Published on 22 February 2023

Rivotril 2 Mg Tablets: Uses, Side Effects, Price & Dosage

Clonazepam (Klonopin) rivotril-2-mg-tablet
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Anxiety is nowadays a common problem, no matter the age. Age is just a factor in this modern world to get things negatively. You might go through various issues and still look fine outside.

The materialistic world has given so many advantages and disadvantages to happiness. Anxiety problems cannot be ignored, yet they should not be taken as more stress. Stress would lead the anxiety levels on a bigger scale.

The very first medicine many people have suggested is Rivotril. It is one of the most used and prescribed medicines for people. Know more about it in detail.

What Is Rivotril?

Rivotril, commonly known by its generic name Clonazepam, is a member of the benzodiazepine drug class. Benzodiazepines are typical sedatives used to reduce anxiety. Besides anxiolytic properties, Rivotril is a controlled substance and also an anticonvulsant.

Another well-known brand name with the same chemical composition is Klonopin. The benzodiazepine Rivotril 2mg has a lengthy half-life and significant potency with the GABA-A receptor. It has agonistic properties to the GABA-A receptor causing anti-anxiolytic effects. It also stimulates the synthesis of serotonin, which has serotonergic effects.

FDA Approved Indications

Seizure Disorders

  • acute management of epilepsy and non-convulsive status epilepticus
  • controls petit mal absences, Lennox-Gastaut syndrome, and infantile spasm
  • helpful in treating psychomotor, myoclonic epilepsies, grand mal, and focal motor seizures.
  • Panic Disorders and acute treatment of panic attacks

Off Label Indications

  • Acute mania
  • Akathisia
  • Restless leg syndrome
  • Insomnia
  • Tardive dyskinesia
  • Rapid eye movement behavior disorder, and
  • Bruxism

How Does Rivotril Work?

Rivotril works by reducing the activity of the nerves in the brain. as a positive allosteric modulator on GABA-A receptors and thus exerts its pharmacological effects. The limbic system and cortex are rich reservoirs of the inhibitory neurotransmitter GABA. It functions by enhancing gamma-aminobutyric acid's action (GABA).

GABA receptors exist in three distinct subtypes: A, B, and C. Benzodiazepines (BZDs) exclusively affect GABA-A receptors. BZDs promote GABA-A activity by increasing the frequency of chloride channel opening, thus leading to hyperpolarization of the neurons and decreased firing.

GABA-A is an inhibitory neurotransmitter in the brain that reduces neuron excitability. When there is a disturbance to this delicate balance, seizures and panic attacks can occur. . When using this medication, the body produces more GABA, causing central nervous system depression, and stops these crises.

Concerning various seizure disorders, Rivotril has a large spectrum of effects. There are different brands or formulations of this drug available.

Frequently Asked Questions

Rivotril can be used off-label as a sleeping pill. As it is a benzodiazepine, which is a class of drugs used to treat anxiety, stop seizures, and calm tense muscles. When used to address sleeping issues, this can also help reduce insomnia and is often prescribed briefly.
Rivotril is not generally recommended for long-term use as there is a high risk of developing an addiction.
The use of benzodiazepines and benzodiazepine-like medications, such as Rivotril, is linked to a higher risk of strokes in patients with Alzheimer's disease in one study only.

Who Can And Cannot Take Rivotril?

Do not take Rivotril if you:

  • Are you allergic to it or any of the medication's constituents, or have you ever experienced an adverse response to a benzodiazepine (e.g., Lorazepam, Diazepam, Oxazepam)
  • Glaucoma that is acute, narrow, or closed-angle (manufacturers stated that Rivotril is not contraindicated for those with open-angle glaucoma).
  • Possess myasthenic fibrosis
  • Have serious respiratory issues
  • Have liver condition
  • Have sleep apnea
  • Have previous mental health or alcohol and drug issues

If you are unsure if you should take Rivotril, consult your doctor.

When Should You Take Rivotril Medicine?

Follow your physician's instructions for the dosage and duration of Rivotril. Swallow it as a whole. Don't chew, break, or crush it. A once-before-bed dose can reduce tiredness.

To maximize the effectiveness of orally disintegrated tablets, patients should swallow the whole pill immediately after taking it out of the package.


There are immediate-release tablets of Rivotril in strengths of 0.5 mg, 1 mg, and 2 mg and orally disintegrating tablets (ODT) in strengths of 0.125 mg, 0.25 mg, 0.5 mg, 1 mg, and 2 mg.

Age Group Condition Dose
Adults and adolescents (weight > 30 kg) Seizure prophylaxis 0.5 mg thrice daily. Until seizures are under control, the dosage may be increased by 0.5 to 1 mg every three days. The daily intake shouldn't exceed 20 mg.
Geriatric patients Seizure prophylaxis Same as adults. It may require lower doses initially.
Pediatric patients (weight < 30 kg) Seizure prophylaxis The initial dosage recommendation is 0.01 to 0.03 mg/kg/day, divided into two or three doses. The maximum dose shouldn't be higher than 0.1 to 0.2 mg/kg in 3 doses.
General population Panic Disorder Take two 0.25 mg tablets twice a day orally for the first three days. After that, increase the dose to 0.5 mg tablets twice a day. The daily intake shouldn't be more than 1 to 4 mg.

Note: A doctor should strictly guide dosage increases.

What If You Overdose On Rivotril?

Seek immediate medical attention if you believe someone has an overdose of Rivotril.

Signs of Rivotril overdose are as follows:

  • Coma
  • Cardiac arrest
  • Dilated pupils or double vision
  • Extreme sedation
  • Impaired coordination
  • Passing out
  • Slowed reflexes
  • Clammy skin
  • Breathing difficulties
  • Weak and rapid pulse
  • Low blood pressure

Treatment for an overdose is mainly supportive care. If breathing issues exist, this may include gastric lavage, intravenous fluids for hypotension, and artificial breathing. The use of Flumenazil as an antidote to Rivotril overdose is currently controversial as it can lead to other severe side effects, especially if multiple drug toxicities are suspected. It is rarely used in severe central nervous depression with close monitoring.

Possible Side Effects

As with any medication, undesired effects can occur after taking the drug. Some mild side effects could appear when using Rivotril for the first time; however, most will disappear as your body gets used to the medication.

Common Side Effects Severe Side Effects
Dizziness Allergic reaction
Drowsiness Depression
Fatigue Suicidal thoughts
Headache Memory problems
Hair Loss Rashes or hives
Dry Mouth Anaphylaxis
Constipation Shortness of breath and wheezing
Vertigo Rapid or irregular heartbeat
Irritability Abnormal thinking (disorientation, delusion)

What Precautions Do You Have To Take?

Precautions are cautionary steps to prevent any unwanted effects of the drug. These are necessary for the safe use of the drug. Benzodiazepines can have serious side effects when coupled with opioid medications or alcohol.

  • Be sure to tell your doctor about any allergies or conditions, drugs you are taking, whether you are pregnant or nursing, and other important health information before taking medication. Before taking any medication, let your doctor know if you have any allergies or conditions and all your medications.
  • Avoid using Rivotril with alcohol or other sedatives, such as narcotic painkillers, sleeping pills, antidepressants, and anti-anxiety medications, as it can result in further drowsiness and difficulty breathing.
  • Severe withdrawal symptoms may occur if the dose is abruptly stopped or lowered. The severity of these withdrawal symptoms can be reduced or avoided by gradually decreasing the amount while under a doctor's care.
  • While taking Rivotril, avoid tasks demanding mental alertness, judgment, and physical coordination, like operating machinery or a vehicle. Note: As a general rule, epileptic patients cannot drive.
  • Since Rivotril is eliminated through the kidneys and processed in the liver, monitor blood levels in patients with either hepatic or renal impairment because either condition can cause toxic drug accumulation in the body.
  • When a person has several different seizure disorders, Rivotril can make their seizures worse. In that scenario, the use of Rivotril needs to be reviewed by your doctor. They may increase the dosage or add another anticonvulsant to the regimen.
  • Rivotril use is linked to a higher risk of depression and suicidal thoughts and actions. Therefore, it is important to warn patients and their caretakers to watch for signs of depression, mood changes, or suicidal thoughts.
  • While taking this drug, avoid consuming grapefruit juice as it may cause your blood levels of Rivotril to rise.
  • This drug enters breast milk. Rivotril used while nursing could cause infant sedation and breathing difficulties.
  • It may not be safe to use Rivotril during pregnancy. This is due to the risk of the infant developing dependency on this medication, thus causing withdrawal symptoms after birth.

While using this drug, you should use an effective form of birth control. Female patients should inform their doctor if they plan to become pregnant or start nursing.

Can Rivotril Use Lead To Abuse?

Continuous Rivotril use may lead to dependence and addiction, similar to benzodiazepines. The risk of dependence and addiction increases with the dose and duration of treatment. Once dependency is developed, you can suddenly produce withdrawal symptoms if you stop taking Rivotril.

Symptoms of Rovotril Abuse:

  • A Lack of Motivation.
  • Fatigue.
  • Memory Loss
  • Constipation.
  • Depression-Like Emotions.
  • A Poor State Of Nutrition.

Rivotril might cause physical dependence if taken enough over time. Due to this, Rivotril is cautiously prescribed and progressively weaned off once treatment is no longer required.

In the United States, 17 million Rivotril prescriptions were written in 2011. The Future Study reports that 7.4% of high school seniors have taken tranquilizer drugs at some point. This group includes benzodiazepines like Rivotril.

Drug Interactions

Interactions between medications could affect how your medications work or lead to side effects. Ask your doctor how to handle any drug interactions that may exist.

  • As benzodiazepines and opioids act on receptor sites in the central nervous system (CNS) that regulate respiration, using them together raises the risk of respiratory depression.
  • Avoid alcohol intake while taking Rivotril because it may make you drowsy, sleepy, and have trouble focusing and breathing problems.

Other drugs that interact with Rivotril include:

  • Opioids such as codeine, hydromorphone, fentanyl, tramadol, dezocine, and methadone
  • Ketamines
  • Antihistamines, including diphenhydramine, cetirizine, and chlorpheniramine
  • Antiepileptic drugs- carbamazepine, phenytoin, and valproic acid
  • Benzodiazepines like diazepam, alprazolam, and lorazepam
  • antipsychotic drugs- clozapine, haloperidol, and risperidone
  • Monoamine oxidase inhibitors (MAOIs)
  • Buspirone
  • Tricyclic antidepressants
  • Barbiturates
  • Zolpidem
  • Antifungal- voriconazole

Bottom Line From Practical Anxiety Solutions

Rivotril medication is frequently provided to patients with epilepsy or other seizure disorders. Rivotril is available only with your physician's prescription. When starting Rivotril for panic attacks or anxiety, your symptoms may improve quickly over a few days or even just a few hours after the first dose.

Long-term Rivotril abusers may discover that they require a hefty dose of the medication to achieve the same euphoria as with earlier use. Rivotril carries the risk of Abuse, misuse, and dependence associated with benzodiazepines. Even when used as directed, Rivotril has the potential to cause addiction, physical dependence, and emotional reliance. Ask your doctor how long the course of treatment should last.

If you have ever struggled with drug abuse or a substance use disorder, mention it to your doctor. You may experience withdrawal symptoms when stopping Rivotril. The risk can be minimized by gradually lowering the dosage. Avoid abruptly stopping the use of Rivotril and refrain from changing your therapy without first talking to your doctor.

  • Zorzanelli, Rafaela, Fabola Giordani, Lusiele Guaraldo, Guacira Corra de Matos, and Arnaldo Gomes de Brito JuniorNcleo. "Consumption of the benzodiazepine clonazepam (Rivotril) in Rio de Janeiro State, 2009-2013: an ecological study Clonazepam (Rivotril) use in Rio de Janeiro, 2009-2013: an ecological study." Obtain On 22/02/2023
  • Mikkelsen, Bent, Peter Berggreen, Poul Joensen, Ole Kristensen, Ole Khler, and Birgit Ohrt Mikkelsen. "Clonazepam (Rivotril) and carbamazepine (Tegretol) in psychomotor epilepsy: a randomized multicenter trial."Epilepsia 22, no. 4 (1981): 415-420. Obtain On 22/02/2023
  • Eeg?Olofsson, Orvar. "EXPERIENCES WITH RIVOTRIL in TREATMENT OF EPILEPSYPARTICULARLY MINOR MOTOR EPILEPSYIN MENTALLY RETARDED CHILDREN."Acta Neurologica Scandinavica 49, no. S53 (1973): 29-31. Obtain On 22/02/2023