It's a type of medicine called a Clonazepam pregnancy and breastfeeding warnings. It is the primary metabolite of clonazepam (Item Nos. Bioanalysis. An official website of the United States government. Benzodiazepines (BZ) are one class of drugs that can be challenging to detect using OF [7], [9], [10]. [103], Combined use of clonazepam with certain antidepressants, anticonvulsants (such as phenobarbital, phenytoin, and carbamazepine), sedative antihistamines, opiates, and antipsychotics, nonbenzodiazepines (such as zolpidem), and alcohol may result in enhanced sedative effects. Urinary analyses of the metabolite 7-aminoclonazepam (7-AC) can be helpful in monitoring drug abuse and in the context of suspected drug-facilitated sexual assaults (DFSA). Tell your doctor right away if you have new or sudden changes in mood or behavior, including new or worse depression or anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, more active or talkative, or have thoughts about suicide or hurting yourself. The following urine samples were collected from each volunteer: one before CLO administration, and 6 h, and 1, 3, 5, 8, 10, 14, 21 and 28 days after. Disposition of toxic drugs and chemicals in man. [105], Clonazepam enhances the activity of the inhibitory neurotransmitter gamma-aminobutyric acid (GABA) in the central nervous system to give its anticonvulsant, skeletal muscle relaxant, and anxiolytic effects. Both the parent drug and 7-aminoclonazepam are unstable in biofluids, and therefore specimens should be preserved with sodium fluoride, stored at the lowest possible temperature and analyzed quickly to minimize losses. Simultaneous analysis of 14 benzodiazepines in oral fluid by solid-phase extraction and LC-MS-MS. The objective of this paper was to determine how long after administration of benzodiazepine clonazepam (CLO), its major metabolite 7-aminoclonazepam (7-ACLO) could be detected in urine collected from 10 healthy volunteers who received a single 3-mg dose of Klonopin (clonazepam). 14263 | ISO60181). panic attacks, insomnia, and generalized anxiety. [9], There is some medical evidence of various malformations (for example, cardiac or facial deformations when used in early pregnancy); however, the data is not conclusive. [116] The anticonvulsant properties of benzodiazepines are due to the enhancement of synaptic GABA responses, and the inhibition of sustained, high-frequency repetitive firing. medicines that don't need a prescription and any illegal drugs you may use. MeSH Afterward, the site may be slightly sore. Follow your doctor's instructions about tapering your dose. Unable to load your collection due to an error, Unable to load your delegates due to an error. Read and carefully follow any Instructions for Use provided with your medicine. [10] For the postmortem group, the cases (n=27) with relatively high (>0.2 mg/kg) clonazepam+7-aminoclonazepam values were examined in greater detail. Qriouet Z, Qmichou Z, Bouchoutrouch N, Mahi H, Cherrah Y, Sefrioui H. J Anal Methods Chem. Clin Infect Dis. A considerable amount of 7-aminoclonazepam (ACZP), a major metabolite of clonazepam (CZP), is present in the brain during CZP treatment, yet the pharmacological properties of ACZP remain unknown. In humans, tolerance to the anticonvulsant effects of clonazepam occurs frequently. Key words: Clonazepam, 7-aminoclonazepam, pain management, LC-MS/MS, immunoassay, patient compliance [127], Clonazepam passes rapidly into the central nervous system, with levels in the brain corresponding with levels of unbound clonazepam in the blood serum. In general, the following guidance may be helpful: Positive for alprazolam and alpha-OH-alprazolam, Write in Other field(Paper Requisition). [75][76] One-third of individuals treated with benzodiazepines for longer than four weeks develop a dependence on the drug and experience a withdrawal syndrome upon dose reduction. 2016 Mar;95(9):e2881. World Psychiatry. 0000004622 00000 n 2009 Apr 28;9:5. doi: 10.1186/1471-227X-9-5. 0000005469 00000 n Mandrioli R, Mercolini L, Raggi MA. If clonazepam is used during pregnancy or breastfeeding, it is recommended that serum levels of clonazepam are monitored and that signs of central nervous system depression and apnea are also checked for. 7-Aminoclonazepam 100 ug/mL in Acetonitrile | Certified Reference Material This certified Snap-N-Spike solution is suitable for use as a starting material in calibrators and controls for numerous GC/MS or LC/MS applications in forensic analysis, clinical toxicology and urine drug testing. and transmitted securely. 2013 Feb 23;74:213-22. doi: 10.1016/j.jpba.2012.11.002. The degree of tolerance is more pronounced with clonazepam than with chlordiazepoxide. Clonazepam can slow or stop your breathing, especially if you have recently used an opioid medication, alcohol, or other drugs that can slow your breathing. [74], Like all benzodiazepines, clonazepam is a GABA-positive allosteric modulator. Benzodiazepines may be detected for a longer period of time in urine compared to oral fluid and blood. J Anal Toxicol. Six of the volunteers had urine concentrations of 7-ACLO that peaked at 1 day after administration. Drugs of Abuse: Note: This product is intended for research and manufacturing uses only. Swallow the regular tablet whole, with a full glass of water. Negrusz A, Moore CM, Kern JL, Janicak PG, Strong MJ, Levy NA. [72] Many individuals treated on a long-term basis develop a dependence. It consists of screening immunoassays for several drugs or drug classes, a quantitative enzymatic assay for ethanol and a gas chromatography-mass spectrometry (GC/MS) assay for a wide variety of therapeutic and abused drugs, as listed below. Patients who drink a lot of water, consume caffeine, take diuretic medications, have disorders of antidiuretic hormone, or other physiologic disturbances affecting urinary concentration may produce less concentrated urine. Pesce A, Rosenthal M, West R, et al. At Aegis, we understand your concerns as you evaluate definitive drug testing results. The stability of benzodiazepines in saliva. 0000000016 00000 n In many cases, the result interpretation may be clarified by correctly indicating the patients prescribed medications when ordering testing. Remove an orally disintegrating tablet from the package only when you are ready to take the medicine. Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. A positive . The concentration ranges of clonazepam+7-aminoclonazepam were 0.002-0.840 mg/kg (median 0.067) for traffic cases, 0.005-0.913 (median 0.071) for criminal cases (offenders), 0.002-0.720 (median 0.030) for criminal cases (victims) and 0.002-1.676 (median 0.115) for postmortem cases. False-positive and false-negative test results in clinical urine drug testing. [97][99][100][101] In turn, Phenytoin may lower clonazepam plasma levels by increasing the speed of clonazepam clearance by approximately 50% and decreasing its half-life by 31%. The criteria for non-medical use in this study were purposefully broad, and include, for example, drug abuse, accidental or intentional overdose, or adverse reactions resulting from legitimate use of the medication.[134]. We measured CLON and its primary metabolite 7-aminoclonazepam (7AC) . J Chromatogr B Analyt Technol Biomed Life Sci. [30][31] Bruxism also responds to clonazepam in the short-term. The benzodiazepine clonazepam is a prescription drug used to treat epilepsy and anxiety. 0 0000000770 00000 n We determined the optimal technical and clinical approach for the detection of CLON use using OF. When the needle pricks your arm, you may feel a slight Copyright 2023 Aegis Sciences Corporation, https://www.aegislabs.com/resources/clinical-reference-guide/, Parent drug may not be present in all results; only one marker is required for a positive result, If parent drug is present in urine with no alpha-OH-alprazolam present, please consult the Aegis Clinical Team as multiple clinical factors may be pertinent to result interpretation, and this does not always indicate aberrant patient behavior, Nordiazepam, Temazepam, and/or Oxazepam may be present, Only one marker is required for a positive result, Presence of other benzodiazepine markers may indicate ingestion of other benzodiazepines, Only Temazepam and/or Oxazepam should be present. 1A Detection frequency NPS TID Prescription/OTC DSS P/A/I 27% 12% 55% 2% 4% Fig. Read the medication guide or patient instructions provided with each medication. Conclusions: government site. 7-Aminoclonazepam | C15H12ClN3O - PubChem Apologies, we are having some trouble retrieving data from our servers. You may report side effects to FDA at 1-800-FDA-1088. Copyright 2016 Elsevier B.V. All rights reserved. The study examined the number of times the non-medical use of certain drugs was implicated in an ED visit. [92], Clonazepam may aggravate hepatic porphyria. [104], The safety profile of clonazepam during pregnancy is less clear than that of other benzodiazepines, and if benzodiazepines are indicated during pregnancy, chlordiazepoxide and diazepam may be a safer choice. [110], Clonazepam's primary mechanism of action is the modulation of GABA function in the brain, by the benzodiazepine receptor, located on GABAA receptors, which, in turn, leads to enhanced GABAergic inhibition of neuronal firing. Our series on interpreting unexpected results concludes with a discussion on the interpretation of benzodiazepine results from Aegis Sciences Corporation. [125] Clonazepam is metabolized extensively via nitroreduction by cytochrome P450 enzymes, including CYP3A4. Providers may also consider recent GI illness in the interpretation of unexpected negative results. Clonazepam was approved in the United States as a generic drug in 1997 and is now manufactured and marketed by several companies. [124][8], Clonazepam is lipid-soluble, rapidly crosses the bloodbrain barrier, and penetrates the placenta. 6 Table 2 lists commonly ordered. Accessibility Immunoassay. 2010;67:1344-50.14. 7-aminoclonazepam is superior to clonazepam for detection of clonazepam use in oral fluid by LC-MS/MS 7AC should be the analyte measured in OF for the detection of CLON use. The detection time may be less in all specimen types in cases of as-needed dosing or ingestion of low doses. The pathway by which clonazepam is metabolized is usually impaired in newborns. PMC Withdrawal symptoms from benzodiazepines in the neonate may include hypotonia, apnoeic spells, cyanosis, and impaired metabolic responses to cold stress. CLO was not detected in any of the samples. Careers. Never use this medicine in larger amounts, or for longer than prescribed. 2023 Jan 23:1-13. doi: 10.1007/s40264-022-01269-x. The .gov means its official. 2016 May;40(4):310-2. doi: 10.1093/jat/bkw020. m@6lm -"`uX. Clonazepam was the second most frequently implicated benzodiazepine in ED visits. This class of drug is also subject to misuse and is frequently included in urine drugs of abuse testing panels. arm. Before Use in very young children may be especially hazardous. Unauthorized use of these marks is strictly prohibited. An overdose of clonazepam can be fatal if you take it with alcohol, opioid medicine, or other drugs that cause drowsiness or slow your breathing. Place the tablet in your mouth and allow it to dissolve, without chewing. Gourlay DL, Heit HA, Caplan YH. Your child's dose needs may change if the child gains or loses weight. Dosage forms: oral tablet (0.5 mg; 1 mg; 2 mg), oral tablet, disintegrating (0.125 mg; 0.25 mg; 0.5 mg; 1 mg; 2 mg) Flurazepam is detected as the metabolite hydroxyethyl-flurazepam. Any questions about how to list medications as prescribed on an Aegis laboratory requisition may be directed to the Aegis Client Services department at 1-800-533-7052. Clonazepam, like other benzodiazepines, while being a first-line treatment for acute seizures, is not suitable for the long-term treatment of seizures due to the development of tolerance to the anticonvulsant effects. Generic name: clonazepam [kloe-NAZ-e-pam] All urine samples (1 mL) were extracted following addition of the internal standard (D(5)-diazepam) and enzymatic hydrolysis ( beta-glucuronidase) using solid-phase extraction columns. Dangerous side effects or death could occur. Benzodiazepines also require special precaution if used by individuals that may be pregnant, alcohol- or drug-dependent, or may have comorbid psychiatric disorders. Bookshelf 0000001741 00000 n In the case of unexpected positive benzodiazepine results, consider the following drug exposures:Chlordiazepoxide (Librax, Librium), Clorazepate (Gen-xene, Tranxene), Diazepam (Valium), Oxazepam, and/or Temazepam (Restoril). 2004 Dec;62 Suppl 12:360-3. 2004 Oct 29;145(2-3):123-30. doi: 10.1016/j.forsciint.2004.04.066. This site needs JavaScript to work properly. The samples were collected using the Orasure Intercept OF sample collection device. [79] In general, short-term therapy is more effective than long-term therapy with clonazepam for the treatment of epilepsy. In OF the levels of 7AC were approximately 2.4-fold higher than CLON. Physiological dependence was demonstrated by flumazenil-precipitated withdrawal. Hart BJ, Wilting J, de Gier JJ. Coronavirus (COVID-19): Latest Updates | Visitation PoliciesVisitation PoliciesVisitation PoliciesVisitation PoliciesVisitation Policies | COVID-19 Testing | Vaccine InformationVaccine InformationVaccine Information. Never share clonazepam with another person. Are there concerns with drug and sample stability such as improper storage or delays in shipment? Urine drug testing in clinical practice: the art and science of patient care. Mikel C, West R, Crews B, et al. Jang M, Chang H, Yang W, Choi H, Kim E, Yu BH, Oh Y, Chung H. J Pharm Biomed Anal. Considerations for Interpreting Unexpected Results. J Anal Toxicol. These medications share common metabolites, and distinguishing which compound was ingested may be impossible.1,2 Note the analytes in red boxes below that are both metabolites and drugs available as a prescription. If the patient reports a recent hospitalization or emergency department visit, follow-up with the hospital may be necessary to determine what medications were administered to the patient. might be drooling, sleepiness, lack of muscle coordination, difficulty breathing, Clonazepam is used to treat certain seizure disorders (including absence seizures or Lennox-Gastaut syndrome) in adults and children. Bioanalysis. Principles of Forensic Toxicology. Clonazepam is also used to treat panic disorder (including agoraphobia) in adults. Class/Isotype: IgG: Cross Reactivity: 7-aminoclonazepam, 7-aminoflunitrazepam, Delorazepam >10%; N-Desalkylflurazepam, Flunitrazepam >1%; Nitrazepam, Desmethyldiazepam, Diazepam : 1% Supplied In: . Eight of the ten volunteers had measurable amounts of the metabolite 21 days after administration. A review of medical records may be necessary to determine the medications given to the patient prior to or during a procedure. Bookshelf It is not a diagnostic device. 0000001552 00000 n Clonazepam, sold under the brand names Klonopin and Rivotril, is a medication used to prevent and treat seizures, panic disorder, anxiety disorders, and the movement disorder known as akathisia. Epub 2012 Oct 16. 2015 Aug;37(4):451-60. doi: 10.1097/FTD.0000000000000174. [121] Benzodiazepines inhibit cold-induced thyroid-stimulating hormone (also known as TSH or thyrotropin) release. The assay can be run on miscellaneous pills, powders and liquids to identify a suspected ingested substance that a patient might arrive with at the hospital, and in this case, only the GC/MS assay is performed. You may have this test if it's possible you have taken an overdose of clonazepam. Deposition of 7-aminoclonazepam and clonazepam in hair following a single dose of Klonopin. [9], Tolerance to the anticonvulsant effects of clonazepam occurs in both animals and humans. Careers. LC-MS/MS extends the range of drug analysis in pain patients. Stamford, CT: PharmaCom Group, Inc.; 2015:1-32.12. 0000008997 00000 n 0000003638 00000 n You may also have this test if you are having side effects from clonazepam. Using clonazepam with other drugs that make you sleepy or slow your breathing can cause dangerous side effects or death. [81][82][83] Sudden withdrawal may also induce the potentially life-threatening condition, status epilepticus. This is a substance your body makes from clonazepam. This benzodiazepine was chosen because it forms one major metabolite, 7-aminoclonazepam which is specific for that drug. Further information regarding specimen stability is available in the Aegis Clinical Reference Guide at https://www.aegislabs.com/resources/clinical-reference-guide/. The https:// ensures that you are connecting to the 1,2 This product is intended for research and forensic applications. It can cause side effects such as drowsiness . You may have life-threatening withdrawal symptoms if you stop using the medicine suddenly after long-term use. Call your doctor for medical advice about side effects. 2000;24:579-88.6. Follow the directions on your prescription label and read all medication guides. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). The mechanism of tolerance includes receptor desensitization, down regulation, receptor decoupling, and alterations in subunit composition and in gene transcription coding. In some individuals, however, peak blood concentrations were reached at 48 hours. It's a type of medicine called a benzodiazepine. It may also be used to treat Version 2.73 28073-57-Aminoclonazepam [Mass/volume] in UrineActive Part Description LP28541-8 7-Aminoclonazepam 7-Aminoclonazepam is a metabolite of clonazepam, a benzdiazepine drug used to treat or control seizures, panic attacks, and akathisia. Vindenes V, Strand DH, Kokster P, Gjerde H. J Anal Toxicol. [9][25], The effectiveness of clonazepam in the short-term treatment of panic disorder has been demonstrated in controlled clinical trials. In: Levine B, ed. [9] Peak blood concentrations of 6.513.5ng/mL were usually reached within 12 hours following a single 2mg oral dose of micronized clonazepam in healthy adults. [95], Clonazepam has similar effectiveness to other benzodiazepines at often a lower dose. Deliberate Self-Poisoning: Real-Time Characterization of Suicidal Habits and Toxidromes in the Food and Drug Administration Adverse Event Reporting System. government site. Clonazepam's mode of action is to decrease abnormal electrical energy in the brain. One volunteer had the highest concentration of 7-ACLO at 3 days, two volunteers at 5 days, and one at 8 days. The objective of this paper was to determine how long after administration of benzodiazepine clonazepam (CLO), its major metabolite 7-aminoclonazepam (7-ACLO) could be detected in urine collected from 10 healthy volunteers who received a single 3-mg dose of Klonopin (clonazepam). A highly sensitive NCI-GC-MS method for the simultaneous quantitation of CLO and its major metabolite 7-ACLO in urine was developed and validated. official website and that any information you provide is encrypted 2016;40:97-107.18. Do not give this medicine to a child without medical advice. National Library of Medicine In settings of abuse or detoxification, the period of detection may be longer. J Opioid Manag. 1B Types of Drugs Detected NPS TID Prescription . Aegis Sciences Corporation Study Shows Widespread Distribution of Xylazine Read More. . Lund HM, iestad El, Gjerde H, Christophersen AS. A tendency for re-offending in drug-facilitated crime. Last updated on Dec 13, 2021. Available for Android and iOS devices. doi: 10.1097/MD.0000000000002881. The https:// ensures that you are connecting to the Methods: In these cases, the claimed sensitivity is inadequate to detect the presence of the drug in urine even after an overdose. Only two studies have reported detection times of 7-AC in urine after a single dose of clonazepam, and no previous studies have reported detection times after repeated . 65044. Does the patient have altered gastrointestinal (GI) function or recent GI illness?Some patients have short-gut syndrome due to previous surgeries or GI disease or may have a history of gastric bypass surgery. Applies only to results expressed in units of measure originally reported by the performing laboratory. Brand names: KlonoPIN, KlonoPIN Wafer An official website of the United States government. Opinion of Brazilian experts]", "Treatment of restless legs syndrome: an evidence-based review and implications for clinical practice", "Sleep and sex: what can go wrong? The challenges of LC-MS/MS analysis of opiates and opioids in urine. This site needs JavaScript to work properly. 7AC should be the analyte measured in OF for the detection of CLON use. Commonly prescribed medications and potential false-positive urine drug screens. 0000009460 00000 n 0000003040 00000 n 2013 Jan-Feb;37(1):25-9. doi: 10.1093/jat/bks080. The immunoassay sensitivities are listed for specific drugs, but each assay can detect related compounds with similar but variable sensitivities (i.e. Clonazepam may harm an unborn baby, but having a seizure during pregnancy could harm both mother and baby. Do not change your doses or medication schedule without your doctor's advice. Bethesda, MD 20894, Web Policies [109] Clonazepam has no effect on GABA levels and has no effect on gamma-aminobutyric acid transaminase. Hospitalization/Emergency Department Visit: Patients who arrive at the emergency room with a suspected poisoning or overdose may be given benzodiazepines depending on their presenting symptoms and the source of the toxicity. Using molecular similarity to highlight the challenges of routine immunoassay-based drug of abuse/toxicology screening in emergency medicine. Confirmation Tests Benzodiazepine Confirmation, Random, Urine Approximate Detection Times Efavirenz treatment and false-positive results in benzodiazepine screening tests. Management of sleep disorders in older people", "Benzodiazepine Equivalency Table: Benzodiazepine Equivalency", "Effects of commonly used benzodiazepines on the fetus, the neonate, and the nursing infant", "Solubilization of peripheral benzodiazepine-binding sites from rat kidney", "What are the equivalent doses of oral benzodiazepines? What medication is the patient prescribed? Nihon Rinsho. Providers may consider the possibility of reduced absorption of drug and potential impact on unexpected negative results in these patients. In the case of improper storage, drug degradation contributing to unexpected negative results may be possible. Your family or caregivers should also watch for sudden changes in your behavior. Clipboard, Search History, and several other advanced features are temporarily unavailable. Mikel C, Pesce AJ, Rosenthal M, West C. Therapeutic monitoring of benzodiazepines in the management of pain: current limitations of point of care immunoassays suggest testing by mass spectrometry to assure accuracy and improve safety. 0000008084 00000 n about all the medicines, herbs, vitamins, and supplements you are taking. You should not take clonazepam if you allergic to it or if you have: a history of allergic reaction to any benzodiazepine (including alprazolam, diazepam, lorazepam, Valium, Xanax, Versed, and others). [10] Dependence occurs in one-third of people who take benzodiazepines for longer than four weeks. [Benzodiazepine (clonazepam, nitrazepam, diazepam)]. Brahm NC, Yeager LL, Fox MD, Farmer KC, Palmer TA. Caution is also required if clonazepam is used during breastfeeding. [87], Clonazepam and 7-aminoclonazepam may be quantified in plasma, serum, or whole blood in order to monitor compliance in those receiving the drug therapeutically. It is thought that benzodiazepines work by enhancing the activity of certain neurotransmitters in the brain. Epub 2006 Jun 30. Get medical help right away if you stop using clonazepam and have symptoms such as: unusual muscle movements, being more active or talkative, sudden and severe changes in mood or behavior, confusion, hallucinations, seizures, or thoughts about suicide. Following a single dose of Alcohol alone was responsible for over twice as many ED visits as clonazepam in the same study. Click on the title Specimen Validity Testing and Specimen Tampering to download a copy of this chapter. The initial test should include the prescribed drug, amphetamines, opioids, cocaine, benzodiazepines, oxycodone, barbiturates, methadone, fentanyl, and marijuana. If evaluating urine results, the sample pH may be an indicator of sample stability. Online ahead of print. These include valproate Clonazepam's mode of action is to decrease abnormal electrical energy in the brain. Abernathy DR, Greenblatt DJ, Divoll M, Shader RI. 8600 Rockville Pike Would you like email updates of new search results? Clonazepam is a benzodiazepine prescription drug and is classified by the DEA as Schedule IV controlled substance under the federal Controlled Substances Act. PUGVIEW FETCH ERROR: 503 National Center for Biotechnology Information 8600 Rockville Pike, Bethesda, MD, 20894 USA Contact Policies FOIA HHS Vulnerability Disclosure National Library of Medicine National Institutes of Health A considerable amount of 7-aminoclonazepam (ACZP), a major metabolite of clonazepam (CZP), is present in the brain during CZP treatment, yet the pharmacological properties of ACZP remain unknown. Fusaroli M, Pelletti G, Giunchi V, Pugliese C, Bartolucci M, Necibi EN, Raschi E, De Ponti F, Pelotti S, Poluzzi E. Drug Saf. It's often prescribed to adults and [128] Clonazepam plasma levels are very unreliable amongst patients. One volunteer was still positive 28 days after administration. 2021 Mar;46(2):205-223. doi: 10.1007/s13318-020-00661-1. 2015;11(1):618.17. Intermolecular Interactions between Eosin Y and Caffeine Using. Clonazepam is used to treat certain seizure disorders (including absence seizures or Lennox-Gastaut syndrome) in adults and children. The data are also inconclusive on whether benzodiazepines such as clonazepam cause developmental deficits or decreases in IQ in the developing fetus when taken by the mother during pregnancy. Schedule IV drugs have a lower potential for abuse relative to drugs in Schedule III (for example, codeine or buprenorphine) but can still be abused. NOTICE: The information above is intended as a resource for health care providers. HHS Vulnerability Disclosure, Help [32] Rapid eye movement sleep behavior disorder responds well to low doses of clonazepam. Clonazepam, like other benzodiazepines, may impair a person's ability to drive or operate machinery. 2009;31(6):746-8.19. 2015:14(2):248.4. We investigated the effects of ACZP on the GABA A receptor-mediated currents (I GABA ) in neurons from the nucleus reticularis thalami (NRT) of the . Your test results may be different depending on the lab used. Kempf J, Wuske T, Schubert R, Weinmann W. Pre-analytical stability of selected benzodiazepines on a polymeric oral fluid sampling device. Determination of bromazepam, clonazepam and metabolites after a single intake in urine and hair by LC-MS/MS. Clonazepam is a benzodiazepine (ben-zoe-dye-AZE-eh-peen). Clin Chim Acta. 0000009216 00000 n [44], The long-term effects of clonazepam can include depression,[9] disinhibition, and sexual dysfunction.[70]. Results: It can cause side effects such as drowsiness, problems with coordination, and .