Clonazepam and Elevated Liver Enzymes

[wooger]

Hi

I'm sorry if this is a basic question to be asking in here, but I was wondering, if someone i.e. were too have raised liver enzymes due to extreme alcohol abuse, would this have any effect on the half life of clonazepam?

thanks in advance

Wooger

 

[mgrady3]

Well here's how klonopin is metabolized:
"Clonazepam is metabolised via nitroreduction (CYP3A4), and has an elimination half life of 19-60 hours, {Riss, J.; Cloyd, J.; Gates, J.; Collins, S. ( Aug 2008 ). "Benzodiazepines in epilepsy: pharmacology and pharmacokinetics}"

So if your alcohol abuse has left you with raised levels of CYP3A4 in your liver then it would appear that the half life of klonopin would go down.

I can not personally comment on whether or not alcohol abuse can raise or lower the levels of CYP3A4 in the liver.

Someone with better knowledge of Pharmacokinetics could probably chime in with better info. I'm not 100% sure that elevated levels of CYP3A4 will increase metabolism; I am fairly sure the opposite is true, that inhibition of CYP3A4 will increase half life (ie. using grapefruit juice as a potentiator for some benzos).

There are CYP3A4 enzymes found in other places than your liver. So it is possible that clonazepam is partially metabolized outside of the liver via the same method of nitroreduction via CYP3A4 such as in your GI track. If this were the case then it possible liver damage from alcohol may not effect the metabolism of clonazepam as strongly if at all. But this is speculation.

CYP3A4 is the enzyme responsible for metabolism of most (if not all) triazolo-benzodiazepines and nitro-benzodiazepines (xanax, klonopin, halcion etc.) but not for others like Temazepam

 

[wooger]

thanks for the info. but I'm still kinda stumped.... I guess the best person to ask about this would be a DR or something but this would be difficult for obvious reasons.

Nevertheless thank you very much for your response

 

[mgrady3]

No problem. There are a few other people that frequent ADD that might chime in eventually with some more exact knowledge of the pharmacology / pharmacokinetics of Clonazepam, so give it some time.

I wouldn't discount talking to a doctor about it. But it depends on your situation. If you are being Rx'd klonopin they you certainly should talk to the Dr. about the situation. If it turns out you were right and that alcohol abuse could effect the half life of klonopin then the doc may suggest a different drug in place of the klonopin. But if you are talking about recreationally use of klonopin then its more of a grey area.

I recommend being open with your doctor, if you are seriously worried about the possible ill effects from alcohol's damage to the liver than its something worth talking to a doctor about.

 

[capRx]

I'm going to take a stab at it, but I'm still pretty new with this stuff, so don't quote me on it.

But first, let me try and get this straight. My thinking was that with alcohol use/cirrhosis of the liver, your liver would produce LESS CYP3A4.. Why do you say that ur enzymes are elevated? Were you tested, or are you just guessing?

 

[Depressicaa]

I think its because of tolerance, so he assumes that it goes up.

 

[/navarone/]

Yep...benzos and alcohol are a perfect recipe for rapid tollerance. Clonazepam being one of the benzos with known fast tollerance development.

From a person that started of with 4-6mg oral for recreational use and ended up with 40mg IV (no kidding) with barely any euphoric effects in less than a year I'd strongly advice to consider your habit and take regular brakes. Benzo tollerance is the slowest restabilizing experience known to me (still after a year 4 mg feel like 2 shots of tequila).

Be safe, have fun.

 

[ferinox]

Elevated liver enzyme generally indicate hepatotoxicity. These enzymes have nothing to with the cytochrome p450 enzyme system. Considering your liver is probably damaged, it should increase the half-life of clonazepam.

 

[wooger]

hey thanks for the info. Yeah, I had my liver enzymes checked and apprently they are elevated I'm not sure to what extent tho but the dr has assured me that it is reversible with abstinence from alcohol.

I haven't touched alcohol for three weeks today :D I'm quite pleased with myself considering I used to drink a abottle of spirits a day