Clobazam (Onfi)
Generic Name: Clobazam
Brand Names: Frisium, Onfi
Drug Class: Benzodiazepine anti-seizure medication
Primary Uses: Lennox-Gastaut syndrome, adjunctive treatment for focal and generalized seizures
Common Side Effects: Drowsiness, drooling, concentration difficulties, slurred speech, sleep disturbance
What is Clobazam?
Clobazam is an anti-seizure medication from the benzodiazepine family. It is used to control certain types of seizures and is often added to other seizure medications to improve seizure control. It has been used successfully for many years, particularly in children with difficult-to-control epilepsy.
How It Works
Clobazam works by enhancing the effect of GABA, a natural calming chemical in the brain. This helps reduce the abnormal electrical activity that causes seizures. Unlike some other benzodiazepines, clobazam is specifically designed for long-term seizure control.
Who Might Take This Medication?
Clobazam is FDA-approved for:
- Lennox-Gastaut syndrome in adults and children 2 years and older
- Adjunctive (add-on) treatment for various seizure types
It is also commonly used off-label for other types of epilepsy, including focal seizures and generalized seizures, under medical supervision.
Common Side Effects
Some children may have one or more of the following side effects. These should go away as your child’s body gets use to the drug. Discuss the side effects with your doctor if they continue:
- Drowsiness
- Concentration difficulties
- Drooling
- Slurred speech
- Sleep disturbance
When to Contact Your Doctor
You should be seen by a medical professional if any of the following develop:
- Weight gain
- EXCESSIVE tiredness or weakness
- Behavioral changes (hyperactivity, agitation, aggression)
- Mood changes (feelings of depression or suicidal thoughts)
- Any other symptom that could be of concern to you
- This medication can cause drowsiness, especially when starting or increasing the dose. Use caution with activities requiring alertness.
- Tolerance may develop over time, meaning the medication may become less effective. Discuss any changes in seizure control with your doctor.
- This is a controlled substance due to potential for dependence with long-term use.
Monitoring and Special Considerations
- Blood levels are not routinely required
- Your doctor may adjust the dose based on response and side effects
- Periodic monitoring of liver function may be recommended
- Starting with a low dose and increasing gradually can help reduce side effects
Frequently Asked Questions
Q: How long does it take to work?
A: Clobazam often works relatively quickly, sometimes within days, though the full effect may take a few weeks as the dose is adjusted.
Q: What if I miss a dose?
A: Take it as soon as you remember. If it is close to the next dose, skip the missed dose and continue your regular schedule. Do not double doses. If you miss several doses, call your doctor before restarting.
Q: Can clobazam cause drowsiness?
A: Yes, drowsiness is one of the most common side effects, especially when starting the medication or increasing the dose. This often improves over time but may persist in some people.
Q: Will my child develop tolerance to clobazam?
A: Some people may develop tolerance over time, meaning the medication becomes less effective. If this happens, your doctor will discuss whether to adjust the dose or consider other treatment options.
Q: Can this medication affect behavior or mood?
A: Yes. Some children may experience behavioral changes such as hyperactivity, agitation, or aggression. Others may have mood changes. Report any concerning changes to your healthcare provider promptly.
Q: Will this medication affect my weight?
A: Some people experience weight gain while taking clobazam. Your doctor will monitor your weight regularly.
Q: How do I know if clobazam is working?
A: Track your seizures and any side effects in a simple log. Discuss changes with your healthcare provider to adjust dosing if needed.
All of the possible uses, cautions, side effects, or interactions of this drug are not covered in this handout. If you want more information about this medication, ask your child’s doctor, pharmacist, or nurse. This information handout does not pertain to pregnancy or breastfeeding—talk to your doctor if this is a concern.
This information is for educational purposes only and does not replace medical advice. Always consult your healthcare provider about medications and treatment decisions.