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=CC=C(Cl)C=C2N(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
| Molecular Formula | C16H13ClN2O2 |
| Molecular Weight | 300.74 |
| Charge | 0 |
| Count |
|
| Stereochemistry | ACHIRAL |
| Additional Stereochemistry | No |
| Defined Stereocenters | 0 / 0 |
| E/Z Centers | 0 |
| Optical Activity | NONE |
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: |
healthy Health Status: healthy Sources: |
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: |
10 mg 2 times / day steady, oral Dose: 10 mg, 2 times / day Route: oral Route: steady Dose: 10 mg, 2 times / day Sources: |
healthy Health Status: healthy Sources: |
Disc. AE: Transaminases increased... AEs leading to discontinuation/dose reduction: Transaminases increased (1 patient) Sources: |
15 mg 2 times / day steady, oral Dose: 15 mg, 2 times / day Route: oral Route: steady Dose: 15 mg, 2 times / day Sources: |
healthy Health Status: healthy Sources: |
Disc. AE: Transaminases increased... AEs leading to discontinuation/dose reduction: Transaminases increased (1 patient) Sources: |
20 mg 2 times / day steady, oral Dose: 20 mg, 2 times / day Route: oral Route: steady Dose: 20 mg, 2 times / day Sources: |
healthy Health Status: healthy Sources: |
Disc. AE: Transaminases increased... AEs leading to discontinuation/dose reduction: Transaminases increased (2 patients) Sources: |
60 mg 2 times / day steady, oral Dose: 60 mg, 2 times / day Route: oral Route: steady Dose: 60 mg, 2 times / day Sources: |
healthy Health Status: healthy Sources: |
Disc. AE: Somnolence... AEs leading to discontinuation/dose reduction: Somnolence (1 patient) Sources: |
70 mg 2 times / day steady, oral Dose: 70 mg, 2 times / day Route: oral Route: steady Dose: 70 mg, 2 times / day Sources: |
healthy Health Status: healthy Sources: |
Disc. AE: Dizziness, Somnolence... AEs leading to discontinuation/dose reduction: Dizziness (1 patient) Sources: Somnolence (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: |
healthy Health Status: healthy Sources: |
| 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: |
healthy Health Status: healthy Sources: |
| 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: |
healthy Health Status: healthy Sources: |
| 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: |
healthy Health Status: healthy Sources: |
| 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: |
healthy Health Status: healthy Sources: |
| 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: |
healthy Health Status: healthy Sources: |
| 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: |
healthy Health Status: healthy Sources: |
| 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: |
healthy Health Status: healthy Sources: |
| 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: |
healthy Health Status: healthy Sources: |
| 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: |
healthy Health Status: healthy Sources: |
| 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: |
healthy Health Status: healthy Sources: |
| 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: |
healthy Health Status: healthy Sources: |
| 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: |
healthy Health Status: healthy Sources: |
| 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: |
healthy Health Status: healthy Sources: |
| 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: |
healthy Health Status: healthy Sources: |
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 |
|---|---|---|
| The detection of sedatives in hair and nail samples using tandem LC-MS-MS. | 2007-02-14 |
|
| Clobazam. | 2007-01 |
|
| Stiripentol. | 2007-01 |
|
| [Epilepsy: which therapy in acute care?]. | 2006-12-08 |
|
| Effects of some antiepileptics on septal-kindled seizures in rats. | 2006-12 |
|
| Oxidative stress in children receiving valproic acid. | 2006-11 |
|
| Quantification of benzodiazepines in whole blood and serum. | 2006-11 |
|
| Treatment in the pediatric emergency department is evidence based: a retrospective analysis. | 2006-10-06 |
|
| Effectiveness of clobazam as add-on therapy in children with refractory focal epilepsy. | 2006-09 |
|
| Landau-Kleffner syndrome is not an eponymic badge of ignorance. | 2006-08 |
|
| Eye rolling as a manifestation of clobazam toxicity in a child with epilepsy. | 2006-07 |
|
| Safety and efficacy of clobazam versus phenytoin-sodium in the antiepileptic drug treatment of solitary cysticercus granulomas. | 2006-06 |
|
| Benign angiopathy of the central nervous system associated with phenytoin intoxication. | 2006-06 |
|
| Clobazam as add-on therapy in children with epileptic encephalopathy. | 2006-05 |
|
| Stiripentol, a putative antiepileptic drug, enhances the duration of opening of GABA-A receptor channels. | 2006-04 |
|
| In vitro and in vivo inhibitory effect of stiripentol on clobazam metabolism. | 2006-04 |
|
| Abusive prescription of psychostimulants: a study of two cases. | 2006-03 |
|
| Anticonvulsant hypersensitivity syndrome to lamotrigine confirmed by lymphocyte stimulation in vitro. | 2006-02 |
|
| Pharmacological properties of GABAA receptors containing gamma1 subunits. | 2006-02 |
|
| 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 |
|
| Molecular regulation of glutamate and GABA transporter proteins by clobazam during epileptogenesis in Fe(+++)-induced epileptic rats. | 2005-12-14 |
|
| Screening method for benzodiazepines and hypnotics in hair at pg/mg level by liquid chromatography-mass spectrometry/mass spectrometry. | 2005-10-15 |
|
| Simultaneous determination of clobazam and its major metabolite in human plasma by a rapid HPLC method. | 2005-09-05 |
|
| [Subacute encephalitis with anti-glutamate receptor antibodies presented with epilepsia partialis continua]. | 2005-08 |
|
| Stiripentol. | 2005-07 |
|
| Screening and confirmatory method for benzodiazepines and hypnotics in oral fluid by LC-MS/MS. | 2005-06-10 |
|
| Neuroembryopathic effect of clobazam in rat: a histological study. | 2005-06 |
|
| A common variable immunodeficient patient who developed acute disseminated encephalomyelitis followed by the Lennox-Gastaut syndrome. | 2005-06 |
|
| Motor impairment on awakening in a patient with an EEG pattern of "unilateral, continuous spikes and waves during slow sleep". | 2005-06 |
|
| Evaluation of health status in epilepsy using the EQ-5D questionnaire: a prospective, observational, 6-month study of adjunctive therapy with anti-epileptic drugs. | 2005-05 |
|
| Visually self-induced seizures sensitive to round objects. | 2005-05 |
|
| Stiripentol: new preparation. Severe myoclonic epilepsy of infancy: promising. | 2005-04 |
|
| A case of toxic epidermal necrolysis with lesions mostly on sun-exposed skin. | 2005-04 |
|
| Clobazam as add-on therapy for temporal lobe epilepsy and hippocampal sclerosis. | 2005-02 |
|
| Effect of antiepileptic drug polytherapy on crystalluria. | 2005-02 |
|
| [Antiepileptic drugs in the treatment of autistic regression syndromes]. | 2005-01-15 |
|
| Intermittent clobazam therapy in febrile seizures. | 2005-01 |
|
| Treatment of electrical status epilepticus during slow-wave sleep with high-dose corticosteroid. | 2005-01 |
|
| 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 |
|
| A major influence of CYP2C19 genotype on the steady-state concentration of N-desmethylclobazam. | 2004-12 |
|
| In vitro characterization of clobazam metabolism by recombinant cytochrome P450 enzymes: importance of CYP2C19. | 2004-11 |
|
| Affinity of various benzodiazepine site ligands in mice with a point mutation in the GABA(A) receptor gamma2 subunit. | 2004-10-15 |
|
| Development of a whole body physiologically based model to characterise the pharmacokinetics of benzodiazepines. 1: Estimation of rat tissue-plasma partition ratios. | 2004-08 |
|
| 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. | 2004-08 |
|
| 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 |
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.
| Substance Class |
Chemical
Created
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on
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| Record UNII |
2MRO291B4U
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Validated (UNII)
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| Classification Tree | Code System | Code | ||
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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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22316-47-8
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31413
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CLOBAZAM
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C012255
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DTXSID2046759
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2789
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336279
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3055
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2MRO291B4U
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DB00349
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SUB06673MIG
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100000084299
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CHEMBL70418
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8343
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2MRO291B4U
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C81615
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244-908-7
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Clobazam
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21241
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m3626
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N0000182137
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PRIMARY | Cytochrome P450 2D6 Inhibitors [MoA] | ||
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7149
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682
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METABOLIC ENZYME -> INDUCER | |||
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BINDING
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EXCRETED UNCHANGED |
FECAL
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EXCRETED UNCHANGED |
Clobazam is cleared mainly by metabolism with subsequent renal elimination of metabolites. In a mass balance study, 82% of the dose administered was recovered in the urine and 11% in the feces. Clobazam represents ~2 % of the dose recovered in urine.
URINE
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ACTIVE MOIETY |
| Name | Property Type | Amount | Referenced Substance | Defining | Parameters | References |
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