Influence of phenytoin and phenobarbital on the disposition of a single oral dose of clonazepam

Clin Pharmacol Ther. 1980 Sep;28(3):368-75. doi: 10.1038/clpt.1980.175.

Abstract

Clonazepam (CZP) was measured in the plasma of eight subjects for 48 hr after a 0.03-mg/kg oral dose. After pretreatment for 19 days with phenytoin (DPH, 4.3 mg/kg/day), plasma CZP concentrations were determined in the same subjects after another 0.03 mg/kg oral dose of CZP. The same protocol was followed in eight additional subjects using phenobarbital (PB, 1.4 mg/kg/day) instead of DPH. DPH pretreatment lowered mean plasma CZP concentration in 8 of the 12 time points. DPH pretreatment increased CZP clearance by 46% to 58% and decreased CZP half-life (t1/2) by 31%. Both changes were statistically significant. After PB pretreatment the mean plasma CZP concentration was lowered by an average of 11%, but the decrease was statistically significant for only 1 of the 12 time points. PB decreased mean CZP t1/2 by 11% and increased CZP clearance by 19% to 24%, but only the increase in clearance was statistically significant. Both DPH and PB increased CZP clearances and decreased the areas under the plasma concentration-time curves without altering the volumes of distribution. This observation is consistent with induction of CZP metabolism. The overall effect of DPH (4.3 mg/kg/day) was greater than the effect of PB (1.4 mg/kg/day). Neither the DPH or PB had a significant effect on the extent of CZP protein binding.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Benzodiazepinones / metabolism*
  • Clonazepam / metabolism*
  • Drug Interactions
  • Female
  • Half-Life
  • Humans
  • Kinetics
  • Male
  • Metabolic Clearance Rate / drug effects
  • Models, Biological
  • Phenobarbital / pharmacology*
  • Phenytoin / pharmacology*

Substances

  • Benzodiazepinones
  • Clonazepam
  • Phenytoin
  • Phenobarbital