Clorazepate
Pronunciation:klor-AZ-uh-pait
Chemical Abstracts Service Registry Number:23887-31-2. (Dipotassium form
57109-90-7)
Formal Names:Tranxene
Type:Depressant (benzodiazepine class).Seepage 21
Federal Schedule Listing:Schedule IV (DEA no. 2768)
USA Availability:Prescription
Pregnancy Category:D
Uses.Clorazepate dipotassium is a “prodrug” related todiazepam. A pro-
drug is a substance that may have little effect itself but that the body metab-
olizes into another chemical that does have a drug effect. For example, one
metabolite of clorazepate dipotassium is desmethyldiazepam, which in turn
transforms intooxazepam. Prodrugs are prescribed when direct administra-
tion of the desired chemical does not work, such as when the chemical would
degrade before it has time to build up in the part of the body where it is
needed or when the normal dosage form cannot be given (perhaps a substance
that can be absorbed through the skin is needed rather than giving an injec-
tion). Although metabolites of clorazepate dipotassium generally create the
medical actions, for simplicity this discussion usually refers only to the pro-
drug clorazepate dipotassium and calls it a drug.
This long-acting drug’s primary medical uses are for anxiety, for convul-
sions, and as a muscle relaxant. The substance can be taken on a long-term
basis for successful control of epilepsy but is described as a “second-line”
medication, meaning it is not used unless other drugs have been tried without
success. Clorazepate dipotassium’s long-term effectiveness against anxiety is
unclear. A common short-term use is to reduce nervousness in surgery pa-
tients shortly before an operation. The drug is also given to ease withdrawal
fromzolpidemandalcohol(including delirium tremens). An injection can
quickly calm a bellicose individual.
Weight, age, and gender can affect dosage. A study found that an active
metabolite (desmethyldiazepam) from a dose of clorazepate dipotassium lasts
almost three times as long in overweight persons compared to normal weight
persons, apparently due to accumulation in body fat. Another study noted