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Introduction About PANAZEP LS TABLET

PANAZEP LS TABLET is a combination of Clonazepam and Paroxetine which belongs to the group of medicines called Anticonvulsants and Antidepressants respectively. It is used to manage depression and anxiety.

It can also be used in the management of fits (epilepsy), panic attacks, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (anxiety caused due to any traumatic event) and in certain types of phobias (fears).

Take PANAZEP LS TABLET preferably with or after meals or as directed by your physician. Do not stop taking this medicine abruptly without consulting your doctor as it may cause certain unpleasant withdrawal symptoms. Talk to your doctor about all the medicines that you take to manage your current illnesses.

Before taking PANAZEP LS TABLET, inform your doctor if you have any problems in your liver, kidney or heart. You must also inform your doctor if you have diabetes, glaucoma, breathing problems, bleeding disorders, mania, previous history of drug abuse, alcohol abuse or suicide as a precaution.

Do not take PANAZEP LS TABLET without consulting your doctor if you are pregnant or breastfeeding. The most common side effects of taking PANAZEP LS TABLET are headache, dizziness, tiredness, sleepiness, tremor, nausea, constipation, diarrhea, dry mouth, increased sweating, lack of sleep, high blood cholesterol levels, erectile dysfunction and weight gain. Consult your doctor if any of these side effect worsens.

You must also inform your doctor immediately if you experience worsening of depression along with suicidal thoughts or having severe muscle stiffness, shakiness, fever and/or chest pain as a precaution.

Uses Of PANAZEP LS TABLET

It is used to manage:

Depression
Anxiety
Fits (epilepsy)
Obsessive-compulsive disorder
Post-traumatic stress disorder
Panic attacks or phobias (fears)
Obsessive-compulsive disorder

How PANAZEP LS TABLET Works

PANAZEP LS TABLET contains two medicines namely clonazepam and paroxetine. Clonazepam is an anticonvulsant. It suppresses the abnormal electrical activity within the brain and induces calmness.

Paroxetine is an antidepressant medicine. It works by regulating the release and uptake of certain chemical messengers (dopamine and serotonin) within the brain that affects thoughts, emotions, body movements and behaviour. As a result, it manages seizures, improves your ability to think, controls your emotions and stabilizes your mental health.

How to use PANAZEP LS TABLET

Take PANAZEP LS TABLET as advised by your physician. Swallow the medicine with a glass of water. Do not crush or chew the medicine. It must be taken with or after meals.

Your doctor will decide the correct dose and duration of therapy for you depending upon your age, body weight and disease conditions.

Do not stop taking PANAZEP LS TABLET without consulting your doctor, even if you feel better during the mid-way of therapy as it could lead to withdrawal symptoms (such as tremors, sleep disturbances, headaches, muscle pain, extreme anxiety, tension, restlessness, confusion, irritability and fits).

Side Effects Of PANAZEP LS TABLET

Common

Headache, dizziness
Tiredness, weakness, sleepiness
Tremor, difficulty in concentration
Nausea, vomiting, constipation, diarrhea, dry mouth
Increased sweating
Lack of sleep
Agitation
Abnormal dreams
Loss of appetite
High blood cholesterol levels
Blurred vision
Abnormal heart rate
Sexual dysfunction, decreased sex drive, erectile dysfunction
Weight gain

Uncommon

Changes in blood sugar levels
Confusion
Hallucinations
Shakiness, involuntary muscle movements
Changes in blood pressure
Feeling dizzy while standing up
Skin rash
Unable to pass urine, painful urination

Rare

Hyperpigmentation
Hair loss
Urge to pass urine
Low blood sodium levels
Joint pain, muscle pain
Breast milk production

Stop taking PANAZEP LS TABLET and contact your doctor immediately if you experience any of the following side effects:

suicidal thoughts and behaviour
feeling restless, urge to move, increased irritation
signs of serotonin syndrome (feeling agitated, hallucinations, confusion, loss of consciousness, fast heartbeat, feeling dizzy, increased sweating, flushing, tremors, stiff muscles, or muscle twitching, loss of coordination, nausea, vomiting, diarrhea or seizures)
signs of Neuroleptic Malignant Syndrome (such as fever, fast heartbeat, sweating, severe muscle stiffness, confusion, increased muscle enzymes)
increased signs of bleeding or bruising
signs of allergic reactions (such as skin rash, itching, swellling of the face, lips, tongue and throat which causes difficulty in breathing or swallowing)
changes in behavior (such as feeling agitated, restless, aggressive, irritable, violent or angry, false beliefs, nightmares and hallucinations or other inappropriate behavior)
fits, memory loss
signs of heart problems (such as fast or irregular heart rate, fainting, dizziness upon standing)

How To Manage Side Effects

Constipation

Eat plenty of fiber rich foods such as fresh fruits, vegetables, and cereals. Drink plenty of fluids. Exercise more regularly. Consult your doctor if this side effect bothers you.

Dizziness Or Drowsiness

Try to rest and relax. Get enough sleep. Avoid driving or operating any tools or machines completely while you are feeling dizzy. Consult your doctor if your dizziness worsens.

Headache

Rest and relax. Keep yourself hydrated by drinking plenty of fluids such as water or electrolytes. Applying a pain-relieving balm on your forehead can be beneficial. Do not consume excessive alcohol, as it could aggravate your headache. Consult your doctor if your headache worsens.

Nausea And Vomiting

Take PANAZEP LS TABLET with or just after meals. Stick to simple meals. Avoid eating oil rich or spicy foods. Consult your doctor if your nausea worsens.

Warning & Precautions

Pregnancy

Risky

PANAZEP LS TABLET is generally not recommended for use in pregnant women unless considered necessary by the physician, as it may harm the growing baby. Therefore, inform your doctor before taking PANAZEP LS TABLET if you are pregnant, think you might be pregnant or planning to have a baby.

Breastfeeding

Contraindicated

PANAZEP LS TABLET is not recommended for use in breastfeeding women as it may pass through the breast milk to the nursing infant. Therefore, consult your doctor before taking it.

Driving and Using Machines

Use with Caution

Do not drive or handle any heavy tools or machines if your ability is affected by PANAZEP LS TABLET.

Alcohol

Consult your doctor

Avoid consumption of alcohol while taking PANAZEP LS TABLET as it might make you feel dizzier and drowsier.

Kidney

Use with Caution

PANAZEP LS TABLET should be used with caution in patients with kidney problems. Therefore, consult your doctor before taking it.

Liver

Consult your doctor

PANAZEP LS TABLET is not recommended for use in patients with severe liver problems (such as liver cirrhosis). It should be used with caution in patients with other liver problems. Therefore, consult your doctor before taking it.

Allergy

Contraindicated

Do not take PANAZEP LS TABLET if you are allergic to Clonazepam or Paroxetine.

Lungs

Consult your doctor

PANAZEP LS TABLET is not recommended for use in patients with severe lung problems (such as pulmonary insufficiency or respiratory insufficiency). It should be used with caution in patients with COPD. Therefore, consult your doctor before taking it.

Heart Disease

Use with Caution

PANAZEP LS TABLET should be used with caution in patients with heart problems. Therefore, consult your doctor before taking it.

Use In Pediatrics

Contraindicated

PANAZEP LS TABLET is not recommended for use in children and adolescents (aged below 18 years). Therefore, consult your doctor before taking it.

Use In Geriatrics

Use with Caution

PANAZEP LS TABLET should be used with caution in elderly patients (aged above 65 years). Therefore, consult your doctor before taking it.

Others

PANAZEP LS TABLET is not recommended for use if you:

have myasthenia gravis (severe muscle weakness)
have sleep apnea (breathing stops and starts during sleep)
are in coma
have an history of alcoholism or drug abuse

Before taking PANAZEP LS TABLET, inform your doctor if you:

have previously experienced depression with thoughts of committing suicide
have poor muscle control caused due to problems in nervous system
have porphyria (a rare inherited blood disorder)
have mania (sudden extreme sense of excitement and hyperactivity)
have diabetes
are in any on-going electroconvulsive therapy
have glaucoma
have any bleeding disorders

Interactions

A. Drug - Drug interactions:

Before taking PANAZEP LS TABLET, inform your doctor if you are taking any of the following medicine such as:

medicine used to manage depression like monoamine oxidase inhibitors (Ex. tranylcypromine, moclobemide iproniazid, nialamide, isocarboxazid, toloxatone), fluvoxamine, lithium, selegiline, amitriptyline, imipramine, bupropion, St. John’s wort
linezolid (a medicine used to manage bacterial infection)
methylene blue (a medicine used to manage high methaemoglobin in blood)
medicines used to manage psychiatric disorders (such as pimozide, haloperidol, risperidone, thioridazine, chlorpromazine, clozapine)
medicines used to manage epilepsy (such as carbamazepine, phenytoin, phenobarbital, sodium valproate, primidone)
medicines used for blood thinning (such as heparin, warfarin)
medicines used for pain relief (such as aspirin, celecoxib, tramadol, ibuprofen, diclofenac)
tamoxifen (a medicine used to manage cancer)
medicines used to reduce anxiety and to induce sleep (such as alprazolam, midazolam, clonazepam, nitrazepam)
general anaesthetic (used to create of loss of consciousness before surgery) such as methoxyflurane and trichloroethylene
muscle relaxants (used for muscle relaxation prior to surgeries) such as tubocurarine
cimetidine (a medicine used for managing stomach ulcers)
rifampicin (a medicine used to manage tuberculosis)
tryptophan (a medicine used to manage mental illness)
medicines used to manage migraine headache (such as sumatriptan)
opioid analgesic medications (such as buprenorphine, morphine, codeine or propoxyphene, pethidine, fentanyl etc.)
pravastatin (a medicine used to control blood cholesterol levels)
medicines used to manage viral infections (such as fosamprenavir/ritonavir)
procyclidine (a medicine used to reduce muscle contractions and body secretions)

B. Drug-Food interactions:

PANAZEP LS TABLET should be taken with or after meals.

Overdosage:

If you or anyone else accidentally took more PANAZEP LS TABLET, consult your doctor immediately or visit the nearby hospital. Symptoms of overdose might include drowsiness, joint pain, rapid eye movements, low blood pressure and breathing difficulties.

Synopsis

Drug	:	Clonazepam, Paroxetine
Pharmacological Category	:	Benzodiazepines, Selective serotonin reuptake inhibitors
Therapeutic Indication	:	Depression, Anxiety
Dosage Forms	:	Tablet, Capsule

More Information

Keep PANAZEP LS TABLET out of reach of children
Store PANAZEP LS TABLET at room temperature

FAQs About PANAZEP LS TABLET

Q: What is the use of PANAZEP LS TABLET?

A: PANAZEP LS TABLET is used to manage depression and anxiety. It can also be used in the management of fits (epilepsy), panic attacks, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (anxiety caused due to any traumatic event) and in certain types of phobias (fears).

Q: How PANAZEP LS TABLET works in my body?

A: PANAZEP LS TABLET suppresses the abnormal electrical activity within the brain and induces sleep. It also regulates the release and uptake of certain chemical messengers (dopamine and serotonin) within the brain that affects thoughts, emotions, body movements, and behaviour. As a result, it improves your ability to think, controls your emotions and stabilizes your mental health.

Q: Can PANAZEP LS TABLET be used in children?

A: PANAZEP LS TABLET is not recommended for use in children and adolescents (aged below 18 years). Therefore, consult your doctor before taking it.

Q: Can PANAZEP LS TABLET be used during pregnancy?

A: PANAZEP LS TABLET is generally not recommended for use in pregnant women unless considered necessary by the physician, as it may harm the growing baby. Therefore, inform your doctor before taking PANAZEP LS TABLET if you are pregnant, think you might be pregnant or planning to have a baby.

Q: Will the use of PANAZEP LS TABLET cause sleepiness?

A: Yes, PANAZEP LS TABLET can make your feel sleepy, drowsy, or tired. Therefore, do not drive or handle heavy machines or tool if you feel drowsy or sleepy. Avoid consumption of alcohol as it can aggravate your drowsiness.

Q: Can I consume alcohol while taking PANAZEP LS TABLET?

A: Avoid consumption of alcohol while taking this medicine as it may make you feel more dizzy or drowsy.

Q: What to do if I forget to take a dose of PANAZEP LS TABLET?

A: If you forget to take a dose of PANAZEP LS TABLET, take it as soon as you remember. However, if it is time to take the next dose, skip the missed dose and take the next one at regular times. Do not take a double dose of PANAZEP LS TABLET to compensate a missed dose, as it could lead to toxicity.

Q: Will taking a higher dose of PANAZEP LS TABLET than the prescribed one be beneficial?

A: No, taking a higher dose of PANAZEP LS TABLET will not be effective rather it can lead to toxicity. Always take the dose prescribed by your doctor. If the prescribed dose is not effective for you, consult your doctor for advice. Your doctor might increase the dose or suggest an alternative therapy.

Q: Can I stop taking PANAZEP LS TABLET once my symptoms subside?

A: No. Do not stop taking PANAZEP LS TABLET without consulting your doctor even if you feel better during the mid-way of the therapy. Sudden discontinuation of therapy may cause withdrawal symptoms such as headaches, muscle pain, tension, restlessness, confusion, mood changes, difficulty in sleeping, irritability, dizziness, tingling sensation, tiredness or weakness, nausea, vomiting and tremors.

Q: Can PANAZEP LS TABLET be taken daily?

A: Yes. PANAZEP LS TABLET can be taken daily as per your doctor’s instruction. However, if you are doubtful, consult your doctor.

Q: How to take PANAZEP LS TABLET?

A: Take PANAZEP LS TABLET as advised by your physician. Swallow the medicine with a glass of water. Do not crush or chew the medicine.

Q: What are the common side effects of taking PANAZEP LS TABLET?

A: The most common side effects of taking PANAZEP LS TABLET are headache, dizziness, tiredness, sleepiness, tremor, nausea, constipation, diarrhea, dry mouth, increased sweating, lack of sleep, high blood cholesterol levels, erectile dysfunction and weight gain. Consult your doctor if any of these side effect worsens.

Q: Can PANAZEP LS TABLET cause weight gain?

A: Yes. Weight gain is one of the common side effects of taking PANAZEP LS TABLET. If this side effect bothers you, contact your doctor.

Q: Will PANAZEP LS TABLET reduce my sex drive?

A: Yes. PANAZEP LS TABLET may affect your sexual life. It may decrease sex drive or cause problems in orgasm, ejaculation or erection. Therefore, consult your doctor if you experience any such symptoms.

References

1. KD. Tripathi. Drugs Acting on Central Nervous System. Antiepileptic Drugs. Drugs Used in Mental Illness: Antidepressant and Antianxiety Drugs. Essentials of Medical Pharmacology. 7th Edition. Page – 418 & 461.

2. Boadie W. Dunlop and Paula G. Davis. Combination Treatment With Benzodiazepines and SSRIs for Comorbid Anxiety and Depression: A Review. NIH. National Library of Medicine. National Center for Biotechnology Information. PMC. PubMed Central. 2008. [Accessed on 23rd February 2023] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2446479/

3. Neuraxpharm UK Limited. Clonazepam Neuraxpharm 0.5 mg, 1 mg and 2 mg. Electronic Medicines Compendium. [Revised in October 2021]. [Accessed on 23rd February 2023] https://www.medicines.org.uk/emc/files/pil.13633.pdf

4. Milpharm Limited. Paroxetine 20 mg film-coated tablets Paroxetine 30 mg film-coated tablets. Electronic Medicines Compendium. [Revised in January 2023]. [Accessed on 23rd February 2023] https://www.medicines.org.uk/emc/files/pil.537.pdf

5. Torrent Pharmaceuticals Ltd. Clonotril P. (Paroxetine Controlled Release and Clonazepam Capsules). [Revised in September 2017]. [Accessed on 23rd February 2023] https://www.torrentian.com/pisheet/Upload/PI_Sheet/2755.pdf

Author Details

Written By Srilekha. R - B.Pharm

Reviewed For Accuracy By Dr. Aravindan Balachandran - MBBS, MD (Psychiatry)

Last updated on 25 Feb 2023 | 03:47 PM(IST)