Details
Stereochemistry | ACHIRAL |
Molecular Formula | C16H13ClN2O2 |
Molecular Weight | 300.74 |
Optical Activity | NONE |
Defined Stereocenters | 0 / 0 |
E/Z Centers | 0 |
Charge | 0 |
SHOW SMILES / InChI
SMILES
CN1C2=C(C=C(Cl)C=C2)N(C3=CC=CC=C3)C(=O)CC1=O
InChI
InChIKey=CXOXHMZGEKVPMT-UHFFFAOYSA-N
InChI=1S/C16H13ClN2O2/c1-18-13-8-7-11(17)9-14(13)19(16(21)10-15(18)20)12-5-3-2-4-6-12/h2-9H,10H2,1H3
DescriptionCurator's Comment: Description was created based on several sources, including https://www.drugs.com/cdi/clobazam.html; http://www.epilepsy.com/medications/clobazam https://www.ncbi.nlm.nih.gov/pubmed/?term=23318278
Curator's Comment: Description was created based on several sources, including https://www.drugs.com/cdi/clobazam.html; http://www.epilepsy.com/medications/clobazam https://www.ncbi.nlm.nih.gov/pubmed/?term=23318278
Clobazam belongs to the 1,5-benzodiazepine class of drugs with antiepileptic properties. It has been used to treat anxiety and epilepsy since 1970s. In the US clobazam was approved for marketing in October of 2011 for the adjunctive treatment of seizures associated with Lennox-Gastaut syndrome. It is also approved for adjunctive therapy for epilepsy in patients who have not responded to first-line drugs and in children who are refractory to first-line drugs. The mechanism of action for clobazam is not fully understood but is thought to involve what is known as potentiation of GABAergic neurotransmission resulting from binding at a benzodiazepine site at the GABA(A) receptor. Possible side effects: constipation, fever, drowsiness, sedation, ataxia, aggressive behavior, lethargy, drooling, and irritability. Other side effects include: urinary tract infection, pneumonia, cough, dysphagia, dysarthria, bronchitis, insomnia, fatigue, decreased appetite, and increased appetite.
Originator
Sources: https://www.ncbi.nlm.nih.gov/pubmed/35198
Curator's Comment: Discovery of Clobazam at the Maestretti Research Laboratories was first published in 1969. Maestretti Research Laboratories became part of Sanofi.
Approval Year
Targets
Primary Target | Pharmacology | Condition | Potency |
---|---|---|---|
Target ID: CHEMBL2093872 Sources: https://www.ncbi.nlm.nih.gov/pubmed/22145708 |
Conditions
Condition | Modality | Targets | Highest Phase | Product |
---|---|---|---|---|
Secondary | ONFI Approved UseIndicated for the adjunctive treatment of seizures associated with Lennox-Gastaut syndrome (LGS) in patients 2 years of age or older. Launch Date2011 |
Cmax
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
641 μg/L EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/6529527/ |
30 mg single, oral dose: 30 mg route of administration: Oral experiment type: SINGLE co-administered: |
CLOBAZAM plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
AUC
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
13741 μg × h/L EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/6529527/ |
30 mg single, oral dose: 30 mg route of administration: Oral experiment type: SINGLE co-administered: |
CLOBAZAM plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
T1/2
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
36 h |
30 mg 1 times / day unknown, oral dose: 30 mg route of administration: Oral experiment type: UNKNOWN co-administered: |
CLOBAZAM plasma | Homo sapiens population: UNKNOWN age: ADULT sex: FEMALE / MALE food status: UNKNOWN |
Funbound
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
10% |
30 mg 1 times / day unknown, oral dose: 30 mg route of administration: Oral experiment type: UNKNOWN co-administered: |
CLOBAZAM plasma | Homo sapiens population: UNKNOWN age: ADULT sex: FEMALE / MALE food status: UNKNOWN |
Doses
Dose | Population | Adverse events |
---|---|---|
80 mg 2 times / day steady, oral Highest studied dose Dose: 80 mg, 2 times / day Route: oral Route: steady Dose: 80 mg, 2 times / day Sources: Page: p. 69-70 |
healthy n = 70 Health Status: healthy Population Size: 70 Sources: Page: p. 69-70 |
Disc. AE: Somnolence, Depressed mood... Other AEs: Delirium... AEs leading to discontinuation/dose reduction: Somnolence (1 patient) Other AEs:Depressed mood (1 patient) Libido decreased (1 patient) Erectile dysfunction (1 patient) Insomnia (1 patient) Dysarthria (1 patient) Unsteady gait (1 patient) Dizziness (1 patient) Delirium (2 patients) Sources: Page: p. 69-70 |
10 mg 2 times / day steady, oral Dose: 10 mg, 2 times / day Route: oral Route: steady Dose: 10 mg, 2 times / day Sources: Page: p. 69 |
healthy n = 24 Health Status: healthy Population Size: 24 Sources: Page: p. 69 |
Disc. AE: Transaminases increased... AEs leading to discontinuation/dose reduction: Transaminases increased (1 patient) Sources: Page: p. 69 |
15 mg 2 times / day steady, oral Dose: 15 mg, 2 times / day Route: oral Route: steady Dose: 15 mg, 2 times / day Sources: Page: p. 69 |
healthy n = 24 Health Status: healthy Population Size: 24 Sources: Page: p. 69 |
Disc. AE: Transaminases increased... AEs leading to discontinuation/dose reduction: Transaminases increased (1 patient) Sources: Page: p. 69 |
20 mg 2 times / day steady, oral Dose: 20 mg, 2 times / day Route: oral Route: steady Dose: 20 mg, 2 times / day Sources: Page: p. 70 |
healthy n = 70 Health Status: healthy Population Size: 70 Sources: Page: p. 70 |
Disc. AE: Transaminases increased... AEs leading to discontinuation/dose reduction: Transaminases increased (2 patients) Sources: Page: p. 70 |
60 mg 2 times / day steady, oral Dose: 60 mg, 2 times / day Route: oral Route: steady Dose: 60 mg, 2 times / day Sources: Page: p. 69 |
healthy n = 24 Health Status: healthy Population Size: 24 Sources: Page: p. 69 |
Disc. AE: Somnolence... AEs leading to discontinuation/dose reduction: Somnolence (1 patient) Sources: Page: p. 69 |
70 mg 2 times / day steady, oral Dose: 70 mg, 2 times / day Route: oral Route: steady Dose: 70 mg, 2 times / day Sources: Page: p. 69 |
healthy n = 24 Health Status: healthy Population Size: 24 Sources: Page: p. 69 |
Disc. AE: Dizziness, Somnolence... AEs leading to discontinuation/dose reduction: Dizziness (1 patient) Sources: Page: p. 69Somnolence (1 patient) |
AEs
AE | Significance | Dose | Population |
---|---|---|---|
Depressed mood | 1 patient Disc. AE |
80 mg 2 times / day steady, oral Highest studied dose Dose: 80 mg, 2 times / day Route: oral Route: steady Dose: 80 mg, 2 times / day Sources: Page: p. 69-70 |
healthy n = 70 Health Status: healthy Population Size: 70 Sources: Page: p. 69-70 |
Dizziness | 1 patient Disc. AE |
80 mg 2 times / day steady, oral Highest studied dose Dose: 80 mg, 2 times / day Route: oral Route: steady Dose: 80 mg, 2 times / day Sources: Page: p. 69-70 |
healthy n = 70 Health Status: healthy Population Size: 70 Sources: Page: p. 69-70 |
Dysarthria | 1 patient Disc. AE |
80 mg 2 times / day steady, oral Highest studied dose Dose: 80 mg, 2 times / day Route: oral Route: steady Dose: 80 mg, 2 times / day Sources: Page: p. 69-70 |
healthy n = 70 Health Status: healthy Population Size: 70 Sources: Page: p. 69-70 |
Erectile dysfunction | 1 patient Disc. AE |
80 mg 2 times / day steady, oral Highest studied dose Dose: 80 mg, 2 times / day Route: oral Route: steady Dose: 80 mg, 2 times / day Sources: Page: p. 69-70 |
healthy n = 70 Health Status: healthy Population Size: 70 Sources: Page: p. 69-70 |
Insomnia | 1 patient Disc. AE |
80 mg 2 times / day steady, oral Highest studied dose Dose: 80 mg, 2 times / day Route: oral Route: steady Dose: 80 mg, 2 times / day Sources: Page: p. 69-70 |
healthy n = 70 Health Status: healthy Population Size: 70 Sources: Page: p. 69-70 |
Libido decreased | 1 patient Disc. AE |
80 mg 2 times / day steady, oral Highest studied dose Dose: 80 mg, 2 times / day Route: oral Route: steady Dose: 80 mg, 2 times / day Sources: Page: p. 69-70 |
healthy n = 70 Health Status: healthy Population Size: 70 Sources: Page: p. 69-70 |
Somnolence | 1 patient Disc. AE |
80 mg 2 times / day steady, oral Highest studied dose Dose: 80 mg, 2 times / day Route: oral Route: steady Dose: 80 mg, 2 times / day Sources: Page: p. 69-70 |
healthy n = 70 Health Status: healthy Population Size: 70 Sources: Page: p. 69-70 |
Unsteady gait | 1 patient Disc. AE |
80 mg 2 times / day steady, oral Highest studied dose Dose: 80 mg, 2 times / day Route: oral Route: steady Dose: 80 mg, 2 times / day Sources: Page: p. 69-70 |
healthy n = 70 Health Status: healthy Population Size: 70 Sources: Page: p. 69-70 |
Delirium | 2 patients | 80 mg 2 times / day steady, oral Highest studied dose Dose: 80 mg, 2 times / day Route: oral Route: steady Dose: 80 mg, 2 times / day Sources: Page: p. 69-70 |
healthy n = 70 Health Status: healthy Population Size: 70 Sources: Page: p. 69-70 |
Transaminases increased | 1 patient Disc. AE |
10 mg 2 times / day steady, oral Dose: 10 mg, 2 times / day Route: oral Route: steady Dose: 10 mg, 2 times / day Sources: Page: p. 69 |
healthy n = 24 Health Status: healthy Population Size: 24 Sources: Page: p. 69 |
Transaminases increased | 1 patient Disc. AE |
15 mg 2 times / day steady, oral Dose: 15 mg, 2 times / day Route: oral Route: steady Dose: 15 mg, 2 times / day Sources: Page: p. 69 |
healthy n = 24 Health Status: healthy Population Size: 24 Sources: Page: p. 69 |
Transaminases increased | 2 patients Disc. AE |
20 mg 2 times / day steady, oral Dose: 20 mg, 2 times / day Route: oral Route: steady Dose: 20 mg, 2 times / day Sources: Page: p. 70 |
healthy n = 70 Health Status: healthy Population Size: 70 Sources: Page: p. 70 |
Somnolence | 1 patient Disc. AE |
60 mg 2 times / day steady, oral Dose: 60 mg, 2 times / day Route: oral Route: steady Dose: 60 mg, 2 times / day Sources: Page: p. 69 |
healthy n = 24 Health Status: healthy Population Size: 24 Sources: Page: p. 69 |
Dizziness | 1 patient Disc. AE |
70 mg 2 times / day steady, oral Dose: 70 mg, 2 times / day Route: oral Route: steady Dose: 70 mg, 2 times / day Sources: Page: p. 69 |
healthy n = 24 Health Status: healthy Population Size: 24 Sources: Page: p. 69 |
Somnolence | 1 patient Disc. AE |
70 mg 2 times / day steady, oral Dose: 70 mg, 2 times / day Route: oral Route: steady Dose: 70 mg, 2 times / day Sources: Page: p. 69 |
healthy n = 24 Health Status: healthy Population Size: 24 Sources: Page: p. 69 |
Overview
CYP3A4 | CYP2C9 | CYP2D6 | hERG |
---|---|---|---|
OverviewOther
Other Inhibitor | Other Substrate | Other Inducer |
---|---|---|
Drug as perpetrator
Target | Modality | Activity | Metabolite | Clinical evidence |
---|---|---|---|---|
Page: 16.0 |
no | |||
Page: 16.0 |
no | |||
Page: 16.0 |
no | |||
Page: 16.0 |
no | |||
Page: 16.0 |
no | |||
Page: 17.0 |
no | |||
Page: 16.0 |
no | |||
Page: 16.0 |
no | |||
Page: 16.0 |
no | |||
Page: 16.0 |
no | |||
Page: 16.0 |
no | yes (co-administration study) Comment: clobazam increased dextromethorphan cmax 90%, auc 59% Page: 16.0 |
||
Page: 17.0 |
weak | |||
Page: 9.0 |
weak | yes (co-administration study) Comment: clobazam decreased midazolam auc 27%, cmax 24% Page: 9.0 |
Drug as victim
Target | Modality | Activity | Metabolite | Clinical evidence |
---|---|---|---|---|
Page: 15.0 |
major | yes (co-administration study) Comment: ketoconazole increased clobazam auc 54%, no effect on cmax Page: 15.0 |
||
Page: 15.0 |
minor | |||
Page: 15.0 |
minor | yes (co-administration study) Comment: omeprazole increased clobazam auc 30-36%, no effect on cmax Page: 15.0 |
||
Page: 96.0 |
no | |||
Page: 17.0 |
yes | yes (co-administration study) Comment: verapamil reduced clobazam transport >96% Page: 17.0 |
Tox targets
Target | Modality | Activity | Metabolite | Clinical evidence |
---|---|---|---|---|
Page: 20.0 |
PubMed
Title | Date | PubMed |
---|---|---|
Clobazam as a new antiepileptic drug and clorazepate dipotassium as an alternative antiepileptic drug in Japan. | 2004 |
|
Therapeutic drug monitoring of old and newer anti-epileptic drugs. | 2004 |
|
Development of a whole body physiologically based model to characterise the pharmacokinetics of benzodiazepines. 1: Estimation of rat tissue-plasma partition ratios. | 2004 Aug |
|
Screening, library-assisted identification and validated quantification of 23 benzodiazepines, flumazenil, zaleplone, zolpidem and zopiclone in plasma by liquid chromatography/mass spectrometry with atmospheric pressure chemical ionization. | 2004 Aug |
|
A major influence of CYP2C19 genotype on the steady-state concentration of N-desmethylclobazam. | 2004 Dec |
|
In vitro characterization of clobazam metabolism by recombinant cytochrome P450 enzymes: importance of CYP2C19. | 2004 Nov |
|
Affinity of various benzodiazepine site ligands in mice with a point mutation in the GABA(A) receptor gamma2 subunit. | 2004 Oct 15 |
|
Management of Landau-Kleffner syndrome. | 2005 |
|
Properties of antiepileptic drugs in the treatment of idiopathic generalized epilepsies. | 2005 |
|
Photosensitivity in idiopathic generalized epilepsies. | 2005 |
|
Levetiracetam in the treatment of infantile spasms. | 2005 |
|
Stiripentol: new preparation. Severe myoclonic epilepsy of infancy: promising. | 2005 Apr |
|
A case of toxic epidermal necrolysis with lesions mostly on sun-exposed skin. | 2005 Apr |
|
[Subacute encephalitis with anti-glutamate receptor antibodies presented with epilepsia partialis continua]. | 2005 Aug |
|
Molecular regulation of glutamate and GABA transporter proteins by clobazam during epileptogenesis in Fe(+++)-induced epileptic rats. | 2005 Dec 14 |
|
Clobazam as add-on therapy for temporal lobe epilepsy and hippocampal sclerosis. | 2005 Feb |
|
Effect of antiepileptic drug polytherapy on crystalluria. | 2005 Feb |
|
Intermittent clobazam therapy in febrile seizures. | 2005 Jan |
|
Treatment of electrical status epilepticus during slow-wave sleep with high-dose corticosteroid. | 2005 Jan |
|
[Antiepileptic drugs in the treatment of autistic regression syndromes]. | 2005 Jan 15 |
|
Stiripentol. | 2005 Jul |
|
Neuroembryopathic effect of clobazam in rat: a histological study. | 2005 Jun |
|
A common variable immunodeficient patient who developed acute disseminated encephalomyelitis followed by the Lennox-Gastaut syndrome. | 2005 Jun |
|
Motor impairment on awakening in a patient with an EEG pattern of "unilateral, continuous spikes and waves during slow sleep". | 2005 Jun |
|
Screening and confirmatory method for benzodiazepines and hypnotics in oral fluid by LC-MS/MS. | 2005 Jun 10 |
|
Evaluation of health status in epilepsy using the EQ-5D questionnaire: a prospective, observational, 6-month study of adjunctive therapy with anti-epileptic drugs. | 2005 May |
|
Visually self-induced seizures sensitive to round objects. | 2005 May |
|
Screening method for benzodiazepines and hypnotics in hair at pg/mg level by liquid chromatography-mass spectrometry/mass spectrometry. | 2005 Oct 15 |
|
Simultaneous determination of clobazam and its major metabolite in human plasma by a rapid HPLC method. | 2005 Sep 5 |
|
Levetiracetam in idiopathic generalised epilepsy and porphyria cutanea tarda. | 2006 |
|
[Epilepsy with electrical status epilepticus during slow sleep: diagnostic criteria and approaches to therapy]. | 2006 |
|
Stiripentol, a putative antiepileptic drug, enhances the duration of opening of GABA-A receptor channels. | 2006 Apr |
|
In vitro and in vivo inhibitory effect of stiripentol on clobazam metabolism. | 2006 Apr |
|
Landau-Kleffner syndrome is not an eponymic badge of ignorance. | 2006 Aug |
|
Effects of some antiepileptics on septal-kindled seizures in rats. | 2006 Dec |
|
[Epilepsy: which therapy in acute care?]. | 2006 Dec 8 |
|
Anticonvulsant hypersensitivity syndrome to lamotrigine confirmed by lymphocyte stimulation in vitro. | 2006 Feb |
|
Pharmacological properties of GABAA receptors containing gamma1 subunits. | 2006 Feb |
|
Eye rolling as a manifestation of clobazam toxicity in a child with epilepsy. | 2006 Jul |
|
Safety and efficacy of clobazam versus phenytoin-sodium in the antiepileptic drug treatment of solitary cysticercus granulomas. | 2006 Jun |
|
Benign angiopathy of the central nervous system associated with phenytoin intoxication. | 2006 Jun |
|
Abusive prescription of psychostimulants: a study of two cases. | 2006 Mar |
|
Clobazam as add-on therapy in children with epileptic encephalopathy. | 2006 May |
|
Oxidative stress in children receiving valproic acid. | 2006 Nov |
|
Quantification of benzodiazepines in whole blood and serum. | 2006 Nov |
|
Treatment in the pediatric emergency department is evidence based: a retrospective analysis. | 2006 Oct 6 |
|
Effectiveness of clobazam as add-on therapy in children with refractory focal epilepsy. | 2006 Sep |
|
The detection of sedatives in hair and nail samples using tandem LC-MS-MS. | 2007 Feb 14 |
|
Clobazam. | 2007 Jan |
|
Stiripentol. | 2007 Jan |
Sample Use Guides
Patients ≤30 kg body weight: Initiate at 5 mg daily and titrate as tolerated up to 20 mg daily. Patients > 30 kg body weight: Initiate at 10 mg daily and titrate as tolerated up to 40 mg daily. For doses above 5 mg/day administer in two divided doses. Dosage adjustment needed in following groups: Geriatric patients. Known CYP2C19 poor metabolizers. Mild or moderate hepatic impairment; no information for severe hepatic impairment.
Route of Administration:
Oral
In Vitro Use Guide
Sources: http://www.ncbi.nlm.nih.gov/pubmed/14636342
Recurrent ictal-like seizures (ILEs, four per hour) were generated in intact corticohippocampal formations (CHFs) of P7-8 rats, and extracellular recordings were performed in the hippocampus and neocortex. Clobazam was applied at clinically relevant concentrations (at least two), during 30 min after the third ILE. Clobazam prevented the occurrence of seizures in recurrent ictal-like seizures.
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DEA NO. |
2751
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FDA ORPHAN DRUG |
248307
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LIVERTOX |
NBK548865
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WHO-ATC |
N05BA09
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NCI_THESAURUS |
C28197
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WHO-VATC |
QN05BA09
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NDF-RT |
N0000175694
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31413
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CLOBAZAM
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C012255
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244-908-7
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Clobazam
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m3626
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N0000182137
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ACTIVE MOIETY
METABOLITE (PARENT)
METABOLITE (PARENT)
METABOLITE (PARENT)
METABOLITE (PARENT)
METABOLITE ACTIVE (PARENT)