Section 01 · Monograph
Clorazepate
Reviewed Nov 2026FDA label
Tranxene T-TabBenzodiazepine
- Forms
- Tab: 3.75, 7.5, 15mg
- Dose
- Adjunct partial seizures: start 7.5mg TID, increase 7.5mg weekly, max 90mg/day
- MOA
- ↑GABA-A Cl- channel frequency
Black Box Warning
- Concomitant use of benzodiazepines and opioids may result in profound sedation, respiratory depression, coma and death
- Abuse, misuse and addiction risk
- Dependence and withdrawal reactions
Indications
- Adjunctive therapy for partial seizuresFDA-labeled
- Anxiety disordersFDA-labeled
- Acute alcohol withdrawalFDA-labeled
Mechanism of Action
- Prodrug converted to the active metabolite desmethyldiazepam; benzodiazepine positive modulation of GABA-A receptors
Full Dosing
Adult / usual
- Adjunct for partial seizures, adults and age over 12: start 7.5mg TID, increase by no more than 7.5mg weekly; maximum 90mg/day
- Ages 9-12: start 7.5mg BID; maximum 60mg/day
- Taper gradually to avoid withdrawal seizures
Contraindications
- Acute narrow-angle glaucoma
- Known hypersensitivity
Drug Interactions
- Opioids and other CNS depressants: profound sedation
- CYP inhibitors may raise levels
Adverse Effects
- Sedation, dizziness, ataxia
- Dependence and withdrawal
- Respiratory depression with opioids
Monitoring Parameters
- Sedation and cognitive effects
- Misuse risk
- Seizure control and gradual taper
Pregnancy & Lactation
- Late-pregnancy exposure can cause neonatal sedation or withdrawal
- Present in milk; monitor infants