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Clorazepate Dipotassium

By Rania Gollakner, BS, DVM, MPH

Medications

What is clorazepate dipotassium?

Clorazepate dipotassium (brand names: Tranxene-SD®, Gen-Xene®) is a benzodiazepine used to treat behavior disorders and seizures. Anxiety disorders and phobias are most often treated with this medication.  

Its use in cats and dogs to treat seizures and behavior disorders is ‘off label’ or ‘extra label’. Many drugs are commonly prescribed for off label use in veterinary medicine. In these instances, follow your veterinarian’s directions and cautions very carefully as their directions may be significantly different from those on the label.

How is clorazepate given?

Clorazepate is given by mouth in the form of a tablet. It may also be compounded into a liquid form. Measure liquid forms carefully. It may be given with or without food; however, if vomiting occurs when dosed on an empty stomach, give future doses with food. When using for phobias or other triggers, if possible, give this medication an hour prior to the triggering event. When using for seizures, give this medication around the same time each day. Do not leave your pet unattended the first time this medication is given.

This medication will take effect quickly, in about 1 to 2 hours, and improvement in clinical signs should follow.

What if I miss giving my pet the medication?

Give the missed dose as soon as you remember, and then wait the recommended amount of time between doses. Never give your pet two doses at once or give extra doses.

Are there any potential side effects?

Common side effects include sleepiness and incoordination, and these effects are usually mild and temporary. Increased appetite, drooling, unusual behaviors, or slow learning may also occur.

In cats, sudden liver damage is possible. Seizures are possible if this medication has been used long-term and then is stopped abruptly. Serious side effects include confusion, coma, lack of appetite, continued vomiting, yellowing of the skin, eyes, and gums, and severe weakness.

This moderate-acting medication should stop working in a few days, although effects can be longer in pets with liver or kidney disease.

Are there any risk factors for this medication?

Clorazepate should not be used in pets that are allergic to it or other benzodiazepines. Do not use clorazepate in pets with significant liver disease. It should be used very cautiously in aggressive, pregnant, older, or debilitated pets, or in pets with glaucoma, general liver disease, or kidney disease. When using clorazepate long-term, do not stop abruptly, as it can cause seizures. Do not use this medication in pets that are nursing; use a milk replacer.   

Are there any drug interactions I should be aware of?

The following medications should be used with caution when given with clorazepate: amiodarone, antacids, antihypertensive agents, carbonic anhydrase inhibitors, central nervous system depressant agents, digoxin, fluoxetine, fluvoxamine, hepatic enzyme inducers or inhibitors, ifosfamide, lithium, nondepolarizing neuromuscular blockers, phenytoin, rifampin, theophylline/aminophylline, tricyclic antidepressants, valproic acid, or yohimbine.

Be sure to tell your veterinarian about any medications (including vitamins, supplements, or herbal therapies) that your pet is taking.

Is there any monitoring that needs to be done with this medication?

There is no specific monitoring that needs to be done while your pet is taking this medication. Your veterinarian may monitor your pet to be sure that the medication is working. Monitor your pet at home for serious side effects.

How do I store clorazepate?

Store this medication at room temperature between 68°F and 77°F (20°C and 25°C), in a dry place and protected from moisture and direct sunlight.

What should I do in case of emergency?

If you suspect an overdose or an adverse reaction to the medication, call your veterinary office immediately. If they are not available, follow their directions in contacting an emergency facility.

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