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Clorazepate (Tranxene®)

By: Dr. Nicholas Dodman

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Overview

  • Behavioral disorders in dogs and cats are a common reason for veterinary visits. Unacceptable or dangerous animal behavior problems may lead to a pet's surrender and/or euthanasia.
  • Recently, veterinarians have placed greater emphasis on proper training and behavior modification of pets, and specialists working in the field of animal behavior have increasingly adopted drugs used in human behavior for animal use. Clorazepate dipotassium is one of these drugs.
  • Clorazepate belongs to a group of drugs known as benzodiazepines. Related drugs include diazepam (Valium®), midazolam and alprazolam.
  • Like diazepam, clorazepate's actions are mediated by its binding to benzodiazepine receptors in the central nervous system.
  • Clorazepate is a prescription drug and can only be obtained from a veterinarian or by prescription from a veterinarian. It is also a controlled substance.
  • This drug is not approved for use in animals by the Food and Drug Administration (FDA) but it may be prescribed legally by veterinarians as an extra-label drug.

    Brand Names and Other Names

  • This drug is registered for use in humans only.
  • Human formulations: Tranxene® (Abbott) and generic preparations
  • Veterinary formulations: None

    Uses of Clorazepate

  • Clorazepate is used to reduce anxiety in dogs and cats. Specific uses include treatment of thunderstorm phobia and other phobias, separation anxiety and other situational fears (car travel, veterinary office visits).
  • Like other benzodiazepines, clorazepate may be used as a muscle relaxant, anticonvulsant, or as an appetite stimulant.
  • It may also be useful for treatment of irritable bowel syndrome.
  • In cats, clorazepate has been recommended for treatment of feline hyperesthesia syndrome.

    Precautions and Side Effects

  • While generally safe and effective when prescribed by a veterinarian, clorazepate may cause side effects in some animals.
  • Clorazepate should not be used in animals with known hypersensitivity or allergy to the drug.
  • It should be avoided in patients with glaucoma.
  • Clorazepate should be used with caution in animals with liver or kidney disease.
  • Clorazepate should probably not be used in pregnant animals because of a risk of producing birth defects.
  • In some animals, clorazepate may cause paradoxical reactions, including hyperactivity and aggression.
  • Long-term treatment with clorazepate may lead to physical dependence and thus undesirable behavioral changes if the drug is discontinued abruptly. For this reason the dose should be tapered off over several weeks at the conclusion of treatment.
  • Elderly patients are prone to the central nervous system depressant effect of benzodiazepines, even at low doses.
  • Clorazepate may interact with other medications. Consult your veterinarian to determine if other drugs your pet is receiving could interact with clorazepate. Such drugs include cimetidine, digoxin, fluoxetine, ketoconazole, metoprolol, phenytoin, propranolol, theophylline and valproic acid.

    How Clorazepate Is Supplied

  • Clorazepate is available as 3.75 mg, 7.5 mg and 15 mg tablets. It is also available as 11.5 mg and 22.5 mg sustained delivery tablets.

    Dosing Information

  • Medication should never be administered without first consulting your veterinarian.
  • The typical dose range for clorazepate in dogs is 0.5 to 1 mg per pound (1 to 2 mg/kg) orally every 8 to 12 hours.
  • It has been recommended that the sustained delivery formulation be dosed at 22.5 mg for large dogs, 11.5 mg for medium-sized dogs, and 5.75 mg for small dogs, given every 12 to 24 hours.
  • In cats, the dose is 0.1 to 0.2 mg per pound (0.2 to 0.4 mg/kg) every 12 to 24 hours for mild conditions or 0.25 to 1 mg per pound (0.5 to 2.0 mg/kg) orally every 12 to 24 hours for severe conditions.
  • Your veterinarian will adjust the dosage depending on its effect on your pet, (such as signs of excessive sedation, excitement or poor coordination).
  • The duration of administration depends on the condition being treated, response to the medication and the development of any adverse effects. Be certain to complete the prescription unless specifically directed by your veterinarian.




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