Anxiolytic / Anticonvulsant  ·  Benzodiazepine

Clonazepam

Also known as: Rivotril, Klonopin, Clonotril

A long-acting benzodiazepine used for epilepsy and panic disorder. It is effective and widely available, with the same dependence risks as all medicines in its class.

ATC CodeN03AE01
Kenya EML 2023Listed
Level of UseLevel 4-6
This is health education, not medical advice. Never start, stop, or change a medication without speaking to a qualified healthcare professional first.
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Controlled Medicine

Clonazepam is a controlled substance in Kenya. It requires a prescription from a registered prescriber under the Narcotic Drugs and Psychotropic Substances Act.

Which conditions is Clonazepam used for?

What is Clonazepam?

Clonazepam is a benzodiazepine medicine used primarily for epilepsy and for panic disorder. It acts more slowly than some other benzodiazepines and lasts longer in the body, which makes it useful for conditions needing sustained coverage.

It is listed in Kenya's Essential Medicines List 2023 and is available through prescription at Level 4 facilities and above.

Like all benzodiazepines, clonazepam is effective when used appropriately. For anxiety and panic disorder, use should be kept as short as possible, as the body adapts to the medicine over weeks and dependence can develop.

What does it do in the brain?

Clonazepam enhances the effect of GABA, the brain's primary calming chemical, at GABA-A receptors throughout the nervous system. This widespread inhibitory effect reduces the abnormal electrical activity responsible for seizures, and also calms the nervous system overactivity associated with panic and severe anxiety.

How is it available?

Tablet
0.5 mg, 1 mg, 2 mg
Taken by mouth
Available at Level 4 to 6
Drops (oral solution)
2.5 mg/mL
Taken by mouth
Limited availability

Where is it available in Africa and what is it called?

Names and availability vary by country. Always confirm with a local pharmacist or healthcare provider.
CountryCommon Brand Name(s)Notes
UgandaRivotril, Clonazepam (generic)Available at private pharmacies in Kampala and at Butabika Hospital for epilepsy.
South AfricaRivotril, Clonazepam (generic)Available in public and private sectors; used for epilepsy and panic disorder.
NigeriaRivotril, KlonopinAvailable at teaching hospitals and private pharmacies in major cities.
GhanaClonazepam (generic)Available at Korle-Bu and larger specialist pharmacies.
TanzaniaClonazepam (generic)Available at Muhimbili National Hospital for epilepsy management.
EthiopiaClonazepam (generic)Available at major teaching hospitals in Addis Ababa.

What might you feel while taking it?

These are the most commonly reported effects. Not everyone experiences them, and many settle within the first few weeks.

  • Drowsiness and sedation, particularly at the start of treatment
  • Dizziness and unsteadiness
  • Memory and concentration difficulties
  • Muscle weakness
  • Slowed reaction time. Do not drive or operate machinery
  • Tolerance developing over time
Go to a doctor or emergency room straight away if you notice any of the following.
  • Dependence with use beyond a few weeks for anxiety
  • Breathing difficulty, particularly if combined with alcohol, opioids, or other sedating medicines
  • Paradoxical reactions, increased agitation in some people, particularly children and elderly

Important warnings before starting

Tell your doctor about all your medical conditions, allergies, and other medicines before starting Clonazepam.
  • Significant breathing problems or sleep apnoea
  • Severe liver disease
  • Myasthenia gravis
  • History of hypersensitivity to benzodiazepines

Situations that need extra attention

  • Do not combine with alcohol
  • Do not drive until you know how the medicine affects you
  • Elderly patients are particularly sensitive and have a higher fall and confusion risk
  • For epilepsy, never stop clonazepam suddenly, seizures can occur
  • For anxiety use, keep treatment as short as possible and discuss a reduction plan early
Pregnancy
Benzodiazepines can affect the baby, particularly near delivery. Speak to your doctor before making any changes if you are pregnant or planning a pregnancy.
Breastfeeding
Passes into breast milk and can cause infant sedation. Not recommended during breastfeeding without specialist review.

Medicines and substances that can interact with it

Always tell your doctor and pharmacist about every medicine, supplement, and herbal remedy you take, including those bought without a prescription.
  • Alcohol and opioid pain medicines: A potentially dangerous combination that greatly increases sedation and the risk of breathing problems.
  • Other sedating medicines: Sedative effects are amplified significantly.
  • Carbamazepine and other enzyme-inducing anticonvulsants: May reduce clonazepam levels. Your doctor will adjust as needed.

What your doctor will monitor

  • Seizure frequency and control for epilepsy use, reviewed at every appointment
  • Signs of tolerance or dependence, discussed openly with your doctor
  • Duration of treatment for anxiety, short-term use only, with regular review

What happens if you stop taking it?

Never stop clonazepam suddenly, especially if you have epilepsy. Abrupt withdrawal can cause seizures. A gradual reduction plan under medical supervision is essential.

What you should know about this medicine in Kenya

Clonazepam is available in Kenya at Level 4 and above and is a useful addition to the epilepsy treatment toolkit.

Its use for panic disorder fills an important gap in settings where access to psychological therapies for panic is limited. However, the goal should always be to use it as a bridge to longer-term treatment.

As with all benzodiazepines, awareness of dependence risk needs to improve to prevent long-term inappropriate use.

References

  1. Ministry of Health, Kenya. (2023). Kenya Essential Medicines List 2023. Nairobi: Ministry of Health.
  2. Ministry of Health, Kenya. (2023). Kenya National Medicines Formulary, 1st Edition. Nairobi: Ministry of Health.
  3. World Health Organization. (2023). Model List of Essential Medicines, 23rd Edition. Geneva: WHO.
  4. Government of Kenya. Narcotic Drugs and Psychotropic Substances Act (Cap 245).