EpilepsyRx

Clorazepate

Tranxene T-Tab · generic clorazepate dipotassium

DailyMed-verified antiseizure indications

Indication / use

Label / evidence summary
Adjunctive treatment of focal (partial) seizures. Use is not recommended in children younger than 9 years.
Role
Maintenance
Class
1,4-benzodiazepine prodrug

Indications checked 27 September 2026. Product, route, age, and treatment-role limits apply. A DailyMed listing alone does not establish FDA approval.

Formulations & strengths

U.S. product labels; strengths per dosage unit.

Brand & formulation labels

Each link names the product and formulation it covers. Archived labels do not establish current availability.

Dosing & administration

Adult / product-specific schedule
Adults and children over 12 years: initial dose no more than 7.5 mg three times daily. Increase the total daily dose by no more than 7.5 mg each week; maximum 90 mg/day.
Pediatric
Ages 9–12 years: initial dose no more than 7.5 mg twice daily. Increase the total daily dose by no more than 7.5 mg each week; maximum 60 mg/day. Not recommended below age 9.
Titration / repeat dosing
Use a gradual, individualized taper when reducing or stopping; abrupt cessation can cause life-threatening withdrawal, including seizures. Lower initial doses are advised in older or debilitated patients.

Practical administration

Product instructions
Oral tablets. The seizure schedule uses divided dosing; do not substitute the once-daily anxiety schedule.

Dose adjustment & concentrations

Renal impairment
Use with caution in impaired renal function; no numeric adjustment algorithm in the cited label.
Hepatic impairment
Use with caution in impaired hepatic function; no numeric adjustment algorithm in the cited label.
Serum reference information
No established therapeutic serum range is supplied in the cited label.

Safety

Boxed warning
Opioid coadministration can cause profound sedation, respiratory depression, coma or death. Abuse, misuse, addiction, physical dependence and potentially life-threatening withdrawal are additional boxed warnings.
Contraindications
Known hypersensitivity to clorazepate; acute narrow-angle glaucoma.
Serious precautions & monitoring
Sedation, respiratory depression, dependence and withdrawal seizures. Monitor for misuse, mood changes and suicidal thoughts. Avoid abrupt discontinuation.

Common / selected adverse effects

  • Drowsiness
  • Dizziness
  • Ataxia
  • Gastrointestinal symptoms
  • Blurred vision / dry mouth

Selected label-reported effects; frequencies cannot be compared across drugs.

Drug interactions: toxicity & clinical action

Partner / combinationClinical effectClinical action
OpioidsAdditive sedation and potentially fatal respiratory depression.Reserve combined use for appropriate clinical circumstances and use close monitoring.
Alcohol / other CNS depressantsIncreased sedation and impaired coordination.Avoid alcohol; review combined depressant exposure.

Selected interactions; consult the full label and complete medication list.

Pregnancy & contraception

Fetal / neonatal risk
Late-pregnancy benzodiazepine exposure can cause neonatal sedation, respiratory depression, hypotonia and withdrawal. The label discusses observational data without a clear association with major birth defects; individualized assessment is required. Breastfeeding is not recommended.

Clinical evidence

Research summaries describe studied populations and outcomes; they do not add indications or constitute treatment recommendations.

Product-label evidence

Trial summary

Study design / duration
No modern pivotal randomized trial is summarized in the cited label.
Primary endpoint
No quantified pivotal endpoint supplied in the cited label.

This profile uses product-label evidence; no pivotal journal publication is asserted.

Comparative evidence

Findings
No head-to-head efficacy comparison is summarized.

Mechanism of action

  • Rapidly decarboxylated to nordiazepam, an active benzodiazepine.
  • The brand label describes benzodiazepine activity through GABA-A receptor binding and increased GABA-mediated inhibition.

Pharmacology

Adult values unless specified. Vd/F denotes apparent oral distribution volume.

Pharmacokinetics

Bioavailability
Absolute bioavailability is not quantified in the cited product label.
Elimination half-life
Parent: essentially absent from circulating blood after oral dosing because of rapid conversion. Active nordiazepam: approximately 40–50 hours.
Volume of distribution
Not quantified in the cited product label.
Active metabolite(s)
Nordiazepam (active); further hydroxylation produces oxazepam before conjugation.
Active-metabolite half-life
Nordiazepam: approximately 40–50 hours. An oxazepam half-life is not quantified in the cited clorazepate labels.
Protein binding
Nordiazepam: 97–98%; this is not a measured parent-clorazepate value.
Metabolism / elimination
Rapid decarboxylation to nordiazepam, followed by hepatic hydroxylation and conjugation. Major urinary product is conjugated oxazepam.

Values reflect the cited product and study population; they are not interchangeable across formulations.

Molecular structure

Molecular structure of Clorazepate
Principal compound; salt and product forms may differ.
NIH PubChem structure and record ↗

Product history

Initial U.S. approval
June 23, 1972 — Tranxene (NDA 017105)
Market / formulation history
FDA lists Tranxene products with strength-specific marketing status; representative generic tablet labels remain available.
Brands
Tranxene T-Tab · generic clorazepate dipotassium
Manufacturer / marketer
ANI (representative generic); Tranxene brand insert linked separately
Generic availability
Yes — representative generic tablet label linked.
Related drugs
Nordiazepam is also an active metabolite of diazepam.

Sources & review status

The ANI clorazepate label is a representative generic source. The Tranxene brand-name insert is linked separately.

Brand reference: Tranxene T-Tab ↗

Indications and DailyMed PDFs checked: 2026-09-27. Other profile sources reviewed: 2026-09-27 · label revision noted at that review: Representative DailyMed label reviewed September 2026; Tranxene FDA insert 2023.. This is a draft reference; final review is pending.