通用名称：氯巴占
英文名称：Clobazam
中文别名：氯巴扎姆、氯巴扎母、氯巴扎酮、氧异安定、异安定酮
英文别名：Frisium
【药理】
本品具有抗焦虑和抗惊厥作用，抗电休克作用的ED50比地西泮小而比苯巴比妥、丙戊酸钠大。治疗安全范围比地西泮、苯巴比妥、丙戊酸钠宽。口服吸收快而完全，服药 1— 3小时后达血药峰浓度，经肝脏代谢，代谢产物为 N-去甲基氧异安定，同样有抗惊厥作用，作用强度为氯巴占的 2/3。 t1/2为 60小时，如每日用药 30mg，约 6天达稳态血浓度。
【适应症】
本品适用于治疗对其它抗癫痫药无效的难治性癫痫，可单独应用，亦可作为辅助治疗用。对复杂部分性发作继发全身性发作和
Lennox-Gas-laut综合征效果更佳。
【用法用量】
口服：从小剂量开始，每日 20— 30mg(0.5— 1mg／kg)，逐步加量。如与其它抗癫痫药合用，则应减少本品剂量，每日应用 5— 15mg(0.1— 0.3mg/kg)。
如连续应用，其抗惊厥作用逐渐减弱，可采用“放假疗法”，如女性患者，在月经期发作时，可在月经来潮前 2—3天开始用药，10天后停用。
【制剂】片剂：每片 10mg， 20mg。
【不良反应】
不良反应与其它苯二氮卓类相似，但都较轻微，偶见有轻度的镇静、焦躁、抑郁和肌无力。
【相互作用】
与卡马西平、苯巴比妥、苯妥英钠、丙戊酸合用时，本品的血浓度降低，而其它药浓度升高。合用丙戊酸钠时，N-去甲基代谢产物血浓度降低，而合用卡马西平、苯妥英钠时， N-甲基代谢产物浓度升高，因而合用时应注意调整剂量。

How does it work?
Clobazam belongs to a group of medicines called benzodiazepines.
The brain and nerves are made up of many nerve cells that communicate with each other through electrical signals. These signals must be carefully regulated for the brain and nerves to function properly.

When abnormally rapid and repetitive electrical signals are released in the brain, it becomes over-stimulated and normal function is disturbed. This results in fits or seizures. Anxiety may also be related to the inappropriate stimulation of nerves in the brain.

GABA is a chemical that, when released in the brain, acts as a natural calming agent and keep the nerve activity in balance. Once the brain absorbs the GABA (uptake), this chemical can no longer act on the nerves. Too little GABA, the brain may become overexcited.

Clobazam acts on receptors in the brain (GABA receptors) to increase the release of GABA. This increases the calming effects of nerve cells by GABA. By calming nerve cells, clobazam prevents excessively rapid and repetitive firing of electrical signals. Thereby electrical nerve activity in the brain is stabilised, leading to prevention and treatment of fits and maintenance of normal brain function.

As clobazam prevents fitting, it may be used (in conjunction with another anti-epileptic medicine) for the treatment of epilepsy.

Clobazam may also be used to relieve anxiety in serious or disabling anxiety related conditions. It is not recommended for the long-term treatment of anxiety due to the development of dependence (recommended maximum of 4 weeks).

What is it used for?
- Epilepsy
- Short term treatment of severe anxiety

Warning!
- This medicine may reduce your ability to drive or operate machinery safely. Do not drive or operate machinery until you know how this medicine affects you and you are sure it won`t affect your performance.
- You should not suddenly stop taking this medicine unless your doctor tells you otherwise.

Use with caution in
- Abnormal muscle weakness (myasthenia gravis)
- Elderly people
- Kidney disease
- Liver disease
- Personality disorders
- Severe or sudden decrease in lung function (severe or acute pulmonary insufficiency)
- Shaky or unsteady voluntary movements e.g walking (cerebellar ataxia)
- Syndrome involving short spells when breathing stops during sleep (sleep apnoea syndrome)

Not to be used in
- Allergy to any medicine in the benzodiazepine family
- Children under three years of age
- Long-term psychotic illness
- Phobias or obsessional states
- Single medicine to treat depression or anxiety related to depression

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.

If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and Breastfeeding
Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.
- This medicine should not be used during pregnancy or breastfeeding. Seek medical advice from your doctor.

Side effects
Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.
- Dry mouth
- Drowsiness
- Shaking, usually of the hands (tremor)
- Addiction to the medicine (dependence)
- Muscle weakness
- Restlessness
- Disturbances of the gut such as diarrhoea, constipation, nausea, vomiting or abdominal pain
- Decreased appetite
- Dizziness

The side effects listed above may not include all of the side effects reported by the drug`s manufacturer.

For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

How can this medicine affect other medicines?
Clobazam blood levels may be increased by cimetidine.
Clobazam may alter the blood levels of some other anti-epileptic medicines such as phenytoin and sodium valproate. Clobazam blood levels may be altered by other antiepileptic medicines such as carbamazepine, phenobarbital and phenytoin.

There may be an increase in side effects such as sedation and dizziness when clobazam is taken with:
- Alcohol
- Antipsychotic medicines such as clozapine
- Pain-relieving medicines such as morphine
- and sedating medicines such as other benzodiazepines.

Clobazam may increase the effect of:
- Muscle relaxants such as baclofen
- and pain relieving medicines such as morphine.