Clomethiazole

CLINICAL USE

Alcohol withdrawal Insomnia Restlessness and agitation

DOSE IN NORMAL RENAL FUNCTION

Alcohol withdrawal: 2–4 capsules stat, then:Day 1: 3 capsules 3 or 4 times daily —Day 2: 2 capsules 3 or 4 times daily —Day 3: 1 capsule 4 times daily —Reduce over a further 4–6 days; give a —total treatment of not more than 9 daysInsomnia: 1–2 capsules at night Restlessness and agitation: 1 capsule 3 times daily

PHARMACOKINETICS

Molecular weight :161.7

%Protein binding :65

%Excreted unchanged in urine : 0.1–5

Volume of distribution (L/kg) :4–16

half-life – normal/ESRD (hrs) :4/Unchanged

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 : Dose as in normal renal function

10 to 20 : Dose as in normal renal function

<10 : Dose as in normal renal function

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD :Unknown dialysability. Dose as in normal renal function

HD :Dialysed. Dose as in normal renal function

HDF/high flux :Dialysed. Dose as in normal renal function

CAV/VVHD :Dialysed. Dose as in normal renal function

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugsAntipsychotics: enhanced sedative effects Antivirals: concentration possibly increased by ritonavirCimetidine: inhibits metabolism of clomethiazole

ADMINISTRATION

Reconstition

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Route

Oral

Rate of Administration

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Comments

Syrup should be stored in a fridge

OTHER INFORMATION

Clomethiazole has a high hepatic extraction ratioIncreased cerebral sensitivity in renal impairmentManufacturers recommend caution should be observed in patients with chronic renal disease

See how to identify renal failure stages according to GFR calculation

See how to diagnose irreversible renal disease

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