drug greater than the maximum recommended doses and uses other drugs, alcohol, or illicit substances.⁴ They develop drug tolerance, which means they need higher doses to achieve the same results they once did with lower doses.

Some individuals may develop drug dependence even if they are taking the recommended dose continuously for a few weeks after starting the treatment. When someone becomes addicted to Klonopin, their brain becomes reliant on it to experience relaxation and calmness.

Drug abuse can be prevented by dispensing small quantities by the pharmacist, regular follow-up visits by specialists to monitor signs of abuse or addiction, and individual counseling on avoiding opioids, alcohol, or illicit substances during treatment. For those with severe addiction, medical detoxification is a safe method that helps eliminate toxins from the body.

Additionally, supervised medication discontinuation under a doctor’s guidance can gradually taper the Klonopin dose over several weeks or months. These methods can prevent life-threatening physical and psychological complications that may arise if left untreated.

What to Expect When Increasing Klonopin Dosage

When the Klonopin dose is increased against the doctor’s advice, individuals may feel anxiety relief, relaxation, and calmness. They may experience symptoms like abdominal pain, lack of appetite, clumsy movements, anxiety, aggression, blurred vision, confusion, depression, disorientation, dizziness, euphoria, impaired concentration and memory, indigestion, irritability, muscle pain, slurred speech, tremors, and vertigo for several weeks.

It is important to remember that a high Klonopin dose can increase the risk of addiction, tolerance, and physical dependence. Therefore, it will increase the side effects of drug withdrawal like headache, hypertension, irritability, insomnia, muscle pain and stiffness, panic attacks, photophobia, restlessness, tachycardia, and tremor.

What if I Miss a Dose of Klonopin?

If a Klonopin dose is missed, or you stop taking the drug without guidance from your doctor, you may experience withdrawal reactions like seizures, high blood pressure, and heart failure.⁵ Therefore, it is recommended to taper the Klonopin dose under the supervision of a doctor. Typically they lower the dose by 0.25 mg weekly after using it for a few weeks.

Before stopping or reducing the drug dose, it is important to consult with your doctor. Abrupt drug discontinuation can lead to confusion, irritation, and depression. When you feel better or experience unpleasant side effects, drug continuation is still required. After an evaluation, your doctor may initiate dose tapering to avoid severe withdrawal symptoms. Once the body adjusts to the new dose, Klonopin withdrawal effects tend to subside after a few days.

Questions to Ask Your Health Team About Klonopin Dosage

Before you start taking Klonopin, tell your doctor if you are taking other drugs, including herbal remedies, vitamins, and supplements, or have any drug allergies. You must seek emergency medical attention by calling 911 and visiting the closest urgent medical care if you or someone else experience slow breathing, blue-colored lips, or can’t be woken up easily.

Questions to ask your care team about Klonopin dosages include:

• Is it safe to take Klonopin with my other medications?
• Will Klonopin be covered by my insurance?
• Does my medical history indicate a need to adjust my dosage?
• How long will it take before my symptoms improve?
• Should I let my therapist know I am taking this medication?
• What should I do if I want to stop taking Klonopin?
• How do I take Klonopin?
• Can I increase the dose if I see no improvement in my symptoms?
• Are there any side effects of Klonopin?
• What should I avoid during the Klonopin treatment?
• What to do if I miss a dose?
• Will I experience withdrawal effects after stopping it?
• Is it safe to use Klonopin during pregnancy and breastfeeding?

How to Get a Klonopin Prescription

Doctors may prescribe Klonopin for panic disorder and other conditions. Providers such as primary care physicians, psychiatrists, and psychiatric nurses may be authorized to prescribe Klonopin in local medical clinics. There are also several online psychiatry services offering professional guidance comparable to in-person services. Getting psychiatric care and prescriptions online may offer some advantages, such as additional privacy, improved access to specialists, and reduced travel time and expenses.

In My Experience

In my experience, Klonopin can be a safe and effective treatment for panic disorders, and acute mania when used correctly with medical guidance. However, due to its potential for abuse, doctors take precautions and monitor individuals to minimize addiction, dependence, and withdrawal risks.

For Further Reading

• Buspirone Vs Xanax: Differences, Similarities, & Which to Take
• How to Get Prescribed Xanax: Everything You Need to Know
• Klonopin Dosage: What to Know