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<script type="text/javascript" src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/jr.boots.min.js"> </script><title>Clorazepate - Drugs and Lactation Database (LactMed®) - NCBI Bookshelf</title>
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<meta name="citation_inbook_title" content="Drugs and Lactation Database (LactMed®) [Internet]">
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<meta name="citation_title" content="Clorazepate">
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<meta name="citation_date" content="2024/01/15">
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<meta name="citation_keywords" content="clorazepate">
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<meta name="citation_keywords" content="Chlorazepam">
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<meta name="citation_keywords" content="Clorazepate dipotassium">
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<meta name="citation_keywords" content="Dikalii clorazepas">
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<meta name="citation_keywords" content="Chlorazepate dipotassium">
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<meta name="citation_keywords" content="Dipotassium chlorazepate">
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<meta name="citation_keywords" content="Clorazepato [DCIT]">
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<meta name="citation_keywords" content="Clorazepato dipotasico">
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<meta name="citation_keywords" content="Abbott-35616">
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<meta name="citation_keywords" content="Dipotassium clorazepate">
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<meta name="citation_keywords" content="TRANXENE SD">
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<meta name="citation_keywords" content="Bipotassium chlorazepate">
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<meta name="citation_keywords" content="Clorazepate dipotassique">
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<meta name="citation_keywords" content="UNII-63FN7G03XY">
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<meta name="citation_keywords" content="Dikalii clorazepas [INN-Latin]">
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<meta name="citation_keywords" content="Clorazepate acid dipotassium salt">
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<meta name="citation_keywords" content="4306 CB">
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<meta name="citation_keywords" content="Dipotassium clorazepate [INN]">
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<meta name="citation_keywords" content="63FN7G03XY">
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<meta name="citation_keywords" content="DEA No. 2768">
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<meta name="citation_keywords" content="EINECS 260-565-6">
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<meta name="citation_keywords" content="Clorazepato dipotasico [INN-Spanish]">
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<meta name="citation_keywords" content="Clorazepate dipotassique [INN-French]">
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<meta name="citation_keywords" content="AH 3232">
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<meta name="citation_keywords" content="Clorazepate dipotassium [USAN:USP:JAN]">
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<meta name="citation_keywords" content="AB 35616">
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<meta name="citation_keywords" content="TR 19119">
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<meta name="citation_keywords" content="57109-90-7">
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<meta name="citation_keywords" content="1H-1,4-Benzodiazepine-3-carboxylic acid, 7-chloro-2,3-dihydro-2-oxo-5-phenyl-, monopotassium salt, compd. with potassium hydroxide (K(OH)) (1:1)">
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<meta name="citation_keywords" content="1H-1,4-Benzodiazepine-3-carboxylic acid, 7-chloro-2,3-dihydro-2-oxo-5-phenyl-, potassium salt compd. with potassium hydroxide (1:1)">
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<meta name="citation_keywords" content="1H-1,4-Benzodiazepine-3-carboxylic acid, 7-chloro-2,3-dihydro-2-oxo-5-phenyl-, potassium salt compound with potassium hydroxide (1:1)">
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<meta name="citation_keywords" content="Potassium 7-chloro-2,3-dihydro-2-oxo-5-phenyl-1H-1,4-benzodiazepine-3-carboxylate compound with potassium hydroxide (1:1)">
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<meta name="DC.Title" content="Clorazepate">
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<meta name="DC.Date" content="2024/01/15">
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<meta name="og:description" content="Clorazepate is excreted into breastmilk and appears to accumulate in the serum of breastfed infants. Because the half-life of clorazepate and its active metabolite are long, timing breastfeeding with respect to the dose is of little or no benefit in reducing infant exposure. Other agents may be preferred, especially while nursing a newborn or preterm infant. If clorazepate is used, monitor the infant for sedation, poor feeding and poor weight gain.">
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class="wsprkl btn" title="Jump to next match">▶</a></nav></nav></div><div id="jr-epub-interstitial" class="hidden"></div><div id="jr-content"><article data-type="main"><div class="main-content lit-style" itemscope="itemscope" itemtype="http://schema.org/CreativeWork"><div class="meta-content fm-sec"><div class="fm-sec"><h1 id="_NBK501210_"><span class="title" itemprop="name">Clorazepate</span></h1><p class="fm-aai"><a href="#_NBK501210_pubdet_">Publication Details</a></p><p><em>Estimated reading time: 1 minute</em></p></div></div><div class="jig-ncbiinpagenav body-content whole_rhythm" data-jigconfig="allHeadingLevels: ['h2'],smoothScroll: false" itemprop="text"><p>CASRN: 57109-90-7</p><a href="https://pubchem.ncbi.nlm.nih.gov/substance/135004253" title="View this structure in PubChem" class="img_link" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubchem"><img src="https://pubchem.ncbi.nlm.nih.gov/image/imgsrv.fcgi?t=l&sid=135004253" alt="image 135004253 in the ncbi pubchem database" /></a><div id="LM345.Drug_Levels_and_Effects"><h2 id="_LM345_Drug_Levels_and_Effects_">Drug Levels and Effects</h2><div id="LM345.Summary_of_Use_during_Lactation"><h3>Summary of Use during Lactation</h3><p>Clorazepate is excreted into breastmilk and appears to accumulate in the serum of breastfed infants. Because the half-life of clorazepate and its active metabolite are long, timing breastfeeding with respect to the dose is of little or no benefit in reducing infant exposure. Other agents may be preferred, especially while nursing a newborn or preterm infant. If clorazepate is used, monitor the infant for sedation, poor feeding and poor weight gain.</p></div><div id="LM345.Drug_Levels"><h3>Drug Levels</h3><p>Clorazepate is a prodrug of nordiazepam (desmethyldiazepam) which is the primary active metabolite of diazepam.</p><p><i>Maternal Levels.</i> After a single 20 mg intramuscular dose of clorazepate in 7 women, milk nordiazepam levels ranged from 7.5 to 15.5 mcg/L at 2 days after the dose and 6 to 12 mcg/L at 4 days after the dose.[<a class="bibr" href="#LM345.REF.1" rid="LM345.REF.1">1</a>]</p><p><i>Infant Levels.</i> Nordiazepam has been found in infants' serum in levels higher than milk levels, indicating accumulation, and only slightly lower than adult therapeutic levels after diazepam use by the mother.[<a class="bibr" href="#LM345.REF.2" rid="LM345.REF.2">2</a>,<a class="bibr" href="#LM345.REF.3" rid="LM345.REF.3">3</a>]</p><p>After a single 20 mg intramuscular dose of clorazepate in 7 women, serum levels of their breastfed infants ranged from trace levels in 5 of the infants to 4 and 7.5 mcg/L in the others on the second day after the dose. On the fourth day after the dose, infant serum levels was a trace amounts in one and ranged from 4 to 8.5 mcg/L in the others, indicating accumulation in infant serum.[<a class="bibr" href="#LM345.REF.1" rid="LM345.REF.1">1</a>]</p></div><div id="LM345.Effects_in_Breastfed_Infants"><h3>Effects in Breastfed Infants</h3><p>Sedation in infants has been reported during maternal use of diazepam which has nordiazepam as its active metabolite.[<a class="bibr" href="#LM345.REF.3" rid="LM345.REF.3">3</a>,<a class="bibr" href="#LM345.REF.4" rid="LM345.REF.4">4</a>] Concern has also been expressed that nordiazepam may compete with bilirubin for hepatic glucuronide conjugation in the neonate.[<a class="bibr" href="#LM345.REF.2" rid="LM345.REF.2">2</a>]</p></div><div id="LM345.Effects_on_Lactation_and_Breastmil"><h3>Effects on Lactation and Breastmilk</h3><p>Relevant published information was not found as of the revision date.</p></div><div id="LM345.Alternate_Drugs_to_Consider"><h3>Alternate Drugs to Consider</h3><p>(Anxiety) <a href="/books/n/lactmed/LM364/?report=reader">Lorazepam</a>, <a href="/books/n/lactmed/LM377/?report=reader">Oxazepam</a>, <a href="/books/n/lactmed/LM388/?report=reader">Temazepam</a> (Seizure Disorder) <a href="/books/n/lactmed/LM400/?report=reader">Carbamazepine</a>, <a href="/books/n/lactmed/LM437/?report=reader">Divalproex</a>, <a href="/books/n/lactmed/LM358/?report=reader">Gabapentin</a>, <a href="/books/n/lactmed/LM399/?report=reader">Lamotrigine</a>, <a href="/books/n/lactmed/LM376/?report=reader">Oxcarbazepine</a>, <a href="/books/n/lactmed/LM402/?report=reader">Phenytoin</a>, <a href="/books/n/lactmed/LM403/?report=reader">Valproic Acid</a></p></div><div id="LM345.References"><h3>References</h3><dl class="temp-labeled-list"><dl class="bkr_refwrap"><dt>1.</dt><dd><div class="bk_ref" id="LM345.REF.1">Rey
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E, Giraux
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P, d'Athis
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P, et al.
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Pharmacokinetics of the placental transfer and distribution of clorazepate and its metabolite nordiazepam into the feto-placental unit and in the neonate.
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Eur J Clin Pharmacol
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1979;15:181-5.
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[<a href="https://pubmed.ncbi.nlm.nih.gov/37090" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 37090</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>2.</dt><dd><div class="bk_ref" id="LM345.REF.2">Erkkola
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R, Kanto
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J.
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Diazepam and breast-feeding.
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Lancet
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1972;299:1235-6.
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[<a href="https://pubmed.ncbi.nlm.nih.gov/4113217" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 4113217</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>3.</dt><dd><div class="bk_ref" id="LM345.REF.3">Wesson
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DR, Camber
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S, Harkey
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M, Smith
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DE. Diazepam and desmethyldiazepam in breast milk.
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J Psychoactive Drugs
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1985;17:55-6.
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[<a href="https://pubmed.ncbi.nlm.nih.gov/3920372" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 3920372</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>4.</dt><dd><div class="bk_ref" id="LM345.REF.4">Patrick
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MJ, Tilstone
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WJ, Reavey
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P. Diazepam and breast-feeding.
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Lancet
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1972;299:542-3.
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[<a href="https://pubmed.ncbi.nlm.nih.gov/4110044" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 4110044</span></a>]</div></dd></dl></dl></div></div><div id="LM345.Substance_Identification"><h2 id="_LM345_Substance_Identification_">Substance Identification</h2><div id="LM345.Substance_Name"><h3>Substance Name</h3><p>Clorazepate</p></div><div id="LM345.CAS_Registry_Number"><h3>CAS Registry Number</h3><p>57109-90-7</p></div><div id="LM345.Drug_Class"><h3>Drug Class</h3><p>Breast Feeding</p><p>Lactation</p><p>Milk, Human</p><p>Hypnotics and Sedatives</p><p>Anti-Anxiety Agents</p><p>Benzodiazepines</p></div></div><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt></dt><dd><div><p class="no_top_margin"><p><b>Disclaimer: </b>Information presented in this database is not meant as a substitute for professional judgment. You should consult your healthcare provider for breastfeeding advice related to your particular situation. The U.S. government does not warrant or assume any liability or responsibility for the accuracy or completeness of the information on this Site.</p></p></div></dd></dl></dl></div><div id="bk_toc_contnr"></div></div></div><div class="fm-sec"><h2 id="_NBK501210_pubdet_">Publication Details</h2><h3>Publication History</h3><p class="small">Last Revision: <span itemprop="dateModified">January 15, 2024</span>.</p><h3>Copyright</h3><div><div class="half_rhythm"><a href="/books/about/copyright/">Copyright Notice</a><p class="small"><b>Attribution Statement:</b> LactMed is a registered trademark of the U.S. Department of Health and Human Services.</p></div></div><h3>Publisher</h3><p><a href="https://www.nlm.nih.gov/" ref="pagearea=page-banner&targetsite=external&targetcat=link&targettype=publisher">National Institute of Child Health and Human Development</a>, Bethesda (MD)</p><h3>NLM Citation</h3><p>Drugs and Lactation Database (LactMed®) [Internet]. Bethesda (MD): National Institute of Child Health and Human Development; 2006-. Clorazepate. [Updated 2024 Jan 15].<span class="bk_cite_avail"></span></p></div><div class="small-screen-prev"><a href="/books/n/lactmed/LM1448/?report=reader"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 100 100" preserveAspectRatio="none"><path d="M75,30 c-80,60 -80,0 0,60 c-30,-60 -30,0 0,-60"></path><text x="20" y="28" textLength="60" style="font-size:25px">Prev</text></svg></a></div><div class="small-screen-next"><a href="/books/n/lactmed/clotiazepam/?report=reader"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 100 100" preserveAspectRatio="none"><path d="M25,30c80,60 80,0 0,60 c30,-60 30,0 0,-60"></path><text x="20" y="28" textLength="60" style="font-size:25px">Next</text></svg></a></div></article></div><div id="jr-scripts"><script src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/libs.min.js"> </script><script src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/jr.min.js"> </script></div></div>
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