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Brand: TRANXENE
Published 2026-02-16 · Last reviewed 2026-02-23 · 5 references
Content sourced from FDA labeling (DailyMed) and peer-reviewed literature.
Clorazepate dipotassium is a benzodiazepine prodrug indicated for the management of anxiety disorders or short-term relief of anxiety symptoms, adjunctive therapy in partial seizures, and symptomatic relief of acute alcohol withdrawal (label; product-dependent).
Clorazepate is rapidly decarboxylated to nordiazepam, a long-acting benzodiazepine metabolite (half-life ~40–50 hours) (label). Long duration can provide smoother coverage but increases next-day impairment, falls, and cognitive slowing risk—especially in older adults and with polypharmacy.
Benzodiazepine risks include abuse/misuse, addiction, and clinically significant physical dependence with withdrawal reactions; these risks support defined duration and taper planning rather than open-ended use (label / safety guidance).
Boxed warning: Concomitant use with opioids can cause profound sedation, respiratory depression, coma, and death; avoid co-prescribing when possible (label).
The clorazepate compare view, clorazepate evidence feed, and clorazepate print page can support counseling about duration, taper planning, and alternatives.
Clorazepate is best thought of as a long-acting benzodiazepine (via nordiazepam). That can be helpful when smoother coverage is desired, but it increases accumulation and carryover impairment. When used, teams often pair it with explicit duration, follow-up, and taper planning, and avoid it in high fall-risk settings when safer alternatives exist.
View labelExactRefer to the Glossary entry on Neurotransmitters for background on receptor systems involved in serious mental illness.
Converted to nordiazepam, which acts as a positive allosteric modulator of GABA-A receptors, increasing inhibitory neurotransmission.
Sedation and cognitive slowing scale with dose and co-administered CNS depressants; total sedative burden drives harm.
Repeated use can lead to tolerance and physical dependence; withdrawal reactions can be severe after abrupt discontinuation.
Sources: FDA/DailyMed label; anxiety and alcohol-withdrawal guideline context; benzodiazepine safety guidance.