Clonazepam for the treatment of sleep disorders in children

What is clonazepam?

Clonazepam is a sedative medicine belonging to group of medicines called benzodiazepines. It can have a calming effect and is prescribed for various conditions, however your consultant has prescribed it for your child’s sleep problems.

How do I give this medicine?

The clinician at your sleep service may prescribe clonazepam 0.5mg or 1mg which is taken as a ‘once a day’ dose, usually at bedtime. It is available as a tablet or liquid (which may contain small amounts of alcohol). Do not change the dose unless your clinician advises you.

Swallowing clonazepam tablets

Clonazepam tablets are small, and most children will manage to swallow them well. Tablets can also be crushed and mixed with a small amount of soft food. Tablets can also be dispersed in a small amount of water.

What should I do if I forget to give the medicine?

If you forget to give the medicine and your child is still awake at bedtime then give it as soon as you remember, realistically within a couple of hours. Taking a sedative in the morning may affect your daily activities.

Never give 2 doses together to make up for a forgotten dose.

Are there any possible side effects?

Most medicines can cause unwanted side effects, although not everyone experiences them. The following are examples of some of the side effects reported by people taking clonazepam. Speak with your doctor, sleep pharmacist or nurse if any of the following continue or become troublesome.

Common or very common side effects:

• groggy
• drowsiness in mornings
• mood alteration
• anxiety
• dizziness
• respiratory depression
• fatigue

Some unusual effects are sometimes seen with children using long term clonazepam such as increased anxiety, aggression, and antisocial acts.

For further information on side effects, please see the manufacturer’s leaflet that comes with the medicine. Clonazepam may form drug dependency over long term use. The effectiveness may be reduced significantly after weeks or months of continuous therapy.

If any of the side effects persist or become a problem, contact your sleep service.

Can I give clonazepam with other medicines?

Clonazepam may interact with some medicines. It is important to let us know about any medicines that your child is currently taking so that we can check clonazepam is suitable for them.

If you are buying any medicines for your child over the counter from a pharmacy, always mention that your child has been prescribed clonazepam. It is safe to take paracetamol and ibuprofen with this medicine but always ask your sleep pharmacist first.

You should get advice when buying herbal or homeopathic remedies.

How will treatment be reviewed?

We will review your child’s treatment on an ongoing basis in the Sleep Clinic and adjust your clonazepam dose in response to your child’s symptoms. Your consultant will want to check to make sure that the treatment is helping. Your child may need to have their blood pressure and heart rate, weight and height checked regularly.

How do I get a repeat prescription?

Your consultant or sleep pharmacist will provide repeat prescriptions.

Stopping clonazepam

Treatment with clonazepam can be long-term for some children. Continue to give the medicine to your child unless a clinician advises you to change this. We do not recommend stopping the medicine suddenly or too quickly as it may cause withdrawal symptoms, and your sleep pharmacist may want you to reduce your dose gradually.

Sleep problems often occur when clonazepam is stopped. It may take several weeks for these to improve.

Discuss with your consultant or sleep pharmacist if you wish to stop clonazepam.

Driving

If you are old enough to drive, you must let the Driver and Vehicle Licensing Authority (DVLA) know if you are taking clonazepam.

You should use your judgement (and your parent’s judgement) every time you need to drive to decide if you have the right ability.

If you are a driver, please be aware that clonazepam may affect your reactions and ability to drive. It is illegal to drive while your reactions are impaired.

Other activities

Drowsiness can affect other activities like bike riding and sports activities. Make sure your child is able and fit to do these physical activities.

Your consultant will advise you about this the first time they prescribe clonazepam.

Pregnancy and breastfeeding

Clonazepam is not recommended for use during pregnancy and breastfeeding. It should be used in circumstances if benefits significantly outweigh risks.

If you discover that you are pregnant you should discuss with your consultant as soon as possible, so that you can agree a management plan.

Sleep routine

It is still important to aim for your child to get around 9 to 11 hours of sleep at night, depending on their age. Your child should try to go to bed when they are tired and get up at about the same time each day. Clonazepam along with appropriate sleep routine will potentially improve sleep and other related symptoms more effectively.

Operations

If your child is due to have an operation or dental treatment, it is important that you tell your consultant or GP who can advise you further.

Drinking alcohol

Do not drink alcohol while you are on clonazepam, as it may increase the risk of side effects such as mood changes, confusion, reduced breathing rate or sleep disturbances.

Expiry dates

The expiry date should be printed on the medicine container and/or strip.

Do not use the medicine after the expiry date. Return any unused medicine to your local pharmacy for safe disposal.

Storage and safety

Clonazepam should be stored safely and kept out of reach of children. Do not share this medicine with anyone else. If anyone other than the person it has been prescribed for takes this medicine, contact NHS 111 for advice. If they are unwell, they should call for an ambulance.

Contact us

Medicines Helpline

If you have any questions or concerns about your medicines, please speak to the medical professionals caring for you.

Sleep team secretaries on 0114 271 7400 between 9am to 5pm, Monday to Friday.

Rowland’s Outpatient pharmacy on 0114 278 8488 between 9am to 5pm, Monday to Friday.

Other resources

Sleep UK
You might find this charity’s website useful for connecting with patients who suffer from the same condition as you, but any information found should not alter your current treatment. You should discuss any new advice with the doctor caring for your condition.

NHS 111
Offers medical help and advice from fully trained advisers supported by experienced nurses and paramedics. Available over the phone 24 hours a day on 111.

NHS.uk
Provides online information and guidance on all aspects of health and healthcare, to help you make choices about your health.