title: Clonazepam for seizure prophylaxis in adult patients treated with high dose busulfan.
abstract: BACKGROUND
  Due to their favorable toxicity profile and lack of interactions, benzodiazepines have been proposed as prophylaxis of busulfan induced seizures. Although they are broadly used in pediatric patients, the experience in adults is limited.
  
  
  OBJECTIVE
  To describe the effectivity for seizure prophylaxis of the fixed 1 mg every 8 h (q8h) i.v. clonazepam dosing in adult patients receiving high dose i.v busulfan, as part of the hematopoietic progenitors transplant conditioning regimen.
  
  
  METHODS
  Retrospective, observational study, from January 2008 to June 2012. Patients over 15 years old that had received high dose busulfan and prophylaxis with 1 mg q8h i.v. clonazepam from 12 h before the first dose of busulfan to 24 h after the last one were selected. The primary endpoint was the occurrence of seizures until 72 h after finishing conditioning.
  
  
  RESULTS
  Thirty-three patients, 13 female and 20 male, median age 48, were included. Autologous transplant was performed in 17 patients and allogeneic in 16. Busulfan dose was 3.2 mg/kg every 24 h with a variable duration of 2-4 days. No seizures were recorded.
  
  
  CONCLUSIONS
  The 1 mg q8h i.v. clonazepam fixed schedule is easily administered and is effective for the prevention of high dose busulfan induced seizures in adult patients.
authors.affiliation: Hospital Pharmacy Department, Virgen de la Arrixaca Hospital, Murcia, Spain. msacramento.diaz@carm.es
authors.forename: Maria Sacramento
authors.initials: MS
authors.lastname: Diaz-Carrasco
authors.forename: Raquel
authors.initials: R
authors.lastname: Olmos
authors.forename: Miguel
authors.initials: M
authors.lastname: Blanquer
authors.forename: Javier
authors.initials: J
authors.lastname: Velasco
authors.forename: Andrés
authors.initials: A
authors.lastname: Sánchez-Salinas
authors.forename: José María
authors.initials: JM
authors.lastname: Moraleda
mesh_terms: D061605:Administration, Intravenous; D000293:Adolescent; D000328:Adult; D000368:Aged; D000927:Anticonvulsants / Q000008:administration & dosage / Q000627:therapeutic use*; D002066:Busulfan / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D002998:Clonazepam / Q000008:administration & dosage / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012640:Seizures / Q000139:chemically induced / Q000517:prevention & control*; D013997:Time Factors; D019172:Transplantation Conditioning; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000927:Anticonvulsants; D007166:Immunosuppressive Agents; D002998:Clonazepam; D002066:Busulfan