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Benzodiazepines
- These may help with pain secondary to muscle spasm and can modify pain in anxious patients.
- Clonazepam appears to have independent efficacy in neuropathic pain the mechanism is unclear.
Clonazepam
- 0.5 mg PO/subcut nocte. Increase if needed to a maximum dose of 2 mg nocte.
- Can be used sublingually via drops 0.1 mg/drop (1-5 drops q6h).
- Can be given via subcut infusion 0.5 4 mg per 24 hours.
Other Alternatives
Diazepam 2-5 mg PO TDS
Lorazepam 0.5-2.5 mg PO TDS
Subcut Flunitrazepam infusion (refer to Section 29 of the Medicines Act 1981 'Unlicensed Medication') at low dose does not necessarily induce sedation (4 8 mg/24 hours) a Palliative Care Referral is recommended.
Topic Code: 4072