Rivotril: is it for sleeping? Know the package leaflet of the medicine

Medicines that relieve psychological and physical symptoms caused by problems such as anxiety or depression are increasingly sought after in pharmacies.

Among the prescribed options, there are several types of psychoactive drugs – drugs that act on the central nervous system – and Rivotril is one of them.

Rivotril is one of the most consumed drugs in Brazil, known for its tranquilizing effects and even for fighting insomnia .

Although indicated for some psychological conditions, it is important to be aware of its indications and form of use, since it can cause dependence.

Keep reading and learn more about the medication!


What is Rivotril?

Rivotril is one of the trade names of Clonazepam, a psychoactive substance – which acts on the central nervous system – used as an active ingredient in some medicines.

It is part of Benzodiazepines, a class of drugs used to treat problems related to the central nervous system.

This type of medication acts by potentiating the action of a neurotransmitter known as GABA (gamma-aminobutyric acid). When it comes into contact with the brain, it has a tranquilizing effect, relieving anxiety symptoms, for example.

Its use is adult and pediatric and, in children, it is indicated for the treatment of epileptic seizures and spasms. For adults, the drug is recommended for the relief of anxiety disorders, mood and psychotic syndromes.

It is available in drops and tablets and is classified as a black label medicine, meaning it can present health risks, including addiction.

What is Rivotril for?

Rivotril is a medicine that is used to treat adults and children, in different problems related to the nervous system, such as disorders and syndromes.

In the case of pediatric use, the drug is used to treat epileptic seizures and infantile spasms, also known as West’s Syndrome.

As for treatment in adults, it is indicated for the relief of anxiety and mood disorders, psychotic syndrome, restless legs and burning mouth, in addition to being used for cases of vertigo and balance disorders.

More specifically, Rivotril is used to:

Epileptic seizures

Epileptic seizures consist of the abnormal behavior of a person’s body, manifesting uncontrollable tremors in the muscles and even seizures .

They are the result of a change in the functioning of electrical impulses from neurons – cells responsible for the transmission of nerve impulses.

With the confused sending of impulses between these cells, there is an abnormal manifestation in the person’s behavior, which can be more or less evident.

Rivotril can be administered as a treatment in cases of epileptic seizures in children.

Infantile spasms (West syndrome)

West syndrome is a form of epilepsy – abnormal activity of nerve cells in the brain, causing seizures – which manifests in childhood and presents symptoms such as:

  • Physical spasms;
  • Delay in neuropsychomotor development;
  • Changes in the electroencephalogram (test that evaluates the electrical activity of the brain).

Rivotril can be used to treat this condition.

Anxiety disorders

Rivotril is indicated as an anxiolytic in general in cases of Anxiety Disorders. In addition, it can also be administered in the treatment of panic disorder and social phobia .

Panic disorder is characterized by a sudden anxiety attack, characterized by a feeling of intense fear and despair. Symptoms such as suffocation, hot flashes, dizziness and nausea can also occur.

Social Phobia, on the other hand, is characterized as irrational anxiety and intense fear of situations that involve great social contact, such as public speaking , for example.

Mood disorders

Both bipolar affective disorder and major depression are problems related to mood disorder that can be treated with Rivotril.

Bipolar affective disorder is characterized by the alternation of two phases in the patient’s mood: mania phase and depression phase.

The manic phase is one in which the patient expresses euphoria, with symptoms such as increased energy, irritability and great psychomotor agitation.

The stage of depression, on the other hand, is one in which the person has a great drop in mood and a decrease in energy. It is usually characterized by symptoms such as a pessimistic feeling about the future, loss of interest in activities previously considered pleasurable and reduced self-esteem.

Rivotril is indicated for relief in episodes of the manic phase, that is, for the improvement of symptoms of exalted mood.

In addition, the drug is also used in conjunction with antidepressants in cases of major depression, for the treatment of anxiety depression.

Anxious depression is a condition in which the patient has symptoms of both anxiety and depression, manifesting feelings such as excessive worries, negative thoughts, insomnia and changes in appetite.

Psychotic syndromes

Among psychotic syndromes, Rivotril can help treat symptoms of Akathisia, which is a condition in which it is very difficult to remain still, with a feeling of muscle tremor throughout the body and great agitation.

If there is a need to remain seated, for example, the person usually has movement in the legs, expressing restlessness.

The condition is usually caused by the use of psychiatric drugs and can be relieved by decreasing or suspending the doses of the medication administered, or even with treatments involving other drugs.

Restless legs syndrome

Restless legs syndrome, as the name implies, is a problem with motor agitation in the lower limbs. The patient feels the urgent need to move the legs nonstop, in addition to feeling discomfort or pain in the area.

The problem usually worsens during the night or when the person is at rest, which can significantly impair sleep.

Vertigo and balance disorders

Vertigo is a type of dizziness in which the person has an altered perception of his movement, with the feeling that he / she or the environment around him is spinning, even if he is stopped. It is characterized as a false sense of movement.

In addition to the perception of spin, other symptoms that may occur are:

  • Nausea;
  • Vomiting;
  • Fainting;
  • Falls caused by imbalance;
  • Tinnitus;
  • Hearing disorders.

The drug can be used to treat this problem.

Burning Mouth Syndrome

Burning mouth syndrome is a disease that consists of a burning sensation in the inner part of the mouth, which can mainly affect the tongue, lips, roof of the mouth or the lateral mucosa.

It occurs even without physical changes, that is, without the region being, in fact, with injuries or high temperature.

In general, it is caused by a dysfunction in the functioning of the nerves in the region, which send incorrect signals to the brain, causing the sensation.

What is the best time to take Rivotril?

The package insert does not have options for specific times for the administration of Rivotril. In general, it is used to control anxiety attacks as soon as they start, and may vary according to medical advice.

In case of doubt regarding the use, it is important to consult the doctor (a) responsible, who will indicate the best way of application for each clinical picture.

Can pregnant take?

It depends . The use of Rivotril should only be done with strict medical indication and control, since the drug can cause possible risks to the fetus, especially if administered in the last trimester of pregnancy.

Possible risks include:

  • Irregularities in the heartbeat;
  • Low body temperature;
  • Respiratory depression
  • Lack of muscle tone;
  • Difficulty sucking.

According to the package insert, Rivotril should only be administered to pregnant women if there is an absolute indication and if the potential benefits of use outweigh the risks to the fetus. 

In addition, if the patient is lactating and needs to use the medication, breastfeeding should be discontinued.

Contraindications: can children and the elderly use it?

The use of Rivotril is contraindicated for people who have:

  • Hypersensitivity to Clonazepam or its excipients;
  • Severe respiratory failure;
  • Severe hepatic impairment;
  • History of sleep apnea;
  • Acute angle-closure glaucoma.

This is because, in patients already sensitized to the liver, for example, this type of medication can cause problems such as hepatic encephalopathy, that is, the loss of brain function when damage to the liver does not allow the organ to remove toxins from the blood.


Pediatric use of the drug should be evaluated taking into account the long-term risks and benefits.

This, because there is the possibility of adverse effects on the physical and mental development of children in the treatment of epileptic disorders, which may be visible only after years.

It is worth mentioning that, according to the package insert, there may be an increase in salivation and bronchial secretions in infant patients.


In the case of elderly patients, the treatment must be careful, since, according to the package leaflet, the effects of the medication appear to be more intense in elderly patients than in young ones.

Thus, it is essential to follow the medical recommendations, which will indicate the best option of use for each clinical picture.

Does Rivotril cause addiction?

-Yeah . The use of Rivotril can cause physical and psychological dependence, and the risks are increased when the doses are high. Patients with a history of alcohol abuse are also more susceptible to addiction.

Clonazepam, the drug’s active ingredient, is part of the Benzodiazepine class, a set of psychoactive substances – which act on the central nervous system – which have a sedative and relaxing action.

What happens is that, after a certain period of use, this type of medication usually causes the body to show tolerance, that is, the reduction of the effects with its continuous use.

Thus, with the decrease in the action of the medication, if there is no correct monitoring by a professional, there is a tendency for the patient to increase the doses more and more, so that the effects are perceived as before.

Thus, the person ends up dependent both physically and psychologically, since he often cannot perform simple tasks without medication, such as sleeping, for example.

In addition, indiscriminate use of the drug can cause other problems to be camouflaged, as people often use the drug to treat symptoms and not the root cause of a possible clinical condition.

Does Rivotril sleep?

You can do it . Rivotril is a medication that acts as a sedative in the body, relieving tension states and acting as a tranquilizer. Thus, drowsiness is one of the possible effects that can be manifested when using the medication.

This is because, with the body relaxed, there is usually a reduction in brain function, which causes sleep. Therefore, the drug is often prescribed for the treatment of insomnia when it is due to anxiety disorders, mood disorders, psychotic syndromes or other conditions.

Get fat or lose weight?

It depends . Weight gain or loss is among the possible side effects of the medication, which can occur in some people.

In addition, its use can also cause reactions such as an increase or decrease in appetite, which can influence body proportion.

Does it have side effects?

Like other medicines, Rivotril can cause side effects in some patients.

Among the possible reactions, some are transient and disappear spontaneously during treatment or with dose reduction.

Despite this, it is worth remembering that each organism reacts differently to medication and, thus, not all people will suffer from the effects.

Adverse reactions known from the use of the drug are:

Disorders of the immune system

The effects related to the immune system that can arise are:

  • Allergic reactions.

Endocrine disorders

The endocrine system is the one responsible for the release of hormones by the body. The related reaction that can happen is: incomplete precocious puberty in children.

According to the package leaflet, this effect was manifested only in isolated cases and is a reversible condition.

Psychiatric disorders

Among the reactions related to psychiatric issues that can manifest with the use of the drug are:

  • Amnesia;
  • Hallucinations;
  • Hysteria;
  • Psychosis;
  • Suicidal ideas;
  • Depersonalization;
  • Memory disorder;
  • Organic disinhibition;
  • Lamentations;
  • Emotional and mood disorders;
  • Confusional state;
  • Disorientation;
  • Restlessness;
  • Agitation;
  • Irritability;
  • Aggressiveness;
  • Nervousness;
  • Hostility;
  • Anxiety;
  • Sleep disorders;
  • Delirium;
  • Anger;
  • Nightmares;
  • Hyperactivity.

Disorders of the nervous system

The nervous system is responsible for the transmission of signals between different parts of the body. Side effects related to this part of the body are:

  • Decreased concentration;
  • Somnolence;
  • Lentification;
  • Muscle hypotonia – weakened muscle tone;
  • Dizziness;
  • Ataxia – impaired balance or motor coordination;
  • Headache;
  • Difficulty articulating speech;
  • Incoordination of movements;
  • Abnormal eye movement;
  • Forgetting recent facts;
  • Behavior change;
  • Increased seizures in some forms of epilepsy;
  • Loss of voice;
  • Tremor;
  • Loss of strength on one side of the body;
  • Light-headed feeling;
  • Lack of energy;
  • Tingling;
  • Alteration of sensitivity in the extremities.

Eye disorders

Vision can be affected by the use of medication. Among the effects are:

  • Double vision;
  • Vitreous eye appearance.

Cardiovascular disorders

The reactions that affect the cardiovascular system are:

  • Palpitations;
  • Chest pain;
  • Cardiac insufficiency;
  • Cardiac arrest;
  • Decrease in the number of platelets;
  • Decrease in white blood cells;
  • Anemia.

Respiratory disorders

Side effects involving the respiratory system include:

  • Pulmonary congestion – accumulation of fluid in the lungs;
  • Nasal congestion;
  • Hypersecretion – excessive secretion;
  • Cough;
  • Shortness of breathe;
  • Bronchitis;
  • Rhinitis;
  • Pharyngitis – inflammation of the pharynx;
  • Respiratory depression – decreased breathing rate;
  • Increased production of saliva in infants and children;
  • Increased bronchial secretion in infants and children.

Gastrointestinal disorders

Rivotril administration may cause some gastrointestinal changes. They are:

  • Loss or increase in appetite;
  • Nausea;
  • Abdominal pain;
  • Gastritis;
  • Gastrointestinal inflammation;
  • Cold;
  • Liver enlargement;
  • Diarrhea;
  • Fecal incontinence;
  • Dry mouth;
  • Toothache;
  • Sore gums;
  • Tasteful tongue.

Skin / subcutaneous tissue disorders

The effects involving the skin and subcutaneous tissues are:

  • Hives – red patches on the skin that cause itching;
  • Itch;
  • Rash;
  • Transient hair loss;
  • Abnormal hair growth;
  • Swelling of the face and ankles;
  • Changes in skin pigmentation.

Musculoskeletal disorders / connective tissue

Muscles and bones can be affected with the use of the medication. Possible effects include:

  • Muscle weakness;
  • Muscle pain;
  • Back pain;
  • Traumatic fracture;
  • Neck pain;
  • Displacements;
  • Tensions.

Renal / urinary disorders

The reactions that damage the kidneys and urinary system are:

  • Difficulty urinating;
  • Urinary loss during sleep;
  • Nocturia – interruption of sleep during the night to urinate;
  • Urinary retention;
  • Urinary tract infection;
  • Incontinence.

Reproductive system disorders

The reproductive system may change with the use of Rivotril. Between them:

  • Menstrual cramps;
  • Decreased sexual interest;
  • Impotence.

Ear Disorders

Problems involving the ear include:

  • Otitis – inflammation of the ear;
  • Vertigo – feeling dizzy.

General disorders

The disorders that affect the body in general, are:

  • Fatigue;
  • Dehydration;
  • Fever;
  • Increased lymph nodes – appearance of linguals;
  • Weight gain or loss;
  • Viral infection;
  • General deterioration.

Dosage: how to use according to the package leaflet

Rivotril’s dosage varies according to the purpose of use: epileptic disorders; anxiety disorders; mood disorders; psychotic syndromes; restless legs syndrome; vertigo and balance disorders or burning mouth syndrome.

Specifically, the package insert indicates:

Epileptic disorders

For the treatment of epileptic disorders, there are two types of dose: initial and maintenance.

The starting dose is usually smaller, so that the patient’s body gets used to the substance. Maintenance is the dose that will be used during treatment.

In adults , the recommendation is:

  • Initial dose: 1.5mg / day, 3 times a day;
  • Maintenance dose: defined at medical discretion, according to the patient’s response.

For newborns and children up to 10 years old (or 30 kg of weight), the drop version should be used as follows: 0.01mg / kg to 0.03mg / kg, divided into 2 to 3 times a day.

It is not recommended to exceed the amount of 0.05mg / kg per day.

For children between 10 and 16 years of age:

  • Initial dose: 1mg / day to 1.5mg / day divided into 2 to 3 doses.
  • Maintenance dose: 3mg / day to 6mg / day, divided into 2 to 3 doses.

It is indicated, whenever possible, to divide the total dose into 3 equal administrations. If it is not possible, take the larger dose before bed.

Anxiety disorders

Doses for the treatment of anxiety disorders vary according to the indication: panic disorder; anxiolytic in general or social phobia.

For cases of Panic Disorder , the recommended dosage is:

  • Initial dose: 0.5mg / day, divided into 2 doses;
  • Maintenance dose: at medical discretion, according to the patient’s response.

As for anxiolytics in general , the recommended doses can vary from 0.25mg to 4mg / day, divided into 3 times a day.

For cases of social phobia, the dosage varies between 0.25 and 6mg per day, divided into 3 applications.

Mood disorders

In cases of treatment of mood disorders, Rivotril has the indication for Bipolar Affective Disorder, in the treatment of the manic phase, and also for use in cases of Major Depression, when associated with antidepressants.

According to the package insert, the dosage for Bipolar Affective Disorder can vary between 1.5mg to 8mg per day.

For cases of major depression , doses can range from 0.5mg to 6mg daily.

Psychotic syndromes

In cases of psychotic syndromes, Rivotril can be administered for the treatment of Akathisia .

In this case, doses can vary from 0.5mg to 4.5mg / day.

Restless legs syndrome

In the treatment of Restless Legs Syndrome, the dosage indicated by the package insert is:

  • 0.5 mg to 2.0 mg / day.

Vertigo and balance disorders

For Vertigo problems or related to balance disorders, the recommended doses are:

  • 0.5mg to 1mg / day, 2 times a day.

Burning Mouth Syndrome

In cases of burning mouth syndrome, the dosage ranges from 0.25mg to 6mg / day.

Are you generic?

-Yeah . Generic drugs are those that have the same active ingredient, dose, pharmaceutical form, indication and route of administration as the reference, but without the commercial nomenclature.

Thus, it is marketed by the name of the active ingredient.

Some of the available generic options of Rivotril in the tablet version are:

  • Clonazepam Tablet Medley ;
  • Clonazepam Pharlab ;
  • Clonazepam Nova Química ;
  • Clonazepam Legrand tablet .

Among the options in the oral solution version are:

  • Clonazepam Drops Geolab ;
  • Clonazepam Drops Germed Pharma ;
  • Clonazepam Teuto ;
  • Clonazepam Oral Solution Medley .

Price: how much does it cost and where to buy?

The price of Rivotril may vary according to the geographic region, establishment of purchase and presentation.

On average, the initial prices * are:

  • Rivotril 2.5mg / mL with 20mL of oral suspension – R $ 17.33;
  • Rivotril 0.25mg, box with 30 sublingual pills – R $ 6.17;
  • Rivotril 0.5mg, box with 30 pills – R $ 11.87
  • Rivotril 2mg, box with 30 pills – R $ 21.36;
  • Rivotril 0.5mg, box with 20 pills – R $ 7.59;
  • Rivotril 2mg, box with 20 pills – R $ 13.76.

If there is a need to compare prices and make the purchase, it is possible to use the website of Consulta Remédios , which indicates the best prices for medicines in different pharmacies in each region.

It is worth mentioning that, to acquire Rivotril, it is necessary to present a B1 Azul prescription.